Contextualising Cholera in Nigeria: Contemporary Epidemiology, Determinants and Recommendations

In 2024, Nigeria reported the highest cholera mortalities among other African countries. From 1 January to 24 November, Nigeria recorded 702 deaths out of 19,178 cholera cases and a case fatality rate of 3.7%. WHO recommends a case fatality rate of less than 1% for cholera management globally. In this light, we highlight the contemporary epidemiology of cholera in Nigeria and expose the determinants of recurrent outbreaks from geopolitical zone contexts. By deploying descriptive analysis of primary data from the Nigerian Center for Disease and Control Prevention (NCDC), we computed an average case fatality ratio of 2.9 % for cholera between 2017 and 2 March 2025. We discovered that the northwest and northeast geopolitical zones had the highest incidences of cholera outbreaks due to disproportionate poverty and religious conflicts. Lagos constituted roughly 46 % of the cases in 2024 due to overstretching water, sanitation, and hygiene (WASH) amenities and flagrant disregard for sanitary practices, which enhance frequent flooding. As of 2 March 2025, the south-south geopolitical zone had the highest incidences of cholera infections. Most of their areas are low-lying and proximal to many river channels and the Atlantic Ocean, predisposing them to recurrent flooding. Hence, we maintain that the main determinants of cholera in Nigeria are poverty, religious conflicts, incessant flooding, and inadequacy of WASH amenities. A study of this caliber would enhance targeted intervention against the menace of cholera based on regional peculiarities. We believe this is a viable step in stemming recurrent cholera epidemics in Nigeria.