Long Range River Discharge Forecasting Using the Gravity Recovery and Climate Experiment (GRACE) Satellite to Predict Conditions for Endemic Cholera

Prediction of conditions of an impending disease outbreak remains a challenge but is achievable if the associated and appropriate large scale hydroclimatic process can be estimated in advance. Outbreaks of diarrheal diseases such as cholera, are related to episodic seasonal variability in river discharge in the regions where water and sanitation infrastructure are inadequate and insufficient. However, forecasting river discharge, few months in advance, remains elusive where cholera outbreaks are frequent, probably due to non-availability of geophysical data as well as transboundary water stresses. Here, we show that satellite derived water storage from Gravity Recovery and Climate Experiment Forecasting (GRACE) sensors can provide reliable estimates on river discharge atleast two months in advance over regional scales. Bayesian regression models predicted flooding and drought conditions, a prerequisite for cholera outbreaks, in Bengal Delta with an overall accuracy of 70% for upto 60 days in advance without using any other ancillary ground based data. Forecasting of river discharge will have significant impacts on planning and designing intervention strategies for potential cholera outbreaks in the coastal regions where the disease remain endemic and often fatal.