Exploring the burden of cholera in the WHO African region: patterns and trends from 2000 to 2023 cholera outbreak data
Introduction Cholera outbreaks remain persistent in the WHO African region, with an increased trend in recent years. This study analyses actual drivers of cholera including correlations with water, sanitation, and hygiene (WASH) indicators, and climate change trends.Methods This was a cross-sectiona...
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/10/1/e016491.full |
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| author | Joseph Okeibunor Saliou Diallo Abdou Salam Gueye Etien Luc Koua Jean Paul Kimenyi Vincent Dossou Sodjinou Fleury Hybriel Moussana Freddy Kambale |
| author_facet | Joseph Okeibunor Saliou Diallo Abdou Salam Gueye Etien Luc Koua Jean Paul Kimenyi Vincent Dossou Sodjinou Fleury Hybriel Moussana Freddy Kambale |
| author_sort | Joseph Okeibunor |
| collection | DOAJ |
| description | Introduction Cholera outbreaks remain persistent in the WHO African region, with an increased trend in recent years. This study analyses actual drivers of cholera including correlations with water, sanitation, and hygiene (WASH) indicators, and climate change trends.Methods This was a cross-sectional descriptive and analytic study. Cholera data from 2000 to 2023 and data relating to cholera drivers were compiled and analysed through multi-level exploratory analysis. We cross-referenced several WASH indicators, and generated a similarity matrix to categorise countries or subnational units into groups using principal component analysis and K-means clustering. We integrated cholera outbreak data with WASH indicators and created a matrix of indicators relevant for analysing cholera burden. We conducted summary statistics, temporal visualisations, Geographic Information System (GIS) mapping, trend analysis and statistical tests for correlations to derive patterns and trends from the data, derive similarities and develop projections.Results A total of 2 727 172 cases and 63 182 deaths were reported from 44 countries, representing 94% of the 47 countries in the region, from 2000 to 2023. The case fatality ratio of 2.3% is suggestive of issues in case management. A total of 684 outbreaks were reported, with the highest burdens in Nigeria and the Democratic Republic of the Congo. Median detection time to outbreak was 2 days, while median time for outbreak control was 92 days. Cholera incidence seemed higher in the period 2014 to 2023 than in the period before 2014. The study results confirmed correlations between WASH indicators and cholera outbreaks. Risks factors include drinking surface water, lacking soap and/or water, and open defaecation. Over 29% and 58.8% of the population lack access to basic water and basic sanitation, respectively.Conclusion Insufficient access to WASH services remains the main predisposing factor for cholera in the WHO African region. Political leaders should invest more in access to WASH, strengthen multisectoral collaboration, and improve availability of needed tools to increase the likelihood of meeting cholera elimination goals by 2030. |
| format | Article |
| id | doaj-art-a4aaedcbfbd8471280a044d2cac1be61 |
| institution | Kabale University |
| issn | 2059-7908 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-a4aaedcbfbd8471280a044d2cac1be612025-01-28T12:50:12ZengBMJ Publishing GroupBMJ Global Health2059-79082025-01-0110110.1136/bmjgh-2024-016491Exploring the burden of cholera in the WHO African region: patterns and trends from 2000 to 2023 cholera outbreak dataJoseph Okeibunor0Saliou Diallo1Abdou Salam Gueye2Etien Luc Koua3Jean Paul Kimenyi4Vincent Dossou Sodjinou5Fleury Hybriel Moussana6Freddy Kambale75 Emergency Preparedness and Response, World Health Organization, Brazzaville, Congo1 World Health Organization, Brazzaville, CongoEmergency Preparedness and Response, WHO Regional Office for Africa, Brazzaville, CongoWHO, WHO, Brazzaville, Congo4 Regional Office for Africa, Brazzaville, CongoEmergency Preparedness and Response, WHO Regional Office for Africa, Dakar, Senegal1 World Health Organization, Brazzaville, Congo3 World Health Organization, Dakar, SenegalIntroduction Cholera outbreaks remain persistent in the WHO African region, with an increased trend in recent years. This study analyses actual drivers of cholera including correlations with water, sanitation, and hygiene (WASH) indicators, and climate change trends.Methods This was a cross-sectional descriptive and analytic study. Cholera data from 2000 to 2023 and data relating to cholera drivers were compiled and analysed through multi-level exploratory analysis. We cross-referenced several WASH indicators, and generated a similarity matrix to categorise countries or subnational units into groups using principal component analysis and K-means clustering. We integrated cholera outbreak data with WASH indicators and created a matrix of indicators relevant for analysing cholera burden. We conducted summary statistics, temporal visualisations, Geographic Information System (GIS) mapping, trend analysis and statistical tests for correlations to derive patterns and trends from the data, derive similarities and develop projections.Results A total of 2 727 172 cases and 63 182 deaths were reported from 44 countries, representing 94% of the 47 countries in the region, from 2000 to 2023. The case fatality ratio of 2.3% is suggestive of issues in case management. A total of 684 outbreaks were reported, with the highest burdens in Nigeria and the Democratic Republic of the Congo. Median detection time to outbreak was 2 days, while median time for outbreak control was 92 days. Cholera incidence seemed higher in the period 2014 to 2023 than in the period before 2014. The study results confirmed correlations between WASH indicators and cholera outbreaks. Risks factors include drinking surface water, lacking soap and/or water, and open defaecation. Over 29% and 58.8% of the population lack access to basic water and basic sanitation, respectively.Conclusion Insufficient access to WASH services remains the main predisposing factor for cholera in the WHO African region. Political leaders should invest more in access to WASH, strengthen multisectoral collaboration, and improve availability of needed tools to increase the likelihood of meeting cholera elimination goals by 2030.https://gh.bmj.com/content/10/1/e016491.full |
| spellingShingle | Joseph Okeibunor Saliou Diallo Abdou Salam Gueye Etien Luc Koua Jean Paul Kimenyi Vincent Dossou Sodjinou Fleury Hybriel Moussana Freddy Kambale Exploring the burden of cholera in the WHO African region: patterns and trends from 2000 to 2023 cholera outbreak data BMJ Global Health |
| title | Exploring the burden of cholera in the WHO African region: patterns and trends from 2000 to 2023 cholera outbreak data |
| title_full | Exploring the burden of cholera in the WHO African region: patterns and trends from 2000 to 2023 cholera outbreak data |
| title_fullStr | Exploring the burden of cholera in the WHO African region: patterns and trends from 2000 to 2023 cholera outbreak data |
| title_full_unstemmed | Exploring the burden of cholera in the WHO African region: patterns and trends from 2000 to 2023 cholera outbreak data |
| title_short | Exploring the burden of cholera in the WHO African region: patterns and trends from 2000 to 2023 cholera outbreak data |
| title_sort | exploring the burden of cholera in the who african region patterns and trends from 2000 to 2023 cholera outbreak data |
| url | https://gh.bmj.com/content/10/1/e016491.full |
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