Exploring the Impact of Traditional Practices on Vibrio cholerae Outbreaks in Rural Nigerian Communities: A Field Study with Educational and Behavioral Interventions

Abstract

This study examined the link between traditional practices, water stewardship, and cholera outbreaks in three rural Nigerian communities (Enugu, Delta, and Ondo States) in 2020. A sample of 180 participants, representing different socio-economic backgrounds, was surveyed using a mixed-methods approach. Knowledge-based pre-test and post-test measures were employed to assess changes in the understanding of cholera transmission, prevention, and water infrastructure. Chi-square and logistic regression analyses were applied to examine the relationship between socioeconomic status, trust in traditional water sources, and cholera knowledge. Educational seminars were conducted, followed by six months, before administering the post-test to the same population. Key findings revealed that 47% of respondents washed animals in water sources, 42% did not treat their water, and 53% were unaware of cholera-reporting practices. The post-test results showed that 80% of participants could correctly identify cholera symptoms following educational interventions (p < 0.001). Water, sanitation, and hygiene (WaSH) program awareness was significantly associated with reduced cholera incidence (p = 0.005), while certain cultural practices, such as washing slaughtered animals in main water sources, were associated with increased cholera (p < 0.002). This study highlights the need for increased awareness of source water quality, better stewardship, and trust-building efforts to provide culturally appropriate interventions in mitigating these outbreaks.

Keywords: WaSH; cholera; community engagement; sanitation; underserved communities; waterborne disease.

Figure 1

Map of Nigeria on the West Coast of Africa showing position of Ondo, Delta, and Enugu States. Adapted from https://d-maps.com/carte.php?num_car=4864&lang=en (accessed on 9 February 2025).

Figure 2

Sampling strategy for community selection and risk categorization in cholera prevention study in rural Nigerian communities.

Figure 3

Trends in cholera incidence before and after the intervention in three Nigerian states (data taken from Table 8, which provides 95% confidence intervals (p < 0.05)).