Review of public health preparedness and response to cholera; lessons from Nigeria’s 2024 outbreak

Cholera is a disease caused by the bacterium Vibrio cholerae and is of public health significance especially in Sub- Saharan Africa where the disease is still endemic in many countries. The symptoms of cholera include acute watery diarrhea, fever, and vomiting which can lead to dehydration and subsequently death if left untreated. Reports from the World Health Organization in July 2024 found 6092 new cases across nine African countries. The cumulative African and Nigerian case fatality rate stands at 1.8% and 2.9% respectively which is above the acceptable 1% level. Nigeria experienced a fresh outbreak in June 2024 with new cases still being diagnosed as of writing despite many public health strategies put in place to prevent recurrent cholera outbreaks in Nigeria. This review aims to evaluate the effectiveness of Nigeria’s public health strategies in controlling cholera outbreaks and assess the preparedness of the healthcare system in managing these crises. We summarised the epidemiology of the current outbreak and critically analyzed the response efforts, identifying both strengths and weaknesses. Challenges identified during the current outbreak include insufficient funding for cholera action plans, inadequate potable water and hygiene practices, open defecation, lack of trained personnel, and shortages of supplies and educational materials in affected communities. Strengthening community-based surveillance, building resilient healthcare infrastructure, and fostering cross-border collaboration are key to cholera preparedness. Prioritizing community engagement and education while continuously evaluating response plans is also essential.