Infectious Disease Management Strategies- Cholera

Did you know that;

  • 2 billion people worldwide drink water from sources contaminated with feaces

  • Each year approximately 2.9 million people contract cholera worldwide

  • Approximately 80 million people live in cholera hotspots in Africa

  • Approximately 95 000 people die from cholera each year

Today’s entry looks at cholera and why this infectious disease is still a problem in many developing countries.

The story of Abdu- Al Nehmi is full of the challenges faced in this region and I quote;

“Despite having severe diarrhoea, 53-year-old Abdu al-Nehmi travelled for 3 hours from his village to Sana’a City, Yemen, for treatment. He was vomiting and the car broke down, but he had no other choice but to make the difficult journey, “There is no health centre in our area,” says Abdu. Since Yemen’s conflict escalated in 2015, more than half of all health facilities have closed or are only partially functional, leaving 14.8 million people without basic healthcare.”

This is one of the many stories of cholera not only in Yemen, but South Sudan, the Democratic Republic of Congo (DRC) and many other countries where cholera is endemic or suffer seasonal outbreaks of cholera.

As of April 2018, cases of cholera outbreaks were reported in Liberia, Congo, DRC, and Nigeria in central and west Africa ; Malawi and Zimbabwe in Southern Africa and Somalia and Uganda in East Africa

From Abdu- Al Nehmi’s story,

five challenges already stand out;

  1. People have to travel long distance and often facing many obstacles to get medical treatment
  2. Poor transportation
  3. Lack of health facilities in his local area
  4. Conflict which has led closure of most health facilities
  5. Lack of basic healthcare

Cholera is a preventable disease and can be controlled by a multi-sectoral approach, including;

a. Basic Water, Sanitation and Hygiene (WASH)

b. Oral Cholera Vaccines (OCV)

With a well functioning health system, proper infrastructure, adequate health personnel, sufficient knowledge and training capabilities, ample financial resources and good governance; it is possible to implement various intervention strategies to tackle cholera in rural communities as well as low income countries.

In as much as countries are part of declaration/s to combat cholera, implementing the agreed measures could be a challenge. This results in continued cholera outbreaks in the affected regions. Despite identification of cholera hotspots, most countries still struggle to control the disease due to various challenges. Implementation can be hampered by ongoing conflicts which further weaken existing health systems. This in turn increases the likelihood of diseases such as cholera, measles, malaria and diarrhoea which are preventable but spread rapidly within communities.

Shortage or lack of safe drinking water, proper sanitation and waste management are some of the main causes of cholera outbreaks. Overcrowding perpetuates the spread of cholera in peri-urban slums and refugee camps where sanitation and availability of safe drinking water could be a challenge.

Rural populations living along rivers and lake shores are also prone to cholera.

To prevent stories like that of Abdu al-Nehmi from happening again and save lives, Countries should take it upon themselves to improve the lives of their communities not only by signing declarations but by further implementing these agreements for the benefit of their populations. Improving governance, transportation, primary healthcare and providing safe drinking water will go along way in reducing diseases such as cholera and other infectious diseases affecting rural populations.

For further reading on infectious diseases and rural populations in developing countries; visit

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Published by People, Pandemics and Epidemics (PPE)

Billions around the world are affected by diseases in one way or the other, be it directly or indirectly. Both communicable and non- communicable diseases affect communities worldwide. Communicable (infectious) diseases have been associated with the environment, socioeconomic status, geographical location and access to healthcare. With various disease outbreaks affecting many parts of the world and millions of people being affected, the year 2020 has ushered in another level of an outbreak, the COVID-19 Pandemic. The disease started as an outbreak in one part of a country, soon spread to other countries and continents becoming a pandemic. People, Pandemics and Epidemics will discuss the various infectious disease outbreaks, the solutions to fighting these outbreaks, and what has been achieved so far.

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