Risk Factors Associated with Vibrio Cholerae Mimics from Diarrhoea Stool and Drinking Water Samples in Internally Displaced Persons (IDP) Camps Within North Central Nigeria

Cholera continues to pose a significant public-health challenge in sub-Saharan Africa, particularly within Internally Displaced Persons (IDP) camps where inadequate water, sanitation, and hygiene (WASH) conditions amplify transmission risks. Diagnostic challenges arise when non-cholera pathogens exhibit phenotypic characteristics similar to Vibrio cholerae, resulting in “V. cholerae mimics” that impede accurate outbreak detection. This study investigated the risk factors associated with the presence of V. cholerae mimics in diarrhoeal stool and drinking water samples collected from IDP camps in North-Central Nigeria. A prospective case-control, event-driven study design was employed, involving diarrhoeic patients and drinking water sources across Benue, Nasarawa, and Plateau States. Standard bacteriological methods were used for isolation and presumptive identification, and structured questionnaires were used to assess socio-demographic, environmental, and behavioral risk factors. Bivariate analysis was conducted using odds ratios (ORs) with 95% confidence intervals (CIs). Findings showed that older age groups (?60 years), female sex, and lower educational levels exhibited higher odds of positive mimics. Environmental factors such as reliance on dam water, open defecation, inadequate shelter, and prolonged stay in camps were associated with increased risk. Behavioral factors—including poor handwashing, lack of access to soap, and limited healthcare—were also significantly associated with the presence of mimics. These findings highlight the complex interaction between sanitation infrastructure, population vulnerability, and diagnostic limitations. Strengthening WASH systems, improving diagnostic capacity, and enhancing public-health surveillance in IDP settings are essential to minimizing misclassification and improving cholera control strategies