Cholera in Nigeria: A review of outbreaks, trends, contributing factors, and public health responses

Main Article Content

Moore Ikechi Mike-Ogburia https://orcid.org/0000-0002-3122-0933
Chinemerem Cynthia Eze
Maureen Onyinyechi Okoli
Inimuvie Ekada
Candid Uzoma Uhegbu
Chioma Ugwu
Priscilla Adonike Ogbakiri
Favour Chigemezu Alozie
Nancy Obutor Ideozu
Ayebaemi Wilfred Amesi
Margaret Afor Ifeanyi

Keywords

Cholera, Vibrio Chlorae, Epidemiology, Public Health, Sanitation, Water, Conflict

Abstract

Cholera remains a significant public health challenge in Nigeria, with recurrent outbreaks exacerbated by inadequate water, sanitation, and hygiene (WASH) infrastructure, as well as conflict and displacement. This review examines cholera outbreaks in Nigeria from 2010 to 2024, analyzing epidemiological trends, contributing factors, and public health responses. Seasonal peaks during periods of heavy rainfall and flooding have consistently facilitated Vibrio cholerae transmission, with Northern regions disproportionately affected due to poor infrastructure and ongoing conflicts. Displacement into overcrowded camps has heightened vulnerability, particularly in conflict-affected areas such as Borno and Adamawa. The outbreaks have exhibited multiple epidemic waves within single periods, reflecting persistent transmission dynamics. Recent outbreaks have seen higher incidence rates among children under the age of five and vulnerable populations, highlighting the need for targeted interventions. Public health responses have focused on improving surveillance, case management, and WASH infrastructure, with coordinated efforts from national and international agencies. Vaccination campaigns, particularly in high-risk areas, have proven effective in controlling outbreaks. However, challenges remain, including inadequate healthcare capacity, vaccine stockouts, and the emergence of antimicrobial-resistant Vibrio cholerae strains (serogroup O1) resistant to antibiotics such as tetracycline, doxycycline, ampicillin, and trimethoprim-sulfamethoxazole, complicating treatment efforts. The COVID-19 pandemic further strained Nigeria’s healthcare system, underscoring the need for an integrated health system to be strengthened to manage concurrent public health crises. This review emphasizes the importance of a multi-sectoral approach to cholera prevention and control, addressing underlying social determinants and ensuring sustained investments in public health infrastructure to mitigate future outbreaks.

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