Cholera trends and climate sensitive early warning modeling in Yemen 2015 2034 using an integrated epidemiological climatic and genomic risk framework

Cholera trends and climate sensitive early warning modeling in Yemen 2015 2034 using an integrated epidemiological climatic and genomic risk framework | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Cholera trends and climate sensitive early warning modeling in Yemen 2015 2034 using an integrated epidemiological climatic and genomic risk framework Hussein Bakery Hussein Dedy, Ali Bannawi ALZubaidy This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8845316/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 3 You are reading this latest preprint version Abstract Cholera remains one of Yemen’s most persistent public health threats, driven by fragile WASH systems, climate variability, population displacement, and the environmental persistence of Vibrio cholerae. The study provides a comprehensive retrospective analysis of cholera trends from 2015 to 2024 and generates a 10 year forecast (2025–2034) using the EWS_ClimateHealth_GenomicYemen_IntegratedMegaSystem an integrated early warning framework combining epidemiological surveillance, climate indicators, and genomic metadata. The system incorporates a Unified Relative Time (URT) model, climate‑epidemiological coupling, and genomic‑risk indices to produce graded (Green/Yellow/Orange/Red) alerts. Results show strong associations between rainfall anomalies, temperature extremes, and cholera surges, with major peaks in 2016–2017 and 2019. Genomic analysis indicates the continued dominance of V. cholerae O1 El Tor Ogawa with limited diversification.Genomic data (n ≈ 45 isolates, 2016–2019) were incorporated as secondary inputs for risk scoring. Forecasts suggest recurrent seasonal waves, amplified during years with strong ENSO/IOD activity and intensified rainfall. Strengthening WASH systems, expanding genomic surveillance, and operationalizing early warning outputs are essential for long term cholera control in Yemen. Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 28 Feb, 2026 Submission checks completed at journal 24 Feb, 2026 First submitted to journal 24 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8845316","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":596513203,"identity":"91b93e9a-ad84-49e3-9191-fdcf9e033626","order_by":0,"name":"Hussein Bakery Hussein Dedy","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABB0lEQVRIiWNgGAWjYBACAyjJ2MCQwP5DwsAGyGNsPECsFgYJi4o0kJYGIrQwQLVUnDkM5uHVYi6R/vjDh4I7sv3sOQYGN9vO261tPwy0pcYmGpcWyxk5ZpIzDJ4Zz+x5Y5A4s+128rYziUAtx9JyG3A57EYOGzOPweHEDTdyDA5LArWYHQBqYWw4jEdL+uPPf4Ba9t/IMWz+23Yu2ez8Q0JaEgykGUC2SOQYM0icOWBndoOQLWfemEn2GBw2nnHmWRkwyJITzG4AbUnA55fjwBD78eewbH978jYGCQM7e7Pz6Q8ffKixwakFCXCA4ygRrDKBsHIQYH8AIu2JUzwKRsEoGAUjCQAAa59tN9Tw0SgAAAAASUVORK5CYII=","orcid":"","institution":"","correspondingAuthor":true,"prefix":"","firstName":"Hussein","middleName":"Bakery Hussein","lastName":"Dedy","suffix":""},{"id":596513204,"identity":"b6e9bd0d-5425-4555-be7e-5e0e405b1558","order_by":1,"name":"Ali Bannawi ALZubaidy","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Ali","middleName":"Bannawi","lastName":"ALZubaidy","suffix":""}],"badges":[],"createdAt":"2026-02-10 21:23:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8845316/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8845316/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":103560234,"identity":"50196b3b-4189-48cc-8576-cb18a7276ece","added_by":"auto","created_at":"2026-02-27 05:40:08","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":663648,"visible":true,"origin":"","legend":"","description":"","filename":"file.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8845316/v1_covered_24062bac-9893-47c6-a6b6-197e2d09d195.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Cholera trends and climate sensitive early warning modeling in Yemen 2015 2034 using an integrated epidemiological climatic and genomic risk framework","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-8845316/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8845316/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eCholera remains one of Yemen\u0026rsquo;s most persistent public health threats, driven by fragile WASH systems, climate variability, population displacement, and the environmental persistence of Vibrio cholerae. 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