Cholera Response in Northwest Syria; Community Perspective and Concerns

Background: In September 2022, the first case of cholera in Northwest Syria was confirmed. The outbreak is compounded by ongoing violence, which complicates efforts to contain it. This study intends to investigate the opinions and concerns of impacted populations in Northwest Syria (NWS) regarding cholera response activities more than a year after the outbreak began.Methods: The study took a cross-sectional qualitative method. Ten focus group discussions (FGDs) were held in five subdistricts.Results: The study included 89 participants: health professionals (44) and community leaders (45), 61 (68.5%) men and 28 (31.5%) women, host community members (35) and internally displaced individuals (54). The participants' ages ranged from 20 to 68 years, with a mean of 40.53. Regarding cholera immunization, 75% (66%) reported obtaining it. The study found that participants had a decent awareness of cholera, its causes, dissemination, and symptoms, as well as fair levels of knowledge of prevention measures, but there were gaps in treatment understanding. The findings show a mixed reaction to the epidemic response, with some voicing worries about distrust, poor awareness, and socioeconomic hurdles. Others, on the other hand, remain positive, emphasizing the importance of trusted influencers in raising awareness, with 75% of participants believing in Community Health Workers and 66% in doctors. Rumors of vaccination adverse effects and conspiracy theories were widely published. Financial restrictions limit access to healthcare. Participants noted issues with trash management and availability to clean water.Conclusion: The study's conclusion provides a detailed picture of the community's cholera response needs, preferences, and problems.