A Generalizable Epidemic Forecasting Framework for Fragile Coastal Regions: Evidence from Yemen
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Background Cholera remains endemic in Yemen, with recurrent outbreaks strongly influenced by climate variability, fragile health infrastructure, and structural vulnerabilities. Traditional surveillance models often fail to integrate environmental amplification and biological susceptibility dynamics. Poverty, poor health infrastructure, inadequate water and sanitation services, and climate factors such as rainfall and high temperatures are major drivers of cholera risk, while integrating climate and surveillance data enhances early warning system performance [1–10]. Methods A Unified Relative Time (URT) equation integrating epidemiological inertia and environmental-biological exposure was used:
