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Review
. 2022 Feb;116(1):3-12.
doi: 10.1080/20477724.2021.1981716. Epub 2021 Oct 2.

Drought-related cholera outbreaks in Africa and the implications for climate change: a narrative review

Gina E C Charnley  1   2 , Ilan Kelman  3   4   5 , Kris A Murray  1   2   6
Affiliations
Review

Drought-related cholera outbreaks in Africa and the implications for climate change: a narrative review

Gina E C Charnley et al. Pathog Glob Health. 2022 Feb.

Abstract

Africa has historically seen several periods of prolonged and extreme droughts across the continent, causing food insecurity, exacerbating social inequity and frequent mortality. A known consequence of droughts and their associated risk factors are infectious disease outbreaks, which are worsened by malnutrition, poor access to water, sanitation and hygiene and population displacement. Cholera is a potential causative agent of such outbreaks. Africa has the highest global cholera burden, several drought-prone regions and high levels of inequity. Despite this, research on cholera and drought in Africa is lacking. Here, we review available research on drought-related cholera outbreaks in Africa and identify a variety of potential mechanisms through which these outbreaks occurred, including poor access to water, marginalization of refugees and nomadic populations, expansion of informal urban settlements and demographic risks. Future climate change may alter precipitation, temperature and drought patterns, resulting in more extremes, although these changes are likely to be spatially heterogeneous. Despite high uncertainty in future drought projections, increases in drought frequency and/or durations have the potential to alter these related outbreaks into the future, potentially increasing cholera burden in the absence of countermeasures (e.g. improved sanitation infrastructure). To enable effective planning for a potentially more drought-prone Africa, inequity must be addressed, research on the health implications of drought should be enhanced, and better drought diplomacy is required to improve drought resilience under climate change.

Keywords: Africa; Vibrio cholerae; climate change; drought; outbreaks.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Risk factors reported in the included literature, covering those stated as being significant either statistically or not.
Figure 2.
Figure 2.
Schematic representation of potential risk factor cascades caused by droughts leading to cholera outbreaks in Africa.
See this image and copyright information in PMC

References

    1. Ali M, Lopez AL, You Y, et al. The global burden of cholera. Bull World Health Organ. 2012;90(3):209–218. - PMC - PubMed
    1. Germani Y, Quilici ML, Glaziou P, et al. Emergence of cholera in the Central African Republic. Eur J Clin Microbiol Infect Dis. 1998;17(12):888. - PubMed
    1. World Health Organization . Cholera. [On-line]; 2020. [cited 2020 Jul 20]. Available from: https://www.who.int/health-topics/cholera#tab=tab_1
    1. Nkoko DB, Giraudoux P, Plisnier PD, et al. Dynamics of cholera outbreaks in Great Lakes region of Africa, 1978–2008. Emerg Infect Dis. 2011;17(11):2026. - PMC - PubMed
    1. World Health Organization . Ending cholera a global roadmap to 2030. In: Ending cholera a global roadmap to 2030. Geneva: World Health Organization; 2017, pp.4.

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