Cholera in Lagos State, Nigeria: a One Health perspective on outbreaks and public health interventions

Background: Cholera continues to pose a significant public health challenge in Nigeria, particularly in Lagos, where rapid urbanization, inadequate sanitation, and climatic variability converge to heighten vulnerability. This study reviews recent cholera outbreaks in Lagos through a One Health perspective, emphasizing their implications, intersectoral drivers, and existing response gaps. Methods: A systematic review was conducted using 48 articles published between 2013 and 2024, retrieved from PubMed, Google Scholar, and official sources such as the Center for Disease Control and Prevention (CDC) and the World Health Organization (WHO). Search terms included "Cholera," "Lagos," "Nigeria," and "One Health." Eligible studies addressed human, animal, and environmental determinants of cholera transmission and control. Results: The review identified 401 cholera cases and 21 deaths in Lagos State in 2024, and three reported cases in 2025. Cholera imposes substantial physical, psychological, and economic burdens. Physically, approximately one in 10 Lagosians may experience adverse health effects, ranging from dehydration to multi-organ complications. Psychologically, fear of infection and crisis conditions contribute to stress, anxiety, and stigma. Economically, cholera generates high direct and indirect costs across households, the health system, government, and the wider economy. Recurring outbreaks are strongly associated with inadequate Water, Sanitation, and Hygiene (WASH) infrastructure, high population density, environmental contamination, and limited laboratory capacity. Conclusion: Effective public health interventions are essential to mitigate cholera outbreaks in Lagos, preventing increased transmission, mortality, and economic disruption. Persistent outbreaks highlight the absence of a coordinated One Health policy in the state. Integrating human, animal, and environmental surveillance within a unified framework is critical to achieving Nigeria's cholera elimination targets by 2030.