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

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.
- University College London United Kingdom
- University of London United Kingdom
- University of Agder Norway
- MRC Unit the Gambia Gambia
- Medical Research Council United Kingdom
330, TRANSMISSION, Climate Change, drought, Review, 910, Environmental & Occupational Health, Disease Outbreaks, Cholera, Tropical Medicine, EAST-AFRICA, EL-NINO, Humans, Vibrio cholerae, Public, Environmental & Occupational Health, VULNERABILITY, RISK, Science & Technology, Water, EPIDEMIC CHOLERA, Public, Droughts, climate change, FRESH-WATER AVAILABILITY, outbreaks, INDIAN-OCEAN, PROJECTIONS, Africa, Parasitology, HEALTH, Life Sciences & Biomedicine
330, TRANSMISSION, Climate Change, drought, Review, 910, Environmental & Occupational Health, Disease Outbreaks, Cholera, Tropical Medicine, EAST-AFRICA, EL-NINO, Humans, Vibrio cholerae, Public, Environmental & Occupational Health, VULNERABILITY, RISK, Science & Technology, Water, EPIDEMIC CHOLERA, Public, Droughts, climate change, FRESH-WATER AVAILABILITY, outbreaks, INDIAN-OCEAN, PROJECTIONS, Africa, Parasitology, HEALTH, Life Sciences & Biomedicine
citations This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).42 popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.Top 10% influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).Top 10% impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.Top 1%
