SPATIAL AND SEASONAL ECOLOGY OF CHOLERA IN ACCRA METROPOLITAN AREA (AMA) FROM 2008 TO 2016

Abstract The Accra Metropolitan Area (AMA) is a cosmopolitan area with people coming from various economic, social and health backgrounds. Cholera has however been endemic in the area for over three decades. The research aimed at finding the conditions causing the endemic presence of the disease within the Accra Metropolitan Area. The study involved the mapping of cholera risk factors across selected communities of different income levels within the AMA in order to show the level of risk faced by the communities. According to the findings, the main mode of spread of cholera in the low income areas was through personal contact or contagious spread. Both middle and high income areas suffered the relocation mode of spread where surrounding communities with poor sanitation were highly influential in the spread of the disease. There were also more cholera risk factors in the form of dumpsites, open defecation sites, open drains and public toilets found within low income communities. These factors coupled with poor sanitation make the areas hotspots for the spread of the disease. Knowledge in terms of cholera was also found to be high across the various study communities in the AMA. There was however a high number of respondents that ate from outside their homes hence increasing the risk of contracting cholera. There was however a complex relationship between weather and cholera in the short term which was explained by other behavioral and sanitation factors. It was observed from literature that the onset of the raining season increases the risk of contracting cholera in the AMA. Based on these findings, the study recommends a community based approach in tackling the sanitation problems in the AMA. There is also the need to intensify and sustain Cholera education in AMA