Recurrent cholera epidemics in Africa: which way forward? A literature review
- 21 Downloads
Outbreaks of cholera in Africa seem to be unrelenting which has been continuous and recurrent leading to high morbidity and mortality in some quarters.
The objective of this narrative review is to investigate and identify factors responsible for the recurrent outbreaks of cholera in Africa and response strategies that have been employed in curbing the problem, with the view of aggregating otherwise sparing data needed for policy formulation geared towards control and eradication of the disease.
Search of literatures indexed in Google Scholar, PubMed and AJOL databases was carried out. Sixty-five eligible articles with reports on the risk factors that drive recurrent outbreaks, endemicity and response strategies were analyzed.
Our findings indicate that continuous and recurrent outbreaks of cholera in Africa are fueled by cross-border migration, environmental reservoirs, socioeconomic factors, climate change and political instability. The review also identified specific response strategies and modelling approaches that have helped in containing and reducing the impact of these outbreaks.
Paying attention and tackling these identified factors that are dependent and independent can help put an end to this running battle.
KeywordsAfrica Cholera Endemic Risk factors Vibrio cholerae
No funding was involved in putting this review together.
Compliance with ethical standards
Conflict of interest
The authors declare no conflict of interest.
- 1.WHO. Cholera. World Health Organization fact sheet. 2017. http://www.who.int/mediacentre/factsheets/fs107/en/. Accessed 12 July 2018.
- 7.WHO. Cholera vaccines: WHO position paper August 2017. World Health Organ Wkly Epidemiol Rec. 2017;92:477–500.Google Scholar
- 13.WHO. Cholera country profile: Angola. World Health Organization Global Task Force on cholera control. http://www.who.int/cholera/countries/AngolaCountryProfile2013.pdf. Accessed 8 Aug 2017.
- 14.Djomassi LD, Gessner BD, Andze GO, Mballa GAE. National surveillance data on the epidemiology of cholera in Cameroon. J Infect Dis. 2013;208(SI):92-7.Google Scholar
- 19.Jeandron A, Saidi JM, Kapama A, Burhole M, Birembano F, Vandevelde T, et al. Water supply interruptions and suspected cholera incidence: a time series regression in the Democratic Republic of Congo. PLoS Med 2015; 12:e1001893. https://doi.org/10.1371/journal.pmed1001893.CrossRefPubMedPubMedCentralGoogle Scholar
- 26.Oguttu DW, Okull OA, Bwire G, Nsubuga P, Ario AR. Cholera outbreak caused by drinking lake water contaminated with human faeces in Kaiso Village, Hoima District, Western Uganda, October 2015. Infect Dis Poverty. 2017;6:146. https://doi.org/10.1186/s40249-017-0359-2.CrossRefPubMedPubMedCentralGoogle Scholar
- 32.WASH Cluster. AWD*/cholera outbreak in Somalia. A WASH situation on the brink. Advocacy and support team water sanitation hygiene. https://www.humanitarianresponse.info/en/operations/somalia/document/wash-cluster-somalia-cholera-outbreak-advocacy-june-2017. Accessed 12 July 2018.
- 33.Green A. Cholera outbreak in the horn of Africa. World Rep. 2017;389:2179. http://www.thelancet.com.
- 39.Hounmanou YMG, Mdegela RH, Dougnon TV, Mhongole OJ, Mayila ES, Malakalinga J, et al. Toxigenic Vibrio cholerae O1 in vegetables and fish raised in wastewater irrigated fields and stabilization ponds during a non-cholera outbreak period in Morogoro, Tanzania: an environmental health study. BMC Res Notes. 2016;9:466. https://doi.org/10.1186/s13104-016-2283-0.CrossRefPubMedPubMedCentralGoogle Scholar
- 40.Chirambo RM, Mufunda J, Songolo P, Kachimba JS, Vwalika B. Epidemiology of the 2016 cholera outbreak of Chibombo district, central Zambia. Med J Zamb. 2016;43:61–3.Google Scholar
- 43.Phiri P, Nzala SH, Baboo KS. Factors associated with the recurring cholera outbreaks in Sinazongwe district of southern Zambia. Med J Zamb. 2015;42:184–92.Google Scholar
- 47.Mason PR. Zimbabwe experiences the worst epidemic of cholera in Africa. J Infect Dis Dev Ctries. 2009;3:148–51.Google Scholar
- 53.Kustner HGV, Plessis GDU. The cholera epidemic in South Africa, 1980–1987. South Afr Med J. 1991;79:539–44.Google Scholar
- 55.WHO. Cholera country profile: Malawi. World Health Organization Global Task Force on cholera control. http://www.who.int/cholera/countries/MalawiCountryProfile2010.pdf. Accessed 15 Jun 2017.
- 60.Eibach D, Herrera-Leon S, Gil H, Hogan B, Ehlkes L, Adjabeng M, et al. Molecular epidemiology and antibiotic susceptibility of Vibrio cholerae associated with a large cholera outbreak in Ghana in 2014. PLoS Negl Trop Dis. 2016;10:e0004751. https://doi.org/10.1371/journal.pntd.0004751.CrossRefPubMedPubMedCentralGoogle Scholar
- 62.WHO. Cholera country profile: Côte d’Ivoire. World Health Organization Global Task Force on cholera control. http://www.who.int/cholera/countries/CotedIvoirecountryprofile2011.pdf. Accessed 15 Jun 2017.
- 65.WHO. Cholera country profile: Nigeria. World Health Organization Global Task Force on cholera control. http://www.who.int/cholera/countries/NigeriaCountryProfile2012.pdf. Accessed 15 Jun 2017.
- 66.Marin MA, Thompson CC, Freitas FS, Fonseca EL, Aboderin AO, Zailani SB. Cholera outbreaks in Nigeria are associated with multidrug resistant atypical El Tor and non-O1/non-O139 Vibrio cholerae. PLoS Negl Trop Dis. 2013;7:e2049. https://doi.org/10.1371/journal.pntd.0002049.CrossRefPubMedPubMedCentralGoogle Scholar
- 69.Adewale AK, Pazhani PG, Abiodun IB, Afolabi O, Kolawole OD, Mukhopadhyay AK, et al. Unique clones of Vibrio cholerae 01 El Tor with Haitian type ctxB allele implicated in the recent cholera epidemics from Nigeria, Africa. PLoS ONE. 2016;11:e0159794. https://doi.org/10.1371/journal.pone.0159794.CrossRefPubMedPubMedCentralGoogle Scholar
- 70.Udonwa NE, Udoh SM, Ikpeme B, Andy I. Intra-family transmission of Vibrio cholerae during a cholera epidemic in rural south-southern Nigeria. Trop Dr. 2008;38:179–80.Google Scholar
- 73.Smith S, Nwaokorie F, Awoderu O, Bamidele T, Akinsinde K, Ochoga M, et al. ERIC-PCR analysis of the clinical and environmental strains of V. cholerae during 2013 epidemic in Nigeria. Int J Adv Health Sci. 2015;12:670–80.Google Scholar
- 75.Roquet D, Diallo A, Kadio B, Daff BM, Fenech C, Etard J-F. The Senegalese cholera epidemic of 1995 to 1996, an example of the geographic approach to health studies. Cah Sante. 1998;8:421–8.Google Scholar
- 78.Landoh DE, Gessner BD, Badciklou K, Tamekloe T, Nassoury DI, Dagnra A, et al. National surveillance data on the epidemiology of cholera in Togo. J Infect Dis. 2013;208:115-9.Google Scholar
- 82.Ngwa MC, Liang S, Kracalik IT, Morris L, Blackburn JK, Mbam LM, et al. Cholera in Cameroon, 2000–2012: spatial and temporal analysis at the operational (Health District) and sub climate level. PLoS Negl Trop Dis. 2016;10:e0005105. https://doi.org/10.1371/journal.pntd.0005105.CrossRefPubMedPubMedCentralGoogle Scholar
- 85.Mayala BK, Mboera LEG, Gwacha F. Mapping of cholera risks using geographical information system in Ilala district, Tanzania. Tanzan Health Res Bull. 2003;5:8–12.Google Scholar
- 87.Msyamboza KP, M’bang’ombe M, Hausi H, Chijuwa A, Nkukumila V, Kubwalohw D, et al. Feasibility and acceptability of oral cholera vaccine mass vaccination campaign in response to an outbreak and floods in Malawi. Pan Afr Med J. 2016;23:20. https://doi.org/10.11604/pamj.2016.23.203.8346.CrossRefGoogle Scholar
- 88.Oyedepo JA, Shittu OB, Popoola TOS, Ogunshola EO. Rapid epidemiological mapping of cholera outbreak in parts of Abeokuta metropolis: a GIS-supported post-epidemic assessment. Int J Public Health Epidemiol. 2015;4:152–7.Google Scholar