Spatial statistics of epidemic data: the case of cholera epidemiology in Ghana

The growing number and increased frequency of major cholera outbreaks, especially in African countries, have heightened concerns about the disease, in particular about its spatial and temporal characteristics and their underlying risk factors. Cholera is transmitted mainly through contaminated water and food; however, demographic and geographic factors can predispose inhabitants to infection. Socioeconomic and environmental factors like environmental sanitation can influence the vulnerability of a population to cholera infection. In Ghana, the recurrent of cholera has raised possible endemic foci in urban communities which seem to report greater percentage of cases during outbreaks. Yet, little is known about the spatial and temporal characteristics of the disease. This thesis uses past cholera epidemic data and spatial statistical methodologies to better understand the effects of socioeconomic and environmental risk factors on the spatial epidemiology of the disease. Two separate study areas in Ghana are used, the Ashanti Region and its capital, Kumasi Metropolis.