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01-06-2019 | Review

Recurrent cholera epidemics in Africa: which way forward? A literature review

Authors: Abraham Ajayi, Stella I. Smith

Published in: Infection | Issue 3/2019

Abstract

Background

Outbreaks of cholera in Africa seem to be unrelenting which has been continuous and recurrent leading to high morbidity and mortality in some quarters.

Objective

The objective of this narrative review is to investigate and identify factors responsible for the recurrent outbreaks of cholera in Africa and response strategies that have been employed in curbing the problem, with the view of aggregating otherwise sparing data needed for policy formulation geared towards control and eradication of the disease.

Methods

Search of literatures indexed in Google Scholar, PubMed and AJOL databases was carried out. Sixty-five eligible articles with reports on the risk factors that drive recurrent outbreaks, endemicity and response strategies were analyzed.

Results

Our findings indicate that continuous and recurrent outbreaks of cholera in Africa are fueled by cross-border migration, environmental reservoirs, socioeconomic factors, climate change and political instability. The review also identified specific response strategies and modelling approaches that have helped in containing and reducing the impact of these outbreaks.

Conclusion

Paying attention and tackling these identified factors that are dependent and independent can help put an end to this running battle.

WHO. Cholera. World Health Organization fact sheet. 2017. http://www.who.int/mediacentre/factsheets/fs107/en/. Accessed 12 July 2018.

Ali M, Lopez AL, YOU YA, Kim YA, Sah B, Maskery B, Clemens J. The global burden of cholera. Bull World Health Organ. 2012;90:209–18A. https://doi.org/10.2471/BLT.11.093427.CrossRef

Charles RC, Ryan ET. Cholera in the 21st century. Curr Opin Infect Dis. 2011;24:472–7.CrossRefPubMed

Piarroux R, Faucher B. Cholera epidemics in 2010: respective roles of environment, strain changes and human-driven dissemination. Clin Microbiol Infect. 2012;18:231–8.CrossRefPubMed

Clemens JD, Nair GB, Ahmed T, Qadri F, Holmgren J. Cholera. Lancet. 2017. https://doi.org/10.1016/s0140-6736(17)30559-7 CrossRefPubMed

Schmid-Hempel P, Frank SA. Pathogenesis, virulence and infective dose. PLoS Pathog. 2007;3:e147. https://doi.org/10.1371/journal.ppat.0030147.CrossRefPubMedCentral

WHO. Cholera vaccines: WHO position paper August 2017. World Health Organ Wkly Epidemiol Rec. 2017;92:477–500.

Gaffga NH, Tauxe RV, Mintz ED. Cholera: a new homeland in Africa. Am J Trop Med Hyg. 2007;77:705–13.CrossRefPubMed

Broeck DV, Horvath C, De Wolf MJ. Vibrio cholerae: cholera toxin. Int J Biochem Cell Biol. 2007;39:1771–5.CrossRef

10.

Somboonwit C, Menezes LJ, Holt DA, Sinnott JT, Shapshak P. Current view and challenges on clinical cholera. Bioinformation. 2017;13:405–9.CrossRefPubMedPubMedCentral

11.

Mengel MA, Delrieu I, Heyerdahl L, Gessner BD. Cholera outbreaks in Africa. Curr Top Microbiol Immunol. 2014;379:117–44.PubMed

12.

Valia R, Taviani E, Spagnoletti M, Ceccarelli D, Cappuccinelli P, Colombo MM. Vibrio cholerae O1 epidemic variants in Angola: a retrospective study between 1992 and 2006. Front Microbiol. 2013. https://doi.org/10.3389/fmicb.2013.00354.CrossRefPubMedPubMedCentral

13.

WHO. Cholera country profile: Angola. World Health Organization Global Task Force on cholera control. http://www.who.int/cholera/countries/AngolaCountryProfile2013.pdf. Accessed 8 Aug 2017.

14.

Djomassi LD, Gessner BD, Andze GO, Mballa GAE. National surveillance data on the epidemiology of cholera in Cameroon. J Infect Dis. 2013;208(SI):92-7.

15.

Nsagha DS, Atashili J, Fon PN, Tanue EA, Ayima CW, Kibu OD. Assessing the risk factors of cholera epidemic in Buea Health District of Cameroon. BMC Public Health. 2015;15:1128.CrossRefPubMedPubMedCentral

16.

Akoachere J-FTK, Mbuntcha CKP. Water sources as reservoirs of Vibrio cholerae O1 and non-O1 strains in Bepanda, Douala (Cameroon): relationship between isolation and physico-chemical factors. BMC Infect Dis. 2014;14:421.CrossRefPubMedPubMedCentral

17.

Cartwright EJ, Patel MK, Mbopi-Keou FX, Ayers T, Haenke B, Wagenaar BH, Mintz E, Quick R. Recurrent epidemic cholera with high mortality in Cameroon: persistent challenges 40 years into the seventh pandemic. Epidemiol Infect. 2013;141:2083–93.CrossRefPubMed

18.

Ngwa MC, Liang S, Mbam LM, Mouhaman A, Tehoh A, Brekmo KM, et al. Cholera public health surveillance in the Republic of Cameroon—opportunities and challenges. Pan Afr Med J. 2016;24:222. https://doi.org/10.11604/pamj.2016.24.222.8045.CrossRefPubMedPubMedCentral

19.

Jeandron A, Saidi JM, Kapama A, Burhole M, Birembano F, Vandevelde T, et al. Water supply interruptions and suspected cholera incidence: a time series regression in the Democratic Republic of Congo. PLoS Med 2015; 12:e1001893. https://doi.org/10.1371/journal.pmed1001893.CrossRefPubMedPubMedCentral

20.

Bompangne D, Vesenbeckh SM, Graudoux P, Castro M, Muyembe J-J, Ilunga BK, Murray M. Cholera ante portas—the reemergence of Cholera in Kinshasa after a ten-year hiatus. PLoS Curr. 2012. https://doi.org/10.1371/currents.RRN1310.CrossRef

21.

Muyembe J-J, Bompangne D, Mutombo G, Akilimali L, Mutombo A, Miwanda B, et al. Elimination of cholera in the Democratic Republic of the Congo. The new national policy. J Infect Dis. 2013;208:86–91.CrossRef

22.

Bompangue D, Graudoux P, Piarroux M, Mutombo G, Shamava R, Sudre B, et al. Cholera epidemics, war and disaster around Goma and Lake Kivu: an eight-year survey. PLoS Negl Trop Dis. 2009;3:e436. https://doi.org/10.1371/journal.pntd.0000436.CrossRefPubMedPubMedCentral

23.

Bwire G, Munier A, Ouedraogo I, Heyerdahl L, Komakech H, Kagirita A, et al. Epidemiology of cholera outbreaks and socioeconomic characteristics of the communities in the fishing villages of Uganda: 2011–2015. PLoS Negl Trop Dis. 2017;11:e0005407.CrossRefPubMedPubMedCentral

24.

Bwire G, Malimbo M, Makumbi I, Kagirita A, Wamala JF, Kalyebi P, et al. Cholera surveillance in Uganda: an analysis of notifications for the years 2007–2011. J Infect Dis. 2013;208:78–85.CrossRef

25.

Cummings MJ, Wamala JF, Eyura M, Malimbo M, Omeke ME, Mayer D, Luwago L. A cholera outbreak among semi-nomadic pastoralists in northeastern Uganda: epidemiology and interventions. Epidemiol Infect. 2012;140:1376–85.CrossRefPubMed

26.

Oguttu DW, Okull OA, Bwire G, Nsubuga P, Ario AR. Cholera outbreak caused by drinking lake water contaminated with human faeces in Kaiso Village, Hoima District, Western Uganda, October 2015. Infect Dis Poverty. 2017;6:146. https://doi.org/10.1186/s40249-017-0359-2.CrossRefPubMedPubMedCentral

27.

Kwesiga B, Pande G, Ario AR, Tumwesigye NM, Matovu JKB, Zhu BP. A prolonged community wide cholera outbreak associated with drinking water contaminated by sewage in Kasese district, western Uganda. BMC Public Health. 2018;18:30. https://doi.org/10.1186/s/2889-017-4589-9.CrossRef

28.

Alajo SO, Nakavuma J, Erume J. Cholera in endemic districts in Uganda during El Nino rains: 2002–2003. Afr Health Sci. 2006;6:93–7.PubMedPubMedCentral

29.

Nkoko DB, Giraudoux P, Plisnier PD, Tinda AM, Piarroux M, Sudre B, Horion S, Tamfun J-JM, Ilunga BK, Piarroux R. Dynamics of cholera outbreaks in great lake region of Africa 1978–2008. Emerg Infect Dis. 2011;17:2026–34. https://doi.org/10.3201/eid1711.110170.CrossRefPubMedCentral

30.

Reyburn R, Kim DR, Emch M, Khatib A, von Seidlein L, Ali M. Climatic variability and the outbreak of cholera in Zanzibar, East Africa. A time series analysis. Am J Trop Med Hyg. 2011;84:862–9.CrossRefPubMedPubMedCentral

31.

Moore SM, Azman AS, Zutchik BF, Mintz ED, Brunkard J, Legros D, et al. El Niño and the shifting geography of cholera in Africa. Proc Natl Acad Sci. 2017;114:4436–41.CrossRefPubMed

32.

WASH Cluster. AWD*/cholera outbreak in Somalia. A WASH situation on the brink. Advocacy and support team water sanitation hygiene. https://www.humanitarianresponse.info/en/operations/somalia/document/wash-cluster-somalia-cholera-outbreak-advocacy-june-2017. Accessed 12 July 2018.

33.

Green A. Cholera outbreak in the horn of Africa. World Rep. 2017;389:2179. http://www.thelancet.com.

34.

Traerup SLM, Ortiz RA, Markandya A. The costs of climate change: a study of cholera in Tanzania. Int J Environ Res Public Health. 2011;8:4386–405. https://doi.org/10.3390/ijerph8124386.CrossRefPubMedPubMedCentral

35.

Acosta CJ, Galindo CM, Kimario J, Senkoro K, Urassa H, Casals C, et al. Cholera outbreak in southern Tanzania: risk factors and patterns of transmission. Emerg Infect Dis. 2001;7:583–7.CrossRefPubMedPubMedCentral

36.

Naha A, Chowdhury G, Ghosh-Banerjee J, Senoh M, Takahashi T, Ley B, et al. Molecular characterization of high-level-cholera-toxin-producing El Tor variant Vibrio cholerae strains in the Zanzibar Archipelago of Tanzania. J Clin Microbiol. 2013;51:1040–5.CrossRefPubMedPubMedCentral

37.

Penrose K, de Castro MC, Werema J, Ryan ET. Informal urban settlements and cholera risk in Dares Salaam, Tanzania. PLoS Negl Trop Dis. 2010;4:e631. https://doi.org/10.1371/journal.pntd.0000631.CrossRefPubMedPubMedCentral

38.

Kachwamba Y, Mohammed AA, Lukupulo H, Urio L, Majigo M, Mosha F. Genetic characterization of Vibrio chloerae 01 isolates from outbreaks between 2011 and 2015 in Tanzania. BMC Infect Dis. 2017;17:157. https://doi.org/10.1186/s12879-017-2252-9.CrossRefPubMedPubMedCentral

39.

Hounmanou YMG, Mdegela RH, Dougnon TV, Mhongole OJ, Mayila ES, Malakalinga J, et al. Toxigenic Vibrio cholerae O1 in vegetables and fish raised in wastewater irrigated fields and stabilization ponds during a non-cholera outbreak period in Morogoro, Tanzania: an environmental health study. BMC Res Notes. 2016;9:466. https://doi.org/10.1186/s13104-016-2283-0.CrossRefPubMedPubMedCentral

40.

Chirambo RM, Mufunda J, Songolo P, Kachimba JS, Vwalika B. Epidemiology of the 2016 cholera outbreak of Chibombo district, central Zambia. Med J Zamb. 2016;43:61–3.

41.

Olu O, Babaniyi O, Songolo P, Matapo B, Chizema E, Kapin’ A-Kanyanga M, et al. Cholera epidemiology in Zambia from 2000 to 2010: implications for improving cholera prevention and control strategies in the country. East Afr Med J. 2013;90:324–31.PubMed

42.

Fernandez MAL, Bauernfeind A, Jimenez JD, Gil CL, Omeiri N, Guibert DH. Influence of temperature and rainfall on the evolution of cholera epidemics in Lusaka, Zambia 2003–2006: analysis of a time series. Trans R Soc Trop Med Hyg. 2009;103:137–43.CrossRef

43.

Phiri P, Nzala SH, Baboo KS. Factors associated with the recurring cholera outbreaks in Sinazongwe district of southern Zambia. Med J Zamb. 2015;42:184–92.

44.

Langa JP, Sema C, Dens ND, Colombo MM, Taviani E. Epidemic waves of cholera in the last two decades in Mozambique. J Infect Dev Ctries. 2015;9:635–41. https://doi.org/10.3855/jidc.6943.CrossRefPubMed

45.

Gujral L, Sema C, Rebaudet S, Taibo CLA, Manjate AA, Piarroux R, et al. Cholera epidemiology in Mozambique using national surveillance data. J Infect Dis. 2013;208:107–14.CrossRef

46.

Morof D, Cookson ST, Laver S, Chirundu D, Desai S, Mathenge P, et al. Community mortality from cholera: urban and rural districts in Zimbabwe. Am J Trop Med Hyg. 2013;88:645–50.CrossRefPubMedPubMedCentral

47.

Mason PR. Zimbabwe experiences the worst epidemic of cholera in Africa. J Infect Dis Dev Ctries. 2009;3:148–51.

48.

Chirisa I, Nyamadzawo L, Bandauko E, Mutsindikwa N. The 2008/2009 cholera outbreak in Harare, Zimbabwe: case of failure in urban environmental health and planning. Rev Environ Health. 2015;30:117–24.CrossRefPubMed

49.

Mutonga D, Langat D, Mwangi D, Tonui J, Njeru M, Abede A, et al. National surveillance data on the epidemiology of cholera in Kenya, 1997–2010. J Infect Dis. 2013;208:55–61.CrossRef

50.

Saidi SM, Chowdhury N, Awasthi SP, Asakura M, Hinenoya A, Iijima Y, et al. Prevalence of Vibrio cholerae O1 El Tor variant in a cholera endemic zone of Kenya. J Med Microbiol. 2014;63:415–20.CrossRefPubMed

51.

Stoltzfus JD, Carter JY, Akpinar-Eki M, Matu M, Kimotho V, Giganti MJ, et al. Interaction between climate, environmental and demographic factors on cholera outbreaks in Kenya. Infect Dis Poverty. 2014;3:37.CrossRefPubMedPubMedCentral

52.

Feikin DR, Tabu CW, Gichuki J. Short report: does water hyacinth on East African lakes promote cholera outbreaks? Am J Trop Med Hyg. 2010;83:370–3.CrossRefPubMedPubMedCentral

53.

Kustner HGV, Plessis GDU. The cholera epidemic in South Africa, 1980–1987. South Afr Med J. 1991;79:539–44.

54.

Ismail H, Smith AM, Tau NP, Sooka A, Keddy KH. Cholera outbreak in South Africa, 2008–2009: laboratory analysis of Vibrio cholerae O1 strains. J Infect Dis. 2013;208:39–45.CrossRef

55.

WHO. Cholera country profile: Malawi. World Health Organization Global Task Force on cholera control. http://www.who.int/cholera/countries/MalawiCountryProfile2010.pdf. Accessed 15 Jun 2017.

56.

Msyamboza KP, Kagoli M, M’bang’Ombe M, Chipeta S, Masuku D. Cholera outbreaks in Malawi in 1998–2012: social and cultural challenges in prevention and control. J Infect Dis Dev Ctries. 2014;8:720–6. https://doi.org/10.3855/jdi.3506.CrossRef

57.

Khonje A, Metcalf CA, Diggle E, Mlozowa D, Jere C, Akesson A, et al. Cholera outbreak in districts around Lake Chilwa, Malawi: lessons learned. Malawi Med J. 2012;24:29–33.PubMedPubMedCentral

58.

Smith AM, Keddy KH, De Lee L. Characterization of cholera outbreak isolates from Namibia, December 2006–2007. Epidemiol Infect. 2008;136:1207–9.CrossRefPubMed

59.

Osei FB, Duker AA. Spatial dependency of V. cholera prevalence on open space refuse dumps in Kumasi, Ghana: a spatial; statistical modelling. Int J Health Geogr. 2008;7:62. https://doi.org/10.1186/1476-072x-7-62.CrossRefPubMedPubMedCentral

60.

Eibach D, Herrera-Leon S, Gil H, Hogan B, Ehlkes L, Adjabeng M, et al. Molecular epidemiology and antibiotic susceptibility of Vibrio cholerae associated with a large cholera outbreak in Ghana in 2014. PLoS Negl Trop Dis. 2016;10:e0004751. https://doi.org/10.1371/journal.pntd.0004751.CrossRefPubMedPubMedCentral

61.

Acquah H, Malm K, Der J, Kye-Duodu G, Mensah EK, Sackey SO, et al. Cholera outbreak following a marriage ceremony in Medinya, Western Ghana. Pan Afr Med J. 2016;25:3. https://doi.org/10.11604/pamj.supp.2016.25.1.6167.CrossRefPubMedPubMedCentral

62.

WHO. Cholera country profile: Côte d’Ivoire. World Health Organization Global Task Force on cholera control. http://www.who.int/cholera/countries/CotedIvoirecountryprofile2011.pdf. Accessed 15 Jun 2017.

63.

Traore SG, Bonfoh B, Krabi R, Odermatt P, Utzinger J, Rose K-N, et al. Risk of Vibrio transmission linked to the consumption of crustacean in coastal towns of Cote d’Ivoire. J Food Prot. 2012;75:1004–11. https://doi.org/10.4315/0362-028x.JFP-11-472.CrossRefPubMedPubMedCentral

64.

Oyedeji KS, Niemogha M-T, Nwaokorie FO, Bamidele TA, Ochoga M, Akinsinde KA, et al. Molecular characterization of the circulating strains of Vibrio cholerae during 2010 cholera outbreak in Nigeria. J Health Popul Nutr. 2013;31:178–84.CrossRefPubMedPubMedCentral

65.

WHO. Cholera country profile: Nigeria. World Health Organization Global Task Force on cholera control. http://www.who.int/cholera/countries/NigeriaCountryProfile2012.pdf. Accessed 15 Jun 2017.

66.

Marin MA, Thompson CC, Freitas FS, Fonseca EL, Aboderin AO, Zailani SB. Cholera outbreaks in Nigeria are associated with multidrug resistant atypical El Tor and non-O1/non-O139 Vibrio cholerae. PLoS Negl Trop Dis. 2013;7:e2049. https://doi.org/10.1371/journal.pntd.0002049.CrossRefPubMedPubMedCentral

67.

Sule IB, Yahaya M, Aisha AA, Zainab AD, Ummulkhulthu M, Nguku P. Descriptive epidemiology of a cholera outbreak in Kaduna state, northwest Nigeria. Pan Afr Med J. 2014;27:172. https://doi.org/10.11604/pamj.2017.27.172.11925.CrossRef

68.

Dupke S, Akinsinde KA, Grunow R, Iwalokun BA, Olukoya DK, Oluwadun A, et al. Characterization of Vibrio cholerae strains isolated from the Nigerian cholera outbreak in 2010. J Clin Microbiol. 2016;54:2618–21.CrossRefPubMedPubMedCentral

69.

Adewale AK, Pazhani PG, Abiodun IB, Afolabi O, Kolawole OD, Mukhopadhyay AK, et al. Unique clones of Vibrio cholerae 01 El Tor with Haitian type ctxB allele implicated in the recent cholera epidemics from Nigeria, Africa. PLoS ONE. 2016;11:e0159794. https://doi.org/10.1371/journal.pone.0159794.CrossRefPubMedPubMedCentral

70.

Udonwa NE, Udoh SM, Ikpeme B, Andy I. Intra-family transmission of Vibrio cholerae during a cholera epidemic in rural south-southern Nigeria. Trop Dr. 2008;38:179–80.CrossRef

71.

Dalhat MM, Isa AN, Nguku P, Nasir S-G, Urban K, Abdulaziz M, et al. Descriptive characterization of the 2010 cholera outbreak in Nigeria. BMC Public Health. 2014;14:1167.CrossRefPubMedPubMedCentral

72.

Ishaku AA, Shadrack BE, Ajumobi O, Olayinka A, Nguku P. Investigation of cholera outbreak in an urban north central Nigeria community—the Akwanga experience. Public Health Res. 2014;4:7–12. https://doi.org/10.11604/panj.2017.27.172.11925.CrossRef

73.

Smith S, Nwaokorie F, Awoderu O, Bamidele T, Akinsinde K, Ochoga M, et al. ERIC-PCR analysis of the clinical and environmental strains of V. cholerae during 2013 epidemic in Nigeria. Int J Adv Health Sci. 2015;12:670–80.

74.

Leckebusch GC, Abdussalam AF. Climate and socioeconomic influences on interannual variability of cholera in Nigeria. Health Place. 2015;34:107–17.CrossRefPubMed

75.

Roquet D, Diallo A, Kadio B, Daff BM, Fenech C, Etard J-F. The Senegalese cholera epidemic of 1995 to 1996, an example of the geographic approach to health studies. Cah Sante. 1998;8:421–8.

76.

Sambe-Ba B, Diallo MH, Seck A, Wane AA, de Magny GC, Boye CSB, et al. Identification of atypical El Tor V. cholerae O1 Ogawa hosting SXT element in Senegal, Africa. Front Microbiol. 2017;8:748. https://doi.org/10.3389/fmicb.2017.00748.CrossRefPubMedPubMedCentral

77.

De Magny GC, Thiaw W, Kumar V, Manga NM, Diop BM, Gueye L, et al. Cholera outbreak in Senegal in 2005: was climate a factor? PLoS ONE. 2012;7:e44577. https://doi.org/10.1371/journal.pone.0044577.CrossRefPubMed

78.

Landoh DE, Gessner BD, Badciklou K, Tamekloe T, Nassoury DI, Dagnra A, et al. National surveillance data on the epidemiology of cholera in Togo. J Infect Dis. 2013;208:115-9.

79.

Amaah P. Quantitative and qualitative analysis of the knowledge, attitudes and social representations of cholera in the extreme northern region of Cameroon: the case of Maroua I and Mokolo. Pan Afr Med J. 2014;7:253. https://doi.org/10.11604/panj.2014.17.253.2799.CrossRef

80.

Ujah IAO, Nwaokorie F, Adeneye A, Oladele D, Bamidele T, Musa S, et al. A review of perception and myth on causes of cholera infection in endemic areas of Nigeria. Afr J Microbiol Res. 2015;9:557–64.CrossRef

81.

Merten S, Schaetti C, Manianga C, Lapika B, Chaignat CL, Hutubessy R, et al. Local perceptions of cholera and anticipated vaccine acceptance in Katanga province, Democratic Republic of Congo. BMC Public Health. 2013;3:60.CrossRef

82.

Ngwa MC, Liang S, Kracalik IT, Morris L, Blackburn JK, Mbam LM, et al. Cholera in Cameroon, 2000–2012: spatial and temporal analysis at the operational (Health District) and sub climate level. PLoS Negl Trop Dis. 2016;10:e0005105. https://doi.org/10.1371/journal.pntd.0005105.CrossRefPubMedPubMedCentral

83.

Bwire G, Malimbo M, Maskery B, Eim YE, Mogasale V, Levin A. The burden of cholera in Uganda. PLoS Negl Trop Dis. 2013;7:e254. https://doi.org/10.1371/journal.pntd.0002545.CrossRef

84.

Bwire G, Malimbo M, Kagirita A, Makumbi I, Mintz E, Mengel MA, Orach CG. Nosocomial cholera outbreak in a mental hospital: challenges and lessons learnt from Butabika National Referral Mental Hospital, Uganda. Am J Trop Med Hyg. 2015;93:534–8.CrossRefPubMedPubMedCentral

85.

Mayala BK, Mboera LEG, Gwacha F. Mapping of cholera risks using geographical information system in Ilala district, Tanzania. Tanzan Health Res Bull. 2003;5:8–12.

86.

Alli M, Deen JL, Khatib A, Enwere G, von Seidlein L, Reyburn R, et al. Paperless registration during survey enumerations and large oral cholera mass vaccination in Zanzibar, the United Republic of Tanzania. Bull World Health Organ. 2010;88:556–9.CrossRef

87.

Msyamboza KP, M’bang’ombe M, Hausi H, Chijuwa A, Nkukumila V, Kubwalohw D, et al. Feasibility and acceptability of oral cholera vaccine mass vaccination campaign in response to an outbreak and floods in Malawi. Pan Afr Med J. 2016;23:20. https://doi.org/10.11604/pamj.2016.23.203.8346.CrossRef

88.

Oyedepo JA, Shittu OB, Popoola TOS, Ogunshola EO. Rapid epidemiological mapping of cholera outbreak in parts of Abeokuta metropolis: a GIS-supported post-epidemic assessment. Int J Public Health Epidemiol. 2015;4:152–7.

89.

Ohene SA, Klenyuie W, Sarpeh M. Assessment of the response to cholera outbreaks in two districts in Ghana. Infect Dis Poverty. 2016;5:99. https://doi.org/10.1186/s40249-016-0192-Z.CrossRefPubMedPubMedCentral

90.

Chao DL, Halloran ME, Longini Jr. IM. Vaccination strategies for epidemic cholera in Haiti with implications for developing world. PNAS. 2011;108:7081–5.CrossRefPubMed

91.

Cabrera A, Lepage JE, Sullivan KM, Seed SM. Vaxchora: a single-dose oral cholera vaccine. Ann Pharmacother. 2017. https://doi.org/10.1177/1060028017698162.CrossRefPubMed

Title: Recurrent cholera epidemics in Africa: which way forward? A literature review
Authors: Abraham Ajayi
Stella I. Smith
Publication date: 01-06-2019
Publisher: Springer Berlin Heidelberg
Published in: Infection / Issue 3/2019
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI: https://doi.org/10.1007/s15010-018-1186-5

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