Mitigating Cholera Outbreaks in Nigeria: Employing a Multifaceted Approach

Cholera is an infectious disease caused by ingesting food or water contaminated with the Vibrio cholerae bacteria.Its symptoms include severe diarrhea, dehydration, muscle cramps, weakness, fever, vomiting, low blood pressure, and intense thirst. 1 In extreme cases, cholera can be fatal within hours due to severe dehydration and intense thirst. 2 Sub-Saharan African nations, including Nigeria, are disproportionately affected by cholera, with global estimates ranging from 2.9 million to 95 000 cases and deaths annually, particularly since the onset of the seventh pandemic in 1961. 3This public health issue has persisted in Nigeria for decades, with current interventions proving largely ineffective.Cholera poses significant public health challenges in Nigeria, highlighting the vulnerabilities within the country's healthcare system, as evidenced by recurrent outbreaks. 4Since the launch of the Global Roadmap initiatives in 2017 by the Global Task Force on Cholera Control (GTFCC) and its partners, Nigeria has implemented several strategic measures.These measures include the development of a national strategic action plan and implementing oral cholera immunization programs, particularly in the northern regions. 5 The 2018 cholera outbreak highlighted the need for additional public health interventions to address the persistent transmission of cholera in Nigeria, alongside existing water, sanitation, and hygiene (WASH) initiatives and oral cholera immunization efforts.A comprehensive review identified that social, biological, environmental, and climatic factors are the primary drivers of cholera transmission in Nigeria. 6These factors, alongside health system weaknesses and the interplay of multiple variables, contribute to the persistence of the disease.