Modelling the Impact of Water, Sanitation and Hygiene (WASH) Interventions on Cholera Spread in Bauchi State, Nigeria
1
Environmental Health Council of Nigeria, Abuja, Nigeria
2
Corona Management Systems, Abuja, Nigeria
3
School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
4
Department of Community Medicine, Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
5
Department of Statistics, Federal University of Technology Akure, Ondo, Nigeria
6
Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Cholera remains a persistent public health threat in Nigeria, particularly in regions with inadequate water, sanitation, and hygiene (WASH) infrastructure. Bauchi State experienced severe outbreaks with 9,725 cases in 2019 and 1,800 cases with 55 deaths in 2021, representing part of the 48% cumulative national burden alongside Kano and Jigawa states1,2. Mathematical and geospatial modeling can provide evidence-based insights to guide targeted interventions.
METHODS:
We developed a compartmental SIRV model incorporating water hygiene (cw) and environmental sanitation (cs) compliance rates as control parameters. The model was parameterized using 2019-2021 outbreak data from Bauchi State and simulated using R software. We calculated the basic reproduction number (R₀), effective reproduction number (Re), and sensitivity indices for key parameters. Geospatial analysis employing Moran's I and Local Indicators of Spatial Association (LISA) identified high-risk clusters across 20 local government areas.
RESULTS:
Without interventions, R₀ = 2.075, indicating high epidemic potential. At current WASH coverage levels (42% water hygiene, 41% environmental sanitation), cholera incidence remained elevated. Scaling water hygiene compliance alone to 50% reduced Re to 1.35. Combined implementation of both water hygiene and environmental sanitation at 50% coverage yielded Re = 0.519, below the epidemic threshold. Sensitivity analysis revealed β (transmission rate) had a positive sensitivity index of +1.0, while cw and cs both showed protective effects with indices of -1.0. LISA mapping identified significant spatial clustering, with high-high clusters concentrated in southern Bauchi, particularly Bauchi and Toro LGAs.
CONCLUSIONS:
Achieving 50% compliance with integrated WASH interventions can reduce cholera transmission below epidemic thresholds in Bauchi State. Geospatial hotspot identification enables targeted resource allocation to high-burden areas. Strengthening WASH infrastructure and promoting hygiene behaviors are critical for sustainable cholera control in Nigeria.
Cholera remains a persistent public health threat in Nigeria, particularly in regions with inadequate water, sanitation, and hygiene (WASH) infrastructure. Bauchi State experienced severe outbreaks with 9,725 cases in 2019 and 1,800 cases with 55 deaths in 2021, representing part of the 48% cumulative national burden alongside Kano and Jigawa states1,2. Mathematical and geospatial modeling can provide evidence-based insights to guide targeted interventions.
METHODS:
We developed a compartmental SIRV model incorporating water hygiene (cw) and environmental sanitation (cs) compliance rates as control parameters. The model was parameterized using 2019-2021 outbreak data from Bauchi State and simulated using R software. We calculated the basic reproduction number (R₀), effective reproduction number (Re), and sensitivity indices for key parameters. Geospatial analysis employing Moran's I and Local Indicators of Spatial Association (LISA) identified high-risk clusters across 20 local government areas.
RESULTS:
Without interventions, R₀ = 2.075, indicating high epidemic potential. At current WASH coverage levels (42% water hygiene, 41% environmental sanitation), cholera incidence remained elevated. Scaling water hygiene compliance alone to 50% reduced Re to 1.35. Combined implementation of both water hygiene and environmental sanitation at 50% coverage yielded Re = 0.519, below the epidemic threshold. Sensitivity analysis revealed β (transmission rate) had a positive sensitivity index of +1.0, while cw and cs both showed protective effects with indices of -1.0. LISA mapping identified significant spatial clustering, with high-high clusters concentrated in southern Bauchi, particularly Bauchi and Toro LGAs.
CONCLUSIONS:
Achieving 50% compliance with integrated WASH interventions can reduce cholera transmission below epidemic thresholds in Bauchi State. Geospatial hotspot identification enables targeted resource allocation to high-burden areas. Strengthening WASH infrastructure and promoting hygiene behaviors are critical for sustainable cholera control in Nigeria.
| eISSN: | 2654-1459 |
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