Masters Dissertation
Cholera is an ancient disease but remains an important public health threat mainly in lowand-
middle-income countries. The disease has been reported almost every year in Burundi.
Understanding its spatial-temporal distribution and the determinants within the country
contribute to early detection and quick response to contain the outbreaks. The objective of
this study was to determine the patterns and factors responsible for cholera outbreaks in
Imbo Region of western Burundi. Data were collected retrospectively from health districts
and hospitals/dispensaries records. A structured questionnaire was administered to selected
participants from affected community to get information on determinants of cholera
outbreaks. The analysis was done by using R software, version 3.6.1. Temporal patterns
were obtained by plotting cholera cases against time (months and weeks). Spatial patterns
were established by tagging cholera cases to their locations for each year whereby Burundi
provinces, communes, Collins shape files were entered in ArcGIS software, version 10.3.
Frequency maps were generated, showing the spatial distribution of cholera disease in the
study area. The findings indicate that most of the cholera outbreaks have occurred during
dry seasons and were associated with a lack of potable water. The multivariate analysis
showed that females were at risk of getting cholera than males (OR=1.85, 95% CI: 1.024 -
3.359) and source of water was a risk factor, whereby use of tap water was protective
compared to use of surface water (OR=0.368, 95% CI: 0.168 - 0.740). In conclusion, most
of the outbreaks in Imbo Region occur during the dry seasons when potable water is in
shortage supply. Improving population access to the potable water distribution system and
promoting sanitation and hygiene will likely reduce the occurrence and spread of cholera in
the Region.
Inter-University Council for East Africa