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Vaccination is a key intervention to prevent and control cholera in conjunction with water, sanitation and hygiene activities. An oral cholera vaccine (OCV) stockpile was established by the World Health Organization (WHO) in 2013. We reviewed its use from July 2013 to all of 2018 in order to assess its role in cholera control. We computed information related to OCV deployments and campaigns conducted including setting, target population, timelines, delivery strategy, reported adverse events, coverage achieved, and costs. In 2013–2018, a total of 83,509,941 OCV doses have been requested by 24 countries, of which 55,409,160 were approved and 36,066,010 eventually shipped in 83 deployments, resulting in 104 vaccination campaigns in 22 countries. OCVs had in general high uptake (mean administrative coverage 1st dose campaign at 90.3%; 2nd dose campaign at 88.2%; mean survey-estimated two-dose coverage at 69.9%, at least one dose at 84.6%) No serious adverse events were reported. Campaigns were organized quickly (five days median duration). In emergency settings, the longest delay was from the occurrence of the emergency to requesting OCV (median: 26 days). The mean cost of administering one dose of vaccine was 2.98 USD. The OCV stockpile is an important public health resource. OCVs were generally well accepted by the population and their use demonstrated to be safe and feasible in all settings. OCV was an inexpensive intervention, although timing was a limiting factor for emergency use. The dynamic created by the establishment of the OCV stockpile has played a role in the increased use of the vaccine by setting in motion a virtuous cycle by which better monitoring and evaluation leads to better campaign organization, better cholera control, and more requests being generated. Further work is needed to improve timeliness of response and contextualize strategies for OCV delivery in the various settings.

Cholera continues to represent a major public health concern in Ethiopia. The country has developed a Multi-sectoral National Cholera Elimination Plan in 2022, which targets prevention and control interventions in cholera hotspots. Multiple methods to classify cholera hotspots have been used in several countries. Since 2014, a classification method developed by United Nations Children's Fund has been applied to guide water, sanitation and hygiene interventions throughout Sub-Saharan Africa based on three outbreak parameters: frequency, duration and standardized attack rate. In 2019, the Global Task Force on Cholera Control (GTFCC) proposed a method based on two parameters: average annual cholera incidence and persistence. In 2023, an updated GTFCC method for multisectoral interventions considers three epidemiological indicators (cumulative incidence, cumulative mortality and persistence,) and a cholera-case confirmation indicator. The current study aimed to classify cholera hotspots in Ethiopia at the woreda level (equivalent to district level) applying the three methods and comparing the results to optimize the hotspot targeting strategy. From 2015 to 2021, cholera hotspots were located along major routes between Addis Ababa and woredas adjacent to the Kenya and Somalia borders, throughout Tigray Region, around Lake Tana, and in Afar Region. The multi-method comparison enables decision makers to prioritize interventions according to a sub-classification of the highest-priority areas.

This study describes the apparent discontinuation of cholera transmission in Haiti since February 2019. Because vulnerabilities persist and vaccination remains limited, our findings suggest that case-area targeted interventions conducted by rapid response teams played a key role. We question the presence of environmental reservoirs in Haiti and discuss progress toward elimination.

Background The Democratic Republic of the Congo (DRC) implemented the first strategic Multisectoral Cholera Elimination Plan (MCEP) in 2008–2012. Two subsequent MCEPs have since been implemented covering the periods 2013–2017 and 2018–2021. The current study aimed to assess the spatiotemporal dynamics of cholera over the recent 22-year period to determine the impact of the MCEPs on cholera epidemics, establish lessons learned and provide an evidence-based foundation to improve the implementation of the next MCEP (2023–2027). Methods In this cross-sectional study, secondary weekly epidemiological cholera data covering the 2000–2021 period was extracted from the DRC Ministry of Health surveillance databases. The data series was divided into four periods: pre-MCEP 2003–2007 (pre-MCEP), first MCEP (MCEP-1), second MCEP (MCEP-2) and third MCEP (MCEP-3). For each period, we assessed the overall cholera profiles and seasonal patterns. We analyzed the spatial dynamics and identified cholera risk clusters at the province level. We also assessed the evolution of cholera sanctuary zones identified during each period. Results During the 2000–2021 period, the DRC recorded 520,024 suspected cases and 12,561 deaths. The endemic provinces remain the most affected with more than 75% of cases, five of the six endemic provinces were identified as risk clusters during each MCEP period (North Kivu, South Kivu, Tanganyika, Haut-Lomami and Haut-Katanga). Several health zones were identified as cholera sanctuary zones during the study period: 14 health zones during MCEP-1, 14 health zones during MCEP-2 and 29 health zones during MCEP-3. Over the course of the study period, seasonal cholera patterns remained constant, with one peak during the dry season and one peak during the rainy season. Conclusion Despite the implementation of three MCEPs, the cholera context in the DRC remains largely unchanged since the pre-MCEP period. To better orient cholera elimination activities, the method used to classify priority health zones should be optimized by analyzing epidemiological; water, sanitation and hygiene; socio-economic; environmental and health indicators at the local level. Improvements should also be made regarding the implementation of the MCEP, reporting of funded activities and surveillance of cholera cases. Additional studies should aim to identify specific bottlenecks and gaps in the coordination and strategic efforts of cholera elimination interventions at the local, national and international levels.

Cholera poses a public health and economic threat to Zanzibar. Detailed epidemiologic analyses are needed to inform a multisectoral cholera elimination plan currently under development. We collated passive surveillance data from 1997 to 2017 and calculated the outbreak-specific and cumulative incidence of suspected cholera per shehia (neighborhood). We explored the variability in shehia-specific relative cholera risk and explored the predictive power of targeting intervention at shehias based on historical incidence. Using flexible regression models, we estimated cholera's seasonality and the relationship between rainfall and cholera transmission. From 1997 and 2017, 11921 suspected cholera cases were reported across 87% of Zanzibar's shehias, representing an average incidence rate of 4.4 per 10000/year. The geographic distribution of cases across outbreaks was variable, although a number of high-burden areas were identified. Outbreaks were highly seasonal with 2 high-risk periods corresponding to the annual rainy seasons. Shehia-targeted interventions should be complemented with island-wide cholera prevention activities given the spatial variability in cholera risk from outbreak to outbreak. In-depth risk factor analyses should be conducted in the high-burden shehias. The seasonal nature of cholera provides annual windows of opportunity for cholera preparedness activities.

Fighting cholera and documenting progress comes with a number of cholera-specific challenges due to its diverse transmission dynamics, the lack of highly cholera-specific symptoms, that laboratory confirmation has little bearing on appropriate treatment and that no intervention alone can sustainably control cholera. Reporting of suspected cholera alone, especially when case definitions vary from place to place, can result in a distorted picture of the true geographic distribution of cholera, both due to differences in the circulation of other pathogens and simple differences in reporting. Other potential indicators include the outbreak recurrence frequency, proportion of months with active cholera transmission, the age distribution of cases, and measures of the geographic expansion of an outbreak after a confirmed case. [...]in incidence hotspots, both short-term and long-term approaches are needed, combining the use of OCV and preparations for appropriate case management with long-term behavior change and infrastructure programs.

Background Cholera remains a significant public health concern in Nigeria, with recurrent outbreaks over the past five decades. Despite advancements in healthcare, the country continues to record high case fatality rates, largely due to inadequate water, sanitation, and hygiene (WASH) infrastructure, poor health systems, climate variability, and conflict-induced displacement. Objective This review aimed to examine the historical trends of cholera in Nigeria, identify key drivers of outbreaks, evaluate government and international responses, and recommend strategic measures for prevention and control. Methods A comprehensive analysis was conducted using historical outbreak data, peer-reviewed literature, and reports from national and international health agencies. The study focuses on outbreaks from 1970 to 2024, highlighting epidemiological trends, response strategies, and systemic challenges. Results Cholera has persisted as an endemic disease in Nigeria, with major outbreaks recorded in 1991, 2010, and 2021. Case fatality rates often exceeded the World Health Organization’s (WHO) recommended threshold of < 1%, indicating systemic deficiencies in outbreak response and healthcare delivery. Contributing factors include poor sanitation, limited access to clean water, underfunded healthcare infrastructure, and weak surveillance systems. Climate change and population displacement due to conflict have further exacerbated the risk of transmission. Conclusion Nigeria’s approach to cholera control remains reactive, with limited progress in sustainable prevention. Multi-sectoral strategies including improved WASH infrastructure, enhanced surveillance, local vaccine production, and community-based interventions are essential to achieving the WHO 2030 cholera elimination goals.

We evaluated published and unpublished data on cholera cases and deaths reported from clinical care facilities in the 56 health districts of the Democratic Republic of Congo to the National Ministry of Health during 2000-2011. Cholera incidence was highest in the eastern provinces bordering lakes and epidemics primarily originated in this region. Along with a strong seasonal component, our data suggest a potential Vibrio cholerae reservoir in the Rift Valley lakes and the possible contribution of the lakes' fishing industry to the spread of cholera. The National Ministry of Health has committed to the elimination—rather than control—of cholera in DRC and has adopted a new national policy built on improved alert, response, case management, and prevention. To achieve this goal and implement all these measures it will require strong partners in the international community with a similar vision.

Efforts to control and eliminate measles and rubella are aided by high-quality surveillance data—supported by laboratory confirmation—to guide decision-making on routine immunization strategies and locations for conducting preventive supplementary immunization activities (SIAs) and outbreak response. Important developments in rapid diagnostic tests (RDTs) for measles and rubella present new opportunities for the global measles and rubella surveillance program to greatly improve the ability to rapidly detect and respond to outbreaks. Here, we review the status of RDTs for measles and rubella Immunoglobulin M (IgM) testing, as well as ongoing questions and challenges regarding the operational use and deployment of RDTs as part of global measles and rubella surveillance. Efforts to develop IgM RDTs that can be produced at scale are underway. Once validated RDTs are available, clear information on the benefits, challenges, and costs of their implementation will be critical for shaping deployment guidance and informing country plans for sustainably deploying such tests. The wide availability of RDTs could provide new programmatic options for measles and rubella elimination efforts, potentially enabling improvements and flexibility for testing, surveillance, and vaccination.

This paper evaluated UNICEF’s Water, Sanitation, and Hygiene (WASH) programme in Nigeria with an emphasis on the successes achieved, challenges encountered, and prospects to build on, with a special focus on Anambra State. This evaluation became pertinent given the report on WATER AIDS, which found that 67% of Nigerians lack access to basic sanitation, which has been linked to the prevalence of diarrhea cholera, typhoid and other deadly diseases, especially among children and women. This study employed descriptive survey and documentary research designs and utilised both primary and secondary methods of data collection. Data were analysed using the descriptive analytical method, and the study was founded on the theory of change. The study found that WASH Programme has improved access to safe drinking water in Anambra state, improved awareness and consciousness of hand-washing practice and aided in the elimination of open defecation. Some challenges to the WASH programme encountered include inadequate funding and poor maintenance of hygiene facilities. As a result, we recommend corporate synergic funding to sustain the achieved results, and an inbuilt maintenance and sustainability plan and massive sensitisation exercises by the local governments concerned.