Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
[Preprint]. 2024 Dec 9:rs.3.rs-5275711.
doi: 10.21203/rs.3.rs-5275711/v1.

Five Social Dynamics Influencing Cholera risks in the City of Goma, Democratic Republic of Congo: A qualitative Study

Felicien Masanga Maisha  1 , Ndemo Mumbere Mbasa  2 , Kennedy Ulikuwe  2 , Serge Kahatwa  3 , Connie Mulligan  4 , Glenn Morris  5 , Kevin Bardosh  6
Affiliations

Five Social Dynamics Influencing Cholera risks in the City of Goma, Democratic Republic of Congo: A qualitative Study

Felicien Masanga Maisha et al. Res Sq. .

Update in

Abstract

Background: Cholera remains a major (and increasing) global public health problem. Goma, in the eastern Democratic Republic of Congo (DRC), has been a major cholera hotspot in Africa since 1994 and is currently experiencing one of the largest outbreaks in the world. This article contributes to the existing scholarship on cholera risk by utilizing a variety of qualitative research methods.

Methods: Data were collected between 2021 and 2022 using in-depth interviews, narrative interviews, key informant interviews, transect walks and a participatory mapping workshop, in six areas of Goma. Local understanding of cholera risk stretched across five categories.

Results: First, specific social groups were at increased risk based on age and gender (children, women, elderly), health status (chronic diseases, exposure to cholera treatment centers [CTC]), occupational risks (fishermen, markets) and socio-economic status (impoverished households, refugees, prisoners). Second, cholera risks were framed in relation to broader events such as conflict, population growth, climate change, and volcanic eruptions. Third, the lack of water infrastructure prompted use of unsafe drinking water from Lake Kivu and surrounding lakes. Accessibility of chlorinated water sources was impacted by social connection and cost. Fourth, cholera risk was ascribed to challenges with care seeking and treatment, such as homecare practices, transportation, and substandard practices at CTCs; and issues with implementation of prevention strategies, including vaccination campaigns. Finally, public health outreach practices were viewed as sources of risk by an overemphasis of emergency response teams and insufficient empowerment of communities.

Conclusion: We offer new empirical perspectives on the range of factors that contribute to cholera risk in Goma. These factors should be addressed by implementing diverse strategies, rather than focusing on rapid response interventions. Specifically, development of a safe and reliable water system to treat the chronic nature of cholera infection in the DRC should be prioritized.

Keywords: Democratic Republic of Congo; Goma; cholera risks; dynamic; public health; safe water; social.

PubMed Disclaimer

Conflict of interest statement

Additional Declarations: No competing interests reported.

Figures

Figure 1
Figure 1
Map of Goma showing the data collection sites
Figure 2
Figure 2
Fieldwork images of cholera risk in Goma, DRC
See this image and copyright information in PMC

References

    1. Ali M, Nelson AR, Lopez AL, Sack DA. Updated global burden of cholera in endemic countries. PLoS Negl Trop Dis. 2015;9(6):e0003832. - PMC - PubMed
    1. WHO. Cholera in the WHO African Region, Weekly Regional Cholera Bulletin. 2023.
    1. Taty N, de Vos D, Pirnay JP, Bompangue D. The cholera endemic in the Democratique republic of Congo: The last decades. Int J Infect Dis. 2020;101:122–3.
    1. WHO. Ending cholera a global roadmap to 2030. In: Ending cholera a global roadmap to 2030. 2017. p. 32–32.
    1. Morris JG Jr. Cholera—modern pandemic disease of ancient lineage. Emerg Infect Dis. 2011;17(11):2099. - PMC - PubMed

Publication types

LinkOut - more resources