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Open AccessArticle

Spatiotemporal Patterns of Cholera Hospitalization in Vellore, India

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Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
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Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, MA 02111, USA
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School of Marine Science and Ocean Engineering, University of New Hampshire, Durham, NH 03824, USA
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Christian Medical College, Vellore, Tamil Nadu 632004, India
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Tufts Medical Center, Boston, MA 02111, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(21), 4257; https://doi.org/10.3390/ijerph16214257
Received: 29 September 2019 / Revised: 24 October 2019 / Accepted: 31 October 2019 / Published: 2 November 2019
(This article belongs to the Special Issue Infectious Disease Modeling in the Era of Complex Data)
Systematically collected hospitalization records provide valuable insight into disease patterns and support comprehensive national infectious disease surveillance networks. Hospitalization records detailing patient’s place of residence (PoR) can be utilized to better understand a hospital’s case load and strengthen surveillance among mobile populations. This study examined geographic patterns of patients treated for cholera at a major hospital in south India. We abstracted 1401 laboratory-confirmed cases of cholera between 2000–2014 from logbooks and electronic health records (EHRs) maintained by the Christian Medical College (CMC) in Vellore, Tamil Nadu, India. We constructed spatial trend models and identified two distinct clusters of patient residence—one around Vellore (836 records (61.2%)) and one in Bengal (294 records (21.5%)). We further characterized differences in peak timing and disease trend among these clusters to identify differences in cholera exposure among local and visiting populations. We found that the two clusters differ by their patient profiles, with patients in the Bengal cluster being most likely older males traveling to Vellore. Both clusters show well-aligned seasonal peaks in mid-July, only one week apart, with similar downward trend and proportion of predominant O1 serotype. Large hospitals can thus harness EHRs for surveillance by utilizing patients’ PoRs to study disease patterns among resident and visitor populations. View Full-Text
Keywords: spatial statistics; disease clusters; cholera; hospitalization; India; electronic health records (EHR); mobile population spatial statistics; disease clusters; cholera; hospitalization; India; electronic health records (EHR); mobile population
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MDPI and ACS Style

Venkat, A.; Falconi, T.M.A.; Cruz, M.; Hartwick, M.A.; Anandan, S.; Kumar, N.; Ward, H.; Veeraraghavan, B.; Naumova, E.N. Spatiotemporal Patterns of Cholera Hospitalization in Vellore, India. Int. J. Environ. Res. Public Health 2019, 16, 4257.

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