Cholera outbreaks: Public health implications, economic burden, and preventive strategies

Mona Gamal Mohamed; Eman Abdelaziz Ahmed Dabou; Shaimaa Abdelsamad; Shaimaa Hashem Elsalous; Mona Gamal Mohamed; Eman Abdelaziz Ahmed Dabou; Shaimaa Abdelsamad; Shaimaa Hashem Elsalous

doi:10.3934/publichealth.2025039

AIMS Public Health

2025, Volume 12, Issue 3: 767-795. doi: 10.3934/publichealth.2025039

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Review Special Issues

Cholera outbreaks: Public health implications, economic burden, and preventive strategies

Running title:Cholera outbreaks: Impacts and prevention strategies

RAK College of Nursing, RAK Medical and Health Sciences University, UAE

Received: 23 March 2025 Revised: 26 June 2025 Accepted: 01 July 2025 Published: 05 August 2025

Background
Cholera remains a persistent and deadly global public health threat, with recent years witnessing a resurgence of large-scale outbreaks, particularly in conflict-affected and resource-limited regions. The disease disproportionately affects vulnerable populations lacking access to clean water, sanitation, and essential healthcare services.
Objective
This systematic review aimed to synthesize evidence published between 2019 and 2024 to examine the evolving public health implications, economic burden, and prevention strategies associated with cholera outbreaks globally.
Methods
Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a comprehensive literature search was conducted across the major databases. Eligible studies were screened and assessed for quality and relevance using predefined inclusion criteria and standardized appraisal tools.
Results
The review reveals an integrated perspective on cholera by analyzing the intersection of epidemiological trends, health system readiness, and socioeconomic vulnerabilities. Emerging factors such as climate change, population displacement, and political instability were identified as key contributors to cholera outbreaks. Innovative tools, including predictive modeling and artificial intelligence, demonstrate promise for early detection and response. The review also highlights the benefits and challenges of oral cholera vaccines (OCVs), the critical need for sustainable water and sanitation infrastructure, and the importance of community-based interventions.
Conclusion
This review reinforces the urgency of adopting a multisectoral, systems-based approach to cholera prevention. Applying the “One Health” framework and aligning public health strategies with economic and policy insights can significantly enhance global efforts to reduce cholera's incidence and mortality. The findings inform key research and policy priorities to strengthen preparedness and resilience in high-burden settings.
- cholera outbreaks,
- public health,
- health implications,
- economic burden,
- preventive strategies,
- cholera prevention,
- global health challenges,
- outbreak management,
- health economics
Citation: Mona Gamal Mohamed, Eman Abdelaziz Ahmed Dabou, Shaimaa Abdelsamad, Shaimaa Hashem Elsalous. Cholera outbreaks: Public health implications, economic burden, and preventive strategies[J]. AIMS Public Health, 2025, 12(3): 767-795. doi: 10.3934/publichealth.2025039

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Abstract

Background

Cholera remains a persistent and deadly global public health threat, with recent years witnessing a resurgence of large-scale outbreaks, particularly in conflict-affected and resource-limited regions. The disease disproportionately affects vulnerable populations lacking access to clean water, sanitation, and essential healthcare services.

Objective

This systematic review aimed to synthesize evidence published between 2019 and 2024 to examine the evolving public health implications, economic burden, and prevention strategies associated with cholera outbreaks globally.

Methods

Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a comprehensive literature search was conducted across the major databases. Eligible studies were screened and assessed for quality and relevance using predefined inclusion criteria and standardized appraisal tools.

Results

The review reveals an integrated perspective on cholera by analyzing the intersection of epidemiological trends, health system readiness, and socioeconomic vulnerabilities. Emerging factors such as climate change, population displacement, and political instability were identified as key contributors to cholera outbreaks. Innovative tools, including predictive modeling and artificial intelligence, demonstrate promise for early detection and response. The review also highlights the benefits and challenges of oral cholera vaccines (OCVs), the critical need for sustainable water and sanitation infrastructure, and the importance of community-based interventions.

Conclusion

This review reinforces the urgency of adopting a multisectoral, systems-based approach to cholera prevention. Applying the “One Health” framework and aligning public health strategies with economic and policy insights can significantly enhance global efforts to reduce cholera's incidence and mortality. The findings inform key research and policy priorities to strengthen preparedness and resilience in high-burden settings.

Authors' contributions

Mona Gamal Mohamed conceptualized the study, supervised its development, and led the drafting and critical revision. Eman Abdelaziz Ahmed Dabou conducted the literature review and analyzed the economic burden of cholera. Shaimaa Abdelsamad developed the preventive strategies section and validated intervention content. Shaimaa Hashem Elsalous contributed to the epidemiological analysis, managed references, and finalized the manuscript. All authors approved the final version and take full responsibility for its content.

Conflict of interest

The authors declare no conflicts of interest.

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