Water, sanitation and hygiene practices in cholera risk areas in Ile-Ife, southwestern Nigeria

Cholera outbreaks remain a pressing public health challenge in Nigeria, with limited evidence-based research addressing the underlying factors sustaining its recurrence. This study thereby assessed the water, sanitation and hygiene (WASH) practices associated with cholera occurrence in sites proximal to environmental risk factors (ERFs) in historical cholera outbreak areas of Ile-Ife, Nigeria; isolated and identified Vibrio cholerae and other heterotrophic bacteria in water sources in the area. Using a cross-sectional study design, the research incorporated spatial mapping of historical cholera cases and ERFs through handheld GPS, high-resolution satellite imagery and ArcGIS 10.1. Spatial analysis was used to stratify the geocoded locations into different zones. Therefore, using a purposive sampling technique, an aggregate of 59 water samples were selected from the zones and 81 respondents were surveyed from the zones on their WASH practices. The water samples were analyzed microbiologically and the survey was descriptively analyzed using IBM SPSS 21. Findings revealed alarming sanitation gaps: 94% practiced improper waste disposal, 89% lacked access to potable water, and 90% lacked adequate toilet facilities. Microbial analysis identified 11 bacterial species, with Klebsiella pneumoniae, Enterobacter aerogenes, Citrobacter freundii, and Salmonella typhi dominant in well water, while Vibrio cholerae, E. coli, and Citrobacter koseri were prevalent in stream water. The study concluded that proximity to ERFs and poor WASH practices may significantly increase the risk of cholera transmission, especially from contaminated stream water. It recommends implementing targeted interventions to improve WASH conditions in the study areas in order to reduce community vulnerability to cholera outbreaks.