Zambia's battle against cholera outbreaks and the path to public health resilience: a narrative review

Abstract

In Zambia, cholera has been a persistent public health concern for decades, mainly attributed to inadequate sanitation and restricted access to clean water in some parts of the country. The literature was collected from PubMed, Google Scholar, and public health organization websites, focusing on cholera outbreaks in Zambia since 2000. Key search terms included 'cholera prevention' and 'Zambia outbreaks.' A total of 30 articles were analyzed to assess public health strategies and identify gaps for future planning. Periodic outbreaks of cholera have characterized Zambia's history by significant fluctuations in case numbers and fatalities since 1977. Notably, the years 1993, 1999, 2003/2004, 2005/2006, 2010, 2017/2018, and the most recent outbreak from October 2023 to February 2024 have marked significant episodes in the country's struggle against this waterborne disease. This narrative review examines the recurrent outbreaks of cholera in Zambia to understand the recent outbreak's extraordinary spread and severity in the context of public health resilience. The most recent outbreak with a staggering 19,719 cases and 682 deaths highlights the unprecedented scale and severity of the current public health emergency. The findings highlight the need for a holistic public health approach that prioritizes resilience in disease prevention.

Keywords: WASH; Zambia; cholera; community engagement; health system strengthening; public health resilience; recurrence.