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Environmental influences on the distribution of the incidence of cholera: a case study in quelimane, mozambique.

Cholera continues to cause widespread suffering in many parts of the world. Previous research has mainly described modes of transmission and has correctly indicated the role of predisposing socio-economic conditions in affected areas. Little field research has been carried out, however, in endemic zones, on the contribution of physical characteristics in environmental reservoirs which prolong the survival time or increase the toxigeneity of Vibrio cholerae 01, despite substantial indication of their significance at laboratory scale. A study carried out in Quelimane, Mozambique, to test for such environmental influences on the spatial and temporal distribution of cholera incidence, is described. The role of population displacement in this relationship is also discussed. The practical implications of the results for prevention of primary infection and subsequent reinfection are outlined.