Can cholera ‘hotspots’ be converted to cholera ‘coldspots’ in cholera endemic countries? The Matlab, Bangladesh experience

BACKGROUND: Cholera remains a major public health threat in low- and middle-income countries. The World Health Organization (WHO) has recently launched a global initiative to end preventable cholera by 2030. Key to the success of this initiative will be the elimination of cholera transmission in cholera 'hotspots' with regularly recurrent disease; this can be achieved via improved surveillance to define hotspot populations, through the use of oral cholera vaccines, and through the implementation of improved water, sanitation, and hygiene (WASH). METHODS: This study was performed to analyze the trend in cholera incidence during the years 1974-2018 in Matlab, Bangladesh (defined population of about 200 000) that has been recognized as one of the world's cholera hotspots. During this period, Matlab…