Endemic and Epidemic Cholera in Africa

Abstract

Cholera had entered the African continent during the late 1880s mainly through trade and travel from the Asian region. The 7th cholera pandemic had started from the early 1970s and is rampant till to-date claiming many lives. Though the endemicity of cholera is common in many African and Asian countries, the morbidity and mortality are relatively high in Africa. This has been attributed mainly due to lack of health and hygiene of the population, scarcity of water, prevailing multidrug-resistant strains of Vibrio cholerae O1, and to a lesser extent the management of cholera in the early 1990s. Molecular epidemiological studies revealed that there is a propensity of the pathogen to change its clonality that has been attributed to the recurrent infection and waves of cholera epidemics in many African countries. One of the mysteries is why the spread of V. cholerae O139 serogroup is restricted only to Asian countries despite the geographical proximity and common mode of transmission. This chapter reviews cholera status in Africa viewed through many aspects of the epidemiology.