{"id":50717,"date":"2025-09-29T14:00:06","date_gmt":"2025-09-29T14:00:06","guid":{"rendered":"https:\/\/www.newsbeep.com\/ie\/50717\/"},"modified":"2025-09-29T14:00:06","modified_gmt":"2025-09-29T14:00:06","slug":"cholera-in-nigeria-a-five-decade-review-of-outbreak-dynamics-and-health-system-responses-journal-of-health-population-and-nutrition","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/ie\/50717\/","title":{"rendered":"Cholera in Nigeria: a five-decade review of outbreak dynamics and health system responses | Journal of Health, Population and Nutrition"},"content":{"rendered":"<p>Sanitation and clean water: analysis of current access to clean water and sanitation facilities<\/p>\n<p>Cholera outbreaks in Nigeria are linked to inadequate access to safe water and poor sanitation. Despite abundant water resources, regional disparities in water availability and management contribute to recurrent outbreaks [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 25\" title=\"Mike-Ogburia M, Eze C, Okoli M, Ekada I, Uhegbu CU, Ugwu C, Ogbakiri PA, Alozie FC, Ideozu NO, Amesi AW, Ifeanyi MA. Cholera in Nigeria: a review of outbreaks, trends, contributing factors, and public health responses. Nigerian Medical Journal. Published online January 10, 2025. 2024;65(6):November to December. &#010;                  https:\/\/doi.org\/10.60787\/NMJ.V65I6.584&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR25\" id=\"ref-link-section-d20969443e1459\" rel=\"nofollow noopener\" target=\"_blank\">25<\/a>]. The Nigerian government, with support from United Nations Children\u2019s Fund (UNICEF) and the Global Task Force on Cholera Control (GTFCC), prioritizes WASHas a key prevention strategy [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 16\" title=\"Eneh S, Onukansi F, Anokwuru C, Ikhuoria O, Edeh G, Obiekwe S, Dauda Z, Praise-God A, Okpara C. Cholera outbreak trends in Nigeria: policy recommendations and innovative approaches to prevention and treatment. Frontiers Public Health Published Online September. 2024;6. &#010;                  https:\/\/doi.org\/10.3389\/fpubh.2024.1464361&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR16\" id=\"ref-link-section-d20969443e1462\" rel=\"nofollow noopener\" target=\"_blank\">16<\/a>]. However, these efforts face persistent challenges.<\/p>\n<p>Access to clean water<\/p>\n<p>Nigeria has substantial water resources, including an estimated 215\u00a0billion cubic meters of surface water and 87\u00a0billion cubic meters of groundwater, sourced mainly from four hydrological basins (the North Central Plateau, Western Highlands, Eastern Highlands, and Uri Plateau) and major rivers such as the Niger and Benue [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 26\" title=\"Department of Climate Change, Federal Ministry of Environment. 2050 Long-Term Vision for Nigeria (LTV-2050). 2021 [cited 2025 Mar 1]. Available from: &#010;                  https:\/\/unfccc.int\/sites\/default\/files\/resource\/Nigeria_LTS1.pdf&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR26\" id=\"ref-link-section-d20969443e1472\" rel=\"nofollow noopener\" target=\"_blank\">26<\/a>]. Despite this, the country faces economic water scarcity due to inadequate investment and weak management, resulting in unmet demand projected to rise from 5.93\u00a0billion cubic meters in 2021 to 16.58\u00a0billion cubic meters by 2030 [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 26\" title=\"Department of Climate Change, Federal Ministry of Environment. 2050 Long-Term Vision for Nigeria (LTV-2050). 2021 [cited 2025 Mar 1]. Available from: &#010;                  https:\/\/unfccc.int\/sites\/default\/files\/resource\/Nigeria_LTS1.pdf&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR26\" id=\"ref-link-section-d20969443e1475\" rel=\"nofollow noopener\" target=\"_blank\">26<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 27\" title=\"Federal Ministry of Finance, Budget and National Planning. National Development Plan (NDP) 2021\u20132025 Volume I. 2021 [cited 2025 Mar 1]. Available from: &#010;                  https:\/\/nationalplanning.gov.ng\/wp-content\/uploads\/2021\/12\/NDP-2021-2025_AA_FINAL_PRINTING.pdf&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR27\" id=\"ref-link-section-d20969443e1478\" rel=\"nofollow noopener\" target=\"_blank\">27<\/a>].<\/p>\n<p>To address these challenges, government initiatives like the Expanded WASH Strategy (2016\u20132030) and the National WASH Sector Revitalization Action Plan (2018\u20132022) have been introduced, alongside a Presidential State of Emergency declaration for the WASH sector [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 28\" title=\"Nigeria Centre for Disease Control and Prevention, National Primary Healthcare Development Agency, Federal Ministry of Health and Social Welfare. Report on the identification of priority area for multi-sectoral intervention (PAMI) tools. Global Task Force for Cholera Control. 2024 [cited 2025 Feb]. Available from: &#010;                  https:\/\/www.gtfcc.org\/wp-content\/uploads\/2025\/02\/pami-report-Nigeria.pdf&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR28\" id=\"ref-link-section-d20969443e1484\" rel=\"nofollow noopener\" target=\"_blank\">28<\/a>]. However, funding gaps persist, with only 17% of health sector ($14\u00a0million of $83\u00a0million) and 1% of WASH sector funding ($612,000 of $92.7\u00a0million) met as of August 2021 [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 7\" title=\"Gulumbe B, Aminu U, Yusuf Z, liman UU, Faggo AA, Abubakar J, Abdulrahim A, Usman NI. Cholera outbreaks in conflict-hit regions of Northern Nigeria: an overview. Afro-Egypt J Infect Endem Dis. 2023;2:134\u201342. &#010;                  https:\/\/doi.org\/10.21608\/aeji.2023.205724.1286&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR7\" id=\"ref-link-section-d20969443e1487\" rel=\"nofollow noopener\" target=\"_blank\">7<\/a>].<\/p>\n<p>Also, frequent power outages limit pipe-borne water supply, forcing reliance on poorly constructed wells that are often contaminated, especially where pit latrines are close to water sources [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 29\" title=\"Umoh JU, Adesiyun AA, Adekeye JO, Nadarajah M. Epidemiological features of an outbreak of gastroenteritis\/cholera in Katsina, Northern Nigeria. J Hyg (Lond). 1983;91(1):101\u201311. &#010;                  https:\/\/doi.org\/10.1017\/s0022172400060083&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR29\" id=\"ref-link-section-d20969443e1493\" rel=\"nofollow noopener\" target=\"_blank\">29<\/a>]. During droughts, dependence on shared, unsafe water sources increases cholera risk, while rising sea levels exacerbate water quality through saltwater intrusion [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 30\" title=\"Lipp EK, Huq A, Colwell RR. Effects of global climate on infectious disease: the cholera model. Clin Microbiol Rev. 2002;15(4):757\u201370. &#010;                  https:\/\/doi.org\/10.1128\/CMR.15.4.757-770.2002&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR30\" id=\"ref-link-section-d20969443e1496\" rel=\"nofollow noopener\" target=\"_blank\">30<\/a>].<\/p>\n<p>Sanitation and hygiene<\/p>\n<p>Sanitation remains a significant challenge in Nigeria, where only 33% of the nearly 200\u00a0million population have access to adequate facilities [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 31\" title=\"Olajide OM, Tajudeen OK, Popoola OV, Onyeanusi SA, Adaobi S, Makinde AA, Oladapo Rk, Oyinyechi PO, Oyetola AB, Adekunle O, Akinrinde B. Cholera scourge in Nigeria: promoting environmental sanitation practice to achieving good health for all. J Infect Dis Epidemiol. 2022;(1). &#010;                  https:\/\/doi.org\/10.23937\/2474-3658\/1510246&#010;                  &#010;                .\" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR31\" id=\"ref-link-section-d20969443e1507\" rel=\"nofollow noopener\" target=\"_blank\">31<\/a>]. The World Bank estimates that inadequate sanitation results in an annual economic loss of about N455\u00a0billion, equivalent to 1.3% of GDP [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 31\" title=\"Olajide OM, Tajudeen OK, Popoola OV, Onyeanusi SA, Adaobi S, Makinde AA, Oladapo Rk, Oyinyechi PO, Oyetola AB, Adekunle O, Akinrinde B. Cholera scourge in Nigeria: promoting environmental sanitation practice to achieving good health for all. J Infect Dis Epidemiol. 2022;(1). &#010;                  https:\/\/doi.org\/10.23937\/2474-3658\/1510246&#010;                  &#010;                .\" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR31\" id=\"ref-link-section-d20969443e1510\" rel=\"nofollow noopener\" target=\"_blank\">31<\/a>]. Poor environmental sanitation has been a major contributor to waterborne diseases, including cholera [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 31\" title=\"Olajide OM, Tajudeen OK, Popoola OV, Onyeanusi SA, Adaobi S, Makinde AA, Oladapo Rk, Oyinyechi PO, Oyetola AB, Adekunle O, Akinrinde B. Cholera scourge in Nigeria: promoting environmental sanitation practice to achieving good health for all. J Infect Dis Epidemiol. 2022;(1). &#010;                  https:\/\/doi.org\/10.23937\/2474-3658\/1510246&#010;                  &#010;                .\" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR31\" id=\"ref-link-section-d20969443e1513\" rel=\"nofollow noopener\" target=\"_blank\">31<\/a>]. Studies in Southern Nigeria\u2019s urban areas reveal widespread reliance on open defecation due to lack of infrastructure [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 31\" title=\"Olajide OM, Tajudeen OK, Popoola OV, Onyeanusi SA, Adaobi S, Makinde AA, Oladapo Rk, Oyinyechi PO, Oyetola AB, Adekunle O, Akinrinde B. Cholera scourge in Nigeria: promoting environmental sanitation practice to achieving good health for all. J Infect Dis Epidemiol. 2022;(1). &#010;                  https:\/\/doi.org\/10.23937\/2474-3658\/1510246&#010;                  &#010;                .\" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR31\" id=\"ref-link-section-d20969443e1516\" rel=\"nofollow noopener\" target=\"_blank\">31<\/a>]. In 2018, over 60\u00a0million Nigerians lacked basic drinking water access, and poor water and sanitation conditions contributed to more than 70,000 deaths annually among children under five [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 31\" title=\"Olajide OM, Tajudeen OK, Popoola OV, Onyeanusi SA, Adaobi S, Makinde AA, Oladapo Rk, Oyinyechi PO, Oyetola AB, Adekunle O, Akinrinde B. Cholera scourge in Nigeria: promoting environmental sanitation practice to achieving good health for all. J Infect Dis Epidemiol. 2022;(1). &#010;                  https:\/\/doi.org\/10.23937\/2474-3658\/1510246&#010;                  &#010;                .\" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR31\" id=\"ref-link-section-d20969443e1519\" rel=\"nofollow noopener\" target=\"_blank\">31<\/a>]. The 2019 National Outcome Routine Mapping of WASH Services (WASHNORM) reported that only 44% of Nigerians had proper sanitation access, with just 16% having safe hygiene facilities [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 31\" title=\"Olajide OM, Tajudeen OK, Popoola OV, Onyeanusi SA, Adaobi S, Makinde AA, Oladapo Rk, Oyinyechi PO, Oyetola AB, Adekunle O, Akinrinde B. Cholera scourge in Nigeria: promoting environmental sanitation practice to achieving good health for all. J Infect Dis Epidemiol. 2022;(1). &#010;                  https:\/\/doi.org\/10.23937\/2474-3658\/1510246&#010;                  &#010;                .\" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR31\" id=\"ref-link-section-d20969443e1523\" rel=\"nofollow noopener\" target=\"_blank\">31<\/a>].<\/p>\n<p>Historical cholera outbreaks have been linked to poor sanitation and contaminated water. For example, in 1982, a water shortage in Katsina forced residents to use contaminated abandoned wells [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 29\" title=\"Umoh JU, Adesiyun AA, Adekeye JO, Nadarajah M. Epidemiological features of an outbreak of gastroenteritis\/cholera in Katsina, Northern Nigeria. J Hyg (Lond). 1983;91(1):101\u201311. &#010;                  https:\/\/doi.org\/10.1017\/s0022172400060083&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR29\" id=\"ref-link-section-d20969443e1529\" rel=\"nofollow noopener\" target=\"_blank\">29<\/a>], while the 1995\u20131996 Kano outbreak was traced to unsafe water sold by street vendors, underscoring the need for improved water safety measures [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 19\" title=\"Hutin Y, Luby S, Paquet C. A large cholera outbreak in Kano city, Nigeria: the importance of hand washing with soap and the danger of street-vended water. J Water Health. 2003;1(1):45\u201352.\" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR19\" id=\"ref-link-section-d20969443e1532\" rel=\"nofollow noopener\" target=\"_blank\">19<\/a>]. Point-of-use water treatment interventions such as chlorination and safe water storage could have lessened outbreak severity [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 19\" title=\"Hutin Y, Luby S, Paquet C. A large cholera outbreak in Kano city, Nigeria: the importance of hand washing with soap and the danger of street-vended water. J Water Health. 2003;1(1):45\u201352.\" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR19\" id=\"ref-link-section-d20969443e1535\" rel=\"nofollow noopener\" target=\"_blank\">19<\/a>].<\/p>\n<p>However, efforts to address sanitation challenges have been initiated, including the USAID-funded WASH program in Kebbi, Sokoto, and Zamfara, with a budget of $9.98\u00a0million in the year 2021 [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 31\" title=\"Olajide OM, Tajudeen OK, Popoola OV, Onyeanusi SA, Adaobi S, Makinde AA, Oladapo Rk, Oyinyechi PO, Oyetola AB, Adekunle O, Akinrinde B. Cholera scourge in Nigeria: promoting environmental sanitation practice to achieving good health for all. J Infect Dis Epidemiol. 2022;(1). &#010;                  https:\/\/doi.org\/10.23937\/2474-3658\/1510246&#010;                  &#010;                .\" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR31\" id=\"ref-link-section-d20969443e1541\" rel=\"nofollow noopener\" target=\"_blank\">31<\/a>]. The World Bank has committed $700\u00a0million to the Nigeria Sustainable Urban and Rural Water Supply, Sanitation, and Hygiene Program (SURWASH) in 2020 to provide 6\u00a0million people with basic drinking water and 1.4\u00a0million with improved sanitation services [3124]. The World Bank, in collaboration with its partners, has backed the National Urban Water Sector Reform Program (NUWSRP) to expand access to safe drinking water by establishing more than 2,300 water points and 6,546 sanitation units throughout Nigeria [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 31\" title=\"Olajide OM, Tajudeen OK, Popoola OV, Onyeanusi SA, Adaobi S, Makinde AA, Oladapo Rk, Oyinyechi PO, Oyetola AB, Adekunle O, Akinrinde B. Cholera scourge in Nigeria: promoting environmental sanitation practice to achieving good health for all. J Infect Dis Epidemiol. 2022;(1). &#010;                  https:\/\/doi.org\/10.23937\/2474-3658\/1510246&#010;                  &#010;                .\" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR31\" id=\"ref-link-section-d20969443e1544\" rel=\"nofollow noopener\" target=\"_blank\">31<\/a>]. Despite these efforts, reports show that most Nigerians still do not have access to clean drinking water and proper sanitation services, necessitating continued investments and policy reforms [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 31\" title=\"Olajide OM, Tajudeen OK, Popoola OV, Onyeanusi SA, Adaobi S, Makinde AA, Oladapo Rk, Oyinyechi PO, Oyetola AB, Adekunle O, Akinrinde B. Cholera scourge in Nigeria: promoting environmental sanitation practice to achieving good health for all. J Infect Dis Epidemiol. 2022;(1). &#010;                  https:\/\/doi.org\/10.23937\/2474-3658\/1510246&#010;                  &#010;                .\" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR31\" id=\"ref-link-section-d20969443e1547\" rel=\"nofollow noopener\" target=\"_blank\">31<\/a>]. A complicated humanitarian catastrophe has also been brought about by the ongoing conflict in Northeast Nigeria, which has limited the implementation of WASH initiatives and caused the Lake Chad basin, the region\u2019s main water source, to diminish, making it more difficult to reach some towns [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 32\" title=\"REACH Initiative. Water, sanitation and hygiene (WASH): Hard-to-reach assessment in Northeast Nigeria\u2014February 2021. REACH\/IMPACT Initiatives; 2021. Accessed July 17, 2025. &#010;                  https:\/\/repository.impact-initiatives.org\/document\/impact\/4484703f\/REACH_NGA_Factsheet_WASH_Hard-to-Reach-Assessment-in-Northeast-Nigeria_February-2021-1.pdf&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR32\" id=\"ref-link-section-d20969443e1550\" rel=\"nofollow noopener\" target=\"_blank\">32<\/a>]. Therefore, it is crucial to close the gap caused by the lack of potable water as well as basic facilities and services for the safe disposal of human wastes like urine and feces if Nigeria is to win the fight against infectious illnesses like cholera [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 31\" title=\"Olajide OM, Tajudeen OK, Popoola OV, Onyeanusi SA, Adaobi S, Makinde AA, Oladapo Rk, Oyinyechi PO, Oyetola AB, Adekunle O, Akinrinde B. Cholera scourge in Nigeria: promoting environmental sanitation practice to achieving good health for all. J Infect Dis Epidemiol. 2022;(1). &#010;                  https:\/\/doi.org\/10.23937\/2474-3658\/1510246&#010;                  &#010;                .\" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR31\" id=\"ref-link-section-d20969443e1553\" rel=\"nofollow noopener\" target=\"_blank\">31<\/a>].<\/p>\n<p>Impact of climate change and extreme weather events on cholera outbreaks<\/p>\n<p>Climate change is a major factor driving cholera outbreaks in Nigeria, as extreme weather events like floods and droughts disrupt water and sanitation systems, facilitating disease transmission [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 16\" title=\"Eneh S, Onukansi F, Anokwuru C, Ikhuoria O, Edeh G, Obiekwe S, Dauda Z, Praise-God A, Okpara C. Cholera outbreak trends in Nigeria: policy recommendations and innovative approaches to prevention and treatment. Frontiers Public Health Published Online September. 2024;6. &#010;                  https:\/\/doi.org\/10.3389\/fpubh.2024.1464361&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR16\" id=\"ref-link-section-d20969443e1565\" rel=\"nofollow noopener\" target=\"_blank\">16<\/a>]. Studies in Katsina\u2019s Funtua area have shown a link between rising temperatures, increased rainfall, and cholera incidence, with outbreaks peaking in August [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 33\" title=\"Abaje IB, Abdullahi N, Jeje OG. Climate change and infectious diseases in Funtua local government area of Katsina state, Nigeria. Int J Sci Technol. 2016;5(1):47\u201358. &#010;                  https:\/\/doi.org\/10.4314\/stech.v5i1.5&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR33\" id=\"ref-link-section-d20969443e1568\" rel=\"nofollow noopener\" target=\"_blank\">33<\/a>]. Research in Kano and Ebonyi States similarly indicates higher case numbers during the rainy season [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 20\" title=\"Onwe F, Agu A, Umezuruike D, Ogbonna C. Factors responsible for the 2015 cholera outbreak and spread in Ebonyi state, Nigeria. J Epidemiol Soc Niger. 2020;2(2):53\u20138. &#010;                  https:\/\/jeson.org.ng\/index.php\/jeson\/article\/view\/23&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR20\" id=\"ref-link-section-d20969443e1571\" rel=\"nofollow noopener\" target=\"_blank\">20<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 21\" title=\"Ngwa MC, Ihekweazu C, Okwor T, Yennan S, Williams N, Elimian K, Karaye NY, Bello IW, Sack DA. The cholera risk assessment in Kano state, Nigeria: a historical review, mapping of hotspots, and evaluation of contextual factors. PLoS Negl Trop Dis. 2021;15(1):e0009046. &#010;                  https:\/\/doi.org\/10.1371\/journal.pntd.0009046&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR21\" id=\"ref-link-section-d20969443e1574\" rel=\"nofollow noopener\" target=\"_blank\">21<\/a>]. A wider analysis across Sub-Saharan Africa confirms that cholera outbreaks often peak with heavy rainfall and flooding [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 34\" title=\"PerezSaez J, Lessler J, Lee EC, Luquero FJ, Malembaka EB, Finger F, Langer JP, Yennan S, Zaitchik B, Azman AS. The seasonality of cholera in subsaharan africa: a statistical modelling study. Lancet Glob Health. 2022;10(6):e831\u20139. &#010;                  https:\/\/doi.org\/10.1016\/S2214-109X(22)00007-9&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR34\" id=\"ref-link-section-d20969443e1577\" rel=\"nofollow noopener\" target=\"_blank\">34<\/a>]. However, regional variations exist within Nigeria; in northern areas such as Kano, outbreaks typically coincide with the rainy season, while in southern Calabar, cholera is more common during the dry season and declines when rains begin [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 1\" title=\"Adagbada AO, Adesida SA, Nwaokorie FO, Niemogha MT, Coker AO. Cholera epidemiology in Nigeria: an overview. Pan Afr Med J. 2012;1259. &#010;                  https:\/\/doi.org\/10.11604\/pamj.2012.12.59.1627&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR1\" id=\"ref-link-section-d20969443e1581\" rel=\"nofollow noopener\" target=\"_blank\">1<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 18\" title=\"Asaolu S, Abiona MM. Epidemiology and burden of cholera in Nigeria. Afr J Biomed Res. 2024;27(2):193\u20139. &#010;                  https:\/\/doi.org\/10.4314\/ajbr.v27i1.1685&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR18\" id=\"ref-link-section-d20969443e1584\" rel=\"nofollow noopener\" target=\"_blank\">18<\/a>]. These patterns suggest that although seasonality affects cholera transmission, outbreaks can occur throughout the year, making their timing in Nigeria less predictable [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 1\" title=\"Adagbada AO, Adesida SA, Nwaokorie FO, Niemogha MT, Coker AO. Cholera epidemiology in Nigeria: an overview. Pan Afr Med J. 2012;1259. &#010;                  https:\/\/doi.org\/10.11604\/pamj.2012.12.59.1627&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR1\" id=\"ref-link-section-d20969443e1587\" rel=\"nofollow noopener\" target=\"_blank\">1<\/a>, <a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 35\" title=\"Idoga PE, Toycan M, Zayyad MA. Analysis of factors contributing to the spread of cholera in developing countries. Eurasian J Med. 2019;51(2):121\u20137. &#010;                  https:\/\/doi.org\/10.5152\/eurasianjmed.2019.18334&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR35\" id=\"ref-link-section-d20969443e1590\" rel=\"nofollow noopener\" target=\"_blank\">35<\/a>].<\/p>\n<p>Impact of flooding<\/p>\n<p>Flooding has played a significant role in cholera outbreaks in Nigeria. In 2010, severe floods in northern Nigeria displaced approximately 258,000 people, heightening cholera risk due to contaminated water and inadequate sanitation [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 2\" title=\"Dalhat MM, Isa AN, Nguku P, Nasir S, Urban K, Abdulaziz M, Dankoli RS, Nsubuga P, Poggensee G. Descriptive characterization of the 2010 cholera outbreak in Nigeria. BMC Public Health. 2014;14:1167. &#010;                  https:\/\/doi.org\/10.1186\/1471-2458-14-1167&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR2\" id=\"ref-link-section-d20969443e1600\" rel=\"nofollow noopener\" target=\"_blank\">2<\/a>]. The floods in Anambra, Kogi, and Niger States in 2018 were also linked to increased cholera transmission and higher case fatality rates [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 23\" title=\"Elimian KO, Musah A, Mezue S, Oyebanji O, Yennan S, Jinadu A, Williams N, Ogunleye A, Fall IS, Yao M, Eteng W, Abok P, Popoola M, Chukwuji M, Omar LH, Ekeng E, Balde T, Mamadu I, Adeyemo A, Namara G, Okudo I, Alemu W, Peter C. Ihekweazu C descriptive epidemiology of cholera outbreak in Nigeria, January\u2013November 2018: implications for the global roadmap strategy. BMC Public Health. 2019;19:1264. &#010;                  https:\/\/doi.org\/10.1186\/s12889-019-7559-6&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR23\" id=\"ref-link-section-d20969443e1603\" rel=\"nofollow noopener\" target=\"_blank\">23<\/a>]. Likewise, the 2022 outbreak in northern Nigeria was primarily attributed to widespread flooding [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 25\" title=\"Mike-Ogburia M, Eze C, Okoli M, Ekada I, Uhegbu CU, Ugwu C, Ogbakiri PA, Alozie FC, Ideozu NO, Amesi AW, Ifeanyi MA. Cholera in Nigeria: a review of outbreaks, trends, contributing factors, and public health responses. Nigerian Medical Journal. Published online January 10, 2025. 2024;65(6):November to December. &#010;                  https:\/\/doi.org\/10.60787\/NMJ.V65I6.584&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR25\" id=\"ref-link-section-d20969443e1606\" rel=\"nofollow noopener\" target=\"_blank\">25<\/a>]. In 2024, Nigeria saw more rainfall than usual, with extended and heavy downpours that caused extensive flooding in a number of states, notably Adamawa, Borno, and Yobe. A favorable environment for the spread of cholera is created when flooding overwhelms water systems and contaminates drinking water sources with Vibrio cholerae from sewage and other waste materials [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 30\" title=\"Lipp EK, Huq A, Colwell RR. Effects of global climate on infectious disease: the cholera model. Clin Microbiol Rev. 2002;15(4):757\u201370. &#010;                  https:\/\/doi.org\/10.1128\/CMR.15.4.757-770.2002&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR30\" id=\"ref-link-section-d20969443e1609\" rel=\"nofollow noopener\" target=\"_blank\">30<\/a>]. Furthermore, the bacterium thrives in stagnant floodwaters, which increases its spread during months with the highest rainfall [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 36\" title=\"Akingbola A, Adegbesan A, Ojo O, Urowoli JO, Alao UH, Owolabi AO, Chuku J. Cholera outbreak in Nigeria: history, review of socioeconomic and meteorological drivers, diagnostic challenges, and artificial intelligence integration. Global Health Epidemiol Genomics. 2025;2025. &#010;                  https:\/\/doi.org\/10.1155\/ghe3\/8898076&#010;                  &#010;                . Article ID 8898076.\" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR36\" id=\"ref-link-section-d20969443e1612\" rel=\"nofollow noopener\" target=\"_blank\">36<\/a>].<\/p>\n<p>Role of rainfall and temperature variability<\/p>\n<p>Statistical analyses indicate that increased rainfall and rising temperatures create favorable conditions for Vibrio cholerae proliferation [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 33\" title=\"Abaje IB, Abdullahi N, Jeje OG. Climate change and infectious diseases in Funtua local government area of Katsina state, Nigeria. Int J Sci Technol. 2016;5(1):47\u201358. &#010;                  https:\/\/doi.org\/10.4314\/stech.v5i1.5&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR33\" id=\"ref-link-section-d20969443e1626\" rel=\"nofollow noopener\" target=\"_blank\">33<\/a>]. In Katsina State\u2019s Funtua area, cholera cases peaked during July to September, coinciding with the heaviest rainfall [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 33\" title=\"Abaje IB, Abdullahi N, Jeje OG. Climate change and infectious diseases in Funtua local government area of Katsina state, Nigeria. Int J Sci Technol. 2016;5(1):47\u201358. &#010;                  https:\/\/doi.org\/10.4314\/stech.v5i1.5&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR33\" id=\"ref-link-section-d20969443e1629\" rel=\"nofollow noopener\" target=\"_blank\">33<\/a>]. Similar patterns were observed in Kano and Ebonyi States, where higher temperatures and rainfall correlated with increased cases [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 16\" title=\"Eneh S, Onukansi F, Anokwuru C, Ikhuoria O, Edeh G, Obiekwe S, Dauda Z, Praise-God A, Okpara C. Cholera outbreak trends in Nigeria: policy recommendations and innovative approaches to prevention and treatment. Frontiers Public Health Published Online September. 2024;6. &#010;                  https:\/\/doi.org\/10.3389\/fpubh.2024.1464361&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR16\" id=\"ref-link-section-d20969443e1632\" rel=\"nofollow noopener\" target=\"_blank\">16<\/a>]. Intense rainfall causes flooding, damages pit latrines, and contaminates water sources, thereby facilitating cholera transmission [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 33\" title=\"Abaje IB, Abdullahi N, Jeje OG. Climate change and infectious diseases in Funtua local government area of Katsina state, Nigeria. Int J Sci Technol. 2016;5(1):47\u201358. &#010;                  https:\/\/doi.org\/10.4314\/stech.v5i1.5&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR33\" id=\"ref-link-section-d20969443e1635\" rel=\"nofollow noopener\" target=\"_blank\">33<\/a>]. Historical data show relatively low cholera incidence from 1985 to 1993, followed by a rise from 1994, peaking in 2013 [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 33\" title=\"Abaje IB, Abdullahi N, Jeje OG. Climate change and infectious diseases in Funtua local government area of Katsina state, Nigeria. Int J Sci Technol. 2016;5(1):47\u201358. &#010;                  https:\/\/doi.org\/10.4314\/stech.v5i1.5&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR33\" id=\"ref-link-section-d20969443e1639\" rel=\"nofollow noopener\" target=\"_blank\">33<\/a>]. Notably, cases were lowest during the severe droughts of the 1980s, underscoring the link between rainfall and outbreaks [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 33\" title=\"Abaje IB, Abdullahi N, Jeje OG. Climate change and infectious diseases in Funtua local government area of Katsina state, Nigeria. Int J Sci Technol. 2016;5(1):47\u201358. &#010;                  https:\/\/doi.org\/10.4314\/stech.v5i1.5&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR33\" id=\"ref-link-section-d20969443e1642\" rel=\"nofollow noopener\" target=\"_blank\">33<\/a>]. The 1996 outbreak deviated from typical seasonality, with peaks in early and late rainfall periods, highlighting the role of seasonal transitions in cholera dynamics [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 37\" title=\"Lawoyin TO, Ogunbodede NA, Olumide EAA, Onadeko MO. Outbreak of cholera in Ibadan, Nigeria. Eur J Epidemiol. 1999;15:365\u20138. &#010;                  https:\/\/doi.org\/10.1023\/a:1007547117763&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR37\" id=\"ref-link-section-d20969443e1645\" rel=\"nofollow noopener\" target=\"_blank\">37<\/a>]. Climate variability and rising temperatures also increase air pollution and extreme weather events, promoting cholera spread through contaminated water and food [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 33\" title=\"Abaje IB, Abdullahi N, Jeje OG. Climate change and infectious diseases in Funtua local government area of Katsina state, Nigeria. Int J Sci Technol. 2016;5(1):47\u201358. &#010;                  https:\/\/doi.org\/10.4314\/stech.v5i1.5&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR33\" id=\"ref-link-section-d20969443e1648\" rel=\"nofollow noopener\" target=\"_blank\">33<\/a>]. Unchecked climate change may expand cholera to new regions, disproportionately impacting vulnerable populations with low immunity [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 33\" title=\"Abaje IB, Abdullahi N, Jeje OG. Climate change and infectious diseases in Funtua local government area of Katsina state, Nigeria. Int J Sci Technol. 2016;5(1):47\u201358. &#010;                  https:\/\/doi.org\/10.4314\/stech.v5i1.5&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR33\" id=\"ref-link-section-d20969443e1651\" rel=\"nofollow noopener\" target=\"_blank\">33<\/a>].<\/p>\n<p>According to data from the Nigeria Meteorological Agency (NiMet), rainfall levels in northern Nigeria rose by 18% during the 2022 rainy season when compared to the 10-year average. In Kano and Jigawa states, which together recorded more than 5000 cholera cases during the same time period, this precipitation rise led to catastrophic flooding [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 38\" title=\"Qiu Y, Zhou Y, Chang Y, Liang X, Zhang H, Lin X, Qing K, Zhou X, Luo Z. The effects of ventilation, humidity, and temperature on bacterial growth and bacterial genera distribution. Int J Environ Res Public Health. 2022;19(22):15345. &#010;                  https:\/\/doi.org\/10.3390\/ijerph192215345&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR38\" id=\"ref-link-section-d20969443e1657\" rel=\"nofollow noopener\" target=\"_blank\">38<\/a>]. These outbreaks, which made up about 40% of the total nationwide, showed a direct correlation between the frequency of cholera and extreme rainfall. According to a retrospective analysis of cholera outbreaks from 2015 to 2020, months with average temperatures above 30\u00a0\u00b0C saw a 22% increase in cholera cases. Particularly in semiarid areas like Borno and Yobe, which frequently record high cholera rates during peak hot seasons, this temperature range improves Vibrio cholerae\u2019s survival and multiplication in water sources [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 36\" title=\"Akingbola A, Adegbesan A, Ojo O, Urowoli JO, Alao UH, Owolabi AO, Chuku J. Cholera outbreak in Nigeria: history, review of socioeconomic and meteorological drivers, diagnostic challenges, and artificial intelligence integration. Global Health Epidemiol Genomics. 2025;2025. &#010;                  https:\/\/doi.org\/10.1155\/ghe3\/8898076&#010;                  &#010;                . Article ID 8898076.\" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR36\" id=\"ref-link-section-d20969443e1660\" rel=\"nofollow noopener\" target=\"_blank\">36<\/a>]. States that experienced floods, such as Lagos, Bayelsa, and Adamawa, had cholera case fatality rates (CFR) of up to 4.5%, while the national average was 3.2% [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 39\" title=\"Elimian K, Yennan S, Musah A, Cheshi ID, King C, Dunkwu L, Mohammed AL, Ekeng E, Akande OW, Ayres S, Gandi B, Pembi E, Saleh F, Omar AN, Crawford E, Olopha OO, Nnaji R, Muhammad B, Luka-Lawal R, Ihueze AC, Olatunji D, Ojukwu C, Akinpelu AM, Adaga E, Abubakar Y, Nwadiuto I, Ngishe S, Alowooye AB, Nwogwugwu PC, Kamaldeen K, Abah HN, Chukwuebuka EH, Yusuff HA, Mamadu I, Mohammed AA, Peter S, Abbah OC, Oladotun PM, Oifoh S, Olugbile M, Agogo E, Ndodo N, Babatunde O, Mba N, Oladejo J, Ilori E, Alfv\u00e9n T, Myles P, Ochu CL, Ihekweazu C. Adetifa I. Epidemiology, diagnostics and factors associated with mortality during a cholera epidemic in Nigeria, October 2020\u2013October 2021: a retrospective analysis of National surveillance data. BMJ Open. 2022;12(9):e063703. &#010;                  https:\/\/doi.org\/10.1136\/bmjopen-2022-063703&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR39\" id=\"ref-link-section-d20969443e1663\" rel=\"nofollow noopener\" target=\"_blank\">39<\/a>].<\/p>\n<p>Conflict and displacement: impact of regional conflicts and population displacement on cholera spread<\/p>\n<p>Conflict-induced displacement has played a major role in exacerbating cholera outbreaks in Nigeria, particularly in the northeastern and northwestern regions [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 7\" title=\"Gulumbe B, Aminu U, Yusuf Z, liman UU, Faggo AA, Abubakar J, Abdulrahim A, Usman NI. Cholera outbreaks in conflict-hit regions of Northern Nigeria: an overview. Afro-Egypt J Infect Endem Dis. 2023;2:134\u201342. &#010;                  https:\/\/doi.org\/10.21608\/aeji.2023.205724.1286&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR7\" id=\"ref-link-section-d20969443e1675\" rel=\"nofollow noopener\" target=\"_blank\">7<\/a>]. Poor cleanliness, frequent travel, and congestion exacerbate the spread of disease in places going through internal crises like social displacement and conflict. These difficulties are made worse by inappropriate waste management and limited access to necessities like sanitary restrooms, potable water, and wholesome food, which increases instability and health hazards [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 40\" title=\"Elimian K, Diaconu K, Ansah J, King C, Dewa O, Yennan S, Gandi B, Forsberg BC, Ihekweazu C, Alfv\u00e9n T. Enablers and barriers to implementing cholera interventions in Nigeria: a community-based system dynamics approach. Health Policy Plan. 2024;39(9):970\u201384. &#010;                  https:\/\/doi.org\/10.1093\/heapol\/czae067&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR40\" id=\"ref-link-section-d20969443e1678\" rel=\"nofollow noopener\" target=\"_blank\">40<\/a>].<\/p>\n<p>Case studies of cholera outbreaks in conflict zones<\/p>\n<p>Maiduguri, Borno State (2015): A cholera outbreak in IDP camps resulted in 385 cases and 13 deaths (CFR: 3.4%) due to poor sanitation and movement between the camps and surrounding communities [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 25\" title=\"Mike-Ogburia M, Eze C, Okoli M, Ekada I, Uhegbu CU, Ugwu C, Ogbakiri PA, Alozie FC, Ideozu NO, Amesi AW, Ifeanyi MA. Cholera in Nigeria: a review of outbreaks, trends, contributing factors, and public health responses. Nigerian Medical Journal. Published online January 10, 2025. 2024;65(6):November to December. &#010;                  https:\/\/doi.org\/10.60787\/NMJ.V65I6.584&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR25\" id=\"ref-link-section-d20969443e1688\" rel=\"nofollow noopener\" target=\"_blank\">25<\/a>].<\/p>\n<p>Borno State (2017): The outbreak predominantly affected IDP camps, with 5,889 cases reported across five local government areas (LGAs), leading to an overall attack rate of 395.3 per 100,000 population [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 25\" title=\"Mike-Ogburia M, Eze C, Okoli M, Ekada I, Uhegbu CU, Ugwu C, Ogbakiri PA, Alozie FC, Ideozu NO, Amesi AW, Ifeanyi MA. Cholera in Nigeria: a review of outbreaks, trends, contributing factors, and public health responses. Nigerian Medical Journal. Published online January 10, 2025. 2024;65(6):November to December. &#010;                  https:\/\/doi.org\/10.60787\/NMJ.V65I6.584&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR25\" id=\"ref-link-section-d20969443e1694\" rel=\"nofollow noopener\" target=\"_blank\">25<\/a>]. The CFR was 0.87%, with the highest mortality rate among individuals aged 60 years and above [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 25\" title=\"Mike-Ogburia M, Eze C, Okoli M, Ekada I, Uhegbu CU, Ugwu C, Ogbakiri PA, Alozie FC, Ideozu NO, Amesi AW, Ifeanyi MA. Cholera in Nigeria: a review of outbreaks, trends, contributing factors, and public health responses. Nigerian Medical Journal. Published online January 10, 2025. 2024;65(6):November to December. &#010;                  https:\/\/doi.org\/10.60787\/NMJ.V65I6.584&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR25\" id=\"ref-link-section-d20969443e1697\" rel=\"nofollow noopener\" target=\"_blank\">25<\/a>]. The destruction of critical infrastructure, including health facilities, sanitation systems, and water supplies, exacerbated the crisis [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 25\" title=\"Mike-Ogburia M, Eze C, Okoli M, Ekada I, Uhegbu CU, Ugwu C, Ogbakiri PA, Alozie FC, Ideozu NO, Amesi AW, Ifeanyi MA. Cholera in Nigeria: a review of outbreaks, trends, contributing factors, and public health responses. Nigerian Medical Journal. Published online January 10, 2025. 2024;65(6):November to December. &#010;                  https:\/\/doi.org\/10.60787\/NMJ.V65I6.584&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR25\" id=\"ref-link-section-d20969443e1700\" rel=\"nofollow noopener\" target=\"_blank\">25<\/a>]. Muna Garage IDP camp was the outbreak\u2019s initial focal point, from where it spread to other LGAs [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 25\" title=\"Mike-Ogburia M, Eze C, Okoli M, Ekada I, Uhegbu CU, Ugwu C, Ogbakiri PA, Alozie FC, Ideozu NO, Amesi AW, Ifeanyi MA. Cholera in Nigeria: a review of outbreaks, trends, contributing factors, and public health responses. Nigerian Medical Journal. Published online January 10, 2025. 2024;65(6):November to December. &#010;                  https:\/\/doi.org\/10.60787\/NMJ.V65I6.584&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR25\" id=\"ref-link-section-d20969443e1703\" rel=\"nofollow noopener\" target=\"_blank\">25<\/a>].<\/p>\n<p>Adamawa State (2022): Six LGAs, including Yola, reported 135 cases and seven fatalities, with temporary population displacement contributing to water contamination [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 7\" title=\"Gulumbe B, Aminu U, Yusuf Z, liman UU, Faggo AA, Abubakar J, Abdulrahim A, Usman NI. Cholera outbreaks in conflict-hit regions of Northern Nigeria: an overview. Afro-Egypt J Infect Endem Dis. 2023;2:134\u201342. &#010;                  https:\/\/doi.org\/10.21608\/aeji.2023.205724.1286&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR7\" id=\"ref-link-section-d20969443e1709\" rel=\"nofollow noopener\" target=\"_blank\">7<\/a>]. Yobe State recorded 1,300 suspected cholera cases across 12 LGAs, but no official outbreak declaration was made [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 7\" title=\"Gulumbe B, Aminu U, Yusuf Z, liman UU, Faggo AA, Abubakar J, Abdulrahim A, Usman NI. Cholera outbreaks in conflict-hit regions of Northern Nigeria: an overview. Afro-Egypt J Infect Endem Dis. 2023;2:134\u201342. &#010;                  https:\/\/doi.org\/10.21608\/aeji.2023.205724.1286&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR7\" id=\"ref-link-section-d20969443e1712\" rel=\"nofollow noopener\" target=\"_blank\">7<\/a>].<\/p>\n<p>Northern Nigeria (2022): Cholera outbreaks were driven by flooding and ongoing conflicts [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 25\" title=\"Mike-Ogburia M, Eze C, Okoli M, Ekada I, Uhegbu CU, Ugwu C, Ogbakiri PA, Alozie FC, Ideozu NO, Amesi AW, Ifeanyi MA. Cholera in Nigeria: a review of outbreaks, trends, contributing factors, and public health responses. Nigerian Medical Journal. Published online January 10, 2025. 2024;65(6):November to December. &#010;                  https:\/\/doi.org\/10.60787\/NMJ.V65I6.584&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR25\" id=\"ref-link-section-d20969443e1718\" rel=\"nofollow noopener\" target=\"_blank\">25<\/a>]. Over 10,000 probable cases were reported between June and September, with Borno State accounting for 70.13% of the 7,700 cases and 324 deaths across Borno, Adamawa, and Yobe states [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 25\" title=\"Mike-Ogburia M, Eze C, Okoli M, Ekada I, Uhegbu CU, Ugwu C, Ogbakiri PA, Alozie FC, Ideozu NO, Amesi AW, Ifeanyi MA. Cholera in Nigeria: a review of outbreaks, trends, contributing factors, and public health responses. Nigerian Medical Journal. Published online January 10, 2025. 2024;65(6):November to December. &#010;                  https:\/\/doi.org\/10.60787\/NMJ.V65I6.584&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR25\" id=\"ref-link-section-d20969443e1721\" rel=\"nofollow noopener\" target=\"_blank\">25<\/a>]. Conflict-induced displacement led to limited access to clean water, increased hospitalizations, and a high mortality rate [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 25\" title=\"Mike-Ogburia M, Eze C, Okoli M, Ekada I, Uhegbu CU, Ugwu C, Ogbakiri PA, Alozie FC, Ideozu NO, Amesi AW, Ifeanyi MA. Cholera in Nigeria: a review of outbreaks, trends, contributing factors, and public health responses. Nigerian Medical Journal. Published online January 10, 2025. 2024;65(6):November to December. &#010;                  https:\/\/doi.org\/10.60787\/NMJ.V65I6.584&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR25\" id=\"ref-link-section-d20969443e1724\" rel=\"nofollow noopener\" target=\"_blank\">25<\/a>].<\/p>\n<p>Northwestern Nigeria (2022): Armed conflicts displaced 455,000 individuals across Katsina, Zamfara, and Sokoto states, with Zamfara and Katsina hosting the highest numbers of IDPs [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 7\" title=\"Gulumbe B, Aminu U, Yusuf Z, liman UU, Faggo AA, Abubakar J, Abdulrahim A, Usman NI. Cholera outbreaks in conflict-hit regions of Northern Nigeria: an overview. Afro-Egypt J Infect Endem Dis. 2023;2:134\u201342. &#010;                  https:\/\/doi.org\/10.21608\/aeji.2023.205724.1286&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR7\" id=\"ref-link-section-d20969443e1731\" rel=\"nofollow noopener\" target=\"_blank\">7<\/a>]. Kaduna State recorded 196 cholera-related deaths in 2022, highlighting the direct link between insecurity and cholera outbreaks [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" aria-label=\"Reference 7\" title=\"Gulumbe B, Aminu U, Yusuf Z, liman UU, Faggo AA, Abubakar J, Abdulrahim A, Usman NI. Cholera outbreaks in conflict-hit regions of Northern Nigeria: an overview. Afro-Egypt J Infect Endem Dis. 2023;2:134\u201342. &#010;                  https:\/\/doi.org\/10.21608\/aeji.2023.205724.1286&#010;                  &#010;                \" href=\"http:\/\/jhpn.biomedcentral.com\/articles\/10.1186\/s41043-025-01096-7#ref-CR7\" id=\"ref-link-section-d20969443e1734\" rel=\"nofollow noopener\" target=\"_blank\">7<\/a>].<\/p>\n","protected":false},"excerpt":{"rendered":"Sanitation and clean water: analysis of current access to clean water and sanitation facilities Cholera outbreaks in Nigeria&hellip;\n","protected":false},"author":2,"featured_media":50718,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[30300,2885,36827,1240,103,26110,61,2757,60,23874,21913,2361],"class_list":["post-50717","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","tag-cholera","tag-climate-change","tag-clinical-nutrition","tag-epidemiology","tag-health","tag-health-promotion-and-disease-prevention","tag-ie","tag-infectious-diseases","tag-ireland","tag-maternal-and-child-health","tag-nigeria","tag-public-health"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/50717","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/comments?post=50717"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/50717\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media\/50718"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media?parent=50717"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/categories?post=50717"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/tags?post=50717"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}