{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T20:28:25Z","timestamp":1793824105939,"version":"4.6.1"},"reference-count":31,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"unspecified","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,1,15]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cholera remains a major global health concern, particularly in fragile and resource-limited settings despite global efforts to reduce cholera morbidity and mortality. While community engagement is widely recognised as a cornerstone of sustainable cholera control, evidence on its effective implementation, particularly the concrete roles of communities in preparedness, response and resilience, is currently fragmented and poorly documented.<\/jats:p>\n                    <jats:p>This protocol describes a systematic review that aims to identify and synthesise global evidence on how communities contribute to cholera preparedness, response and resilience, with a focus on identifying enablers, barriers and best practices in diverse contexts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This protocol adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols updated in 2020 guidelines. A comprehensive literature search will be conducted across major databases (eg, PubMed\/MEDLINE, Web of Science, CINAHL, AJOL) and institutional repositories (eg, WHO Institutional Repository for Information Sharing (IRIS),International Federation of Red Cross and Red Crescent Societies, United Nations Office for the Coordination of Humanitarian Affairs (OCHA)). The search will target peer-reviewed and grey literature published between January 2000 and December 2025 in all languages. Eligible studies include those describing community-level interventions, participation or engagement in cholera epidemic preparedness, response or resilience activities. Study selection and data extraction will be independently performed by six reviewers in pairs, with quality appraised using Joanna Briggs Institute tools. A narrative and thematic synthesis will be conducted across the three domains (preparedness, response and resilience), with subgroup analyses performed where data allow.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval is not required. Findings will be disseminated through publications and presentations and will identify crucial research gaps. This review will support global health actors, including the Global Task Force on Cholera Control, by directly informing guidance for community-driven cholera control strategies and policy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD420251105088.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-003743","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T16:05:15Z","timestamp":1776269115000},"page":"e003743","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Role of communities in preparedness, response and resilience to cholera epidemics: a systematic review protocol"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4612-5058","authenticated-orcid":false,"given":"Aime Gilbert","family":"Mbonda Noula","sequence":"first","affiliation":[{"name":"Public Health, University of Yaounde Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Njuwa Fai","sequence":"additional","affiliation":[{"name":"Africa CDC, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tavar\u00e8s","family":"Koudimba Mboungou","sequence":"additional","affiliation":[{"name":"Union for the Study and Research on Population and Development (UERPOD), Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Lemonge","sequence":"additional","affiliation":[{"name":"Clinton Health Access Initiative, Yaounde, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tambe","family":"Elvis Akem","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res, Yaounde, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9206-1596","authenticated-orcid":false,"given":"Stephen Ogirima","family":"Ohize","sequence":"additional","affiliation":[{"name":"Global Task Force on Cholera Control (GTFCC) Country Support Platform, IFRC, Yaounde, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Hajjar","sequence":"additional","affiliation":[{"name":"University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Fouda Mbarga","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Kamgno","sequence":"additional","affiliation":[{"name":"University of Yaounde, Yaound\u00e9, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"2026041509051073000_4.2.e003743.1","unstructured":"WHO . Ending cholera a global roadmap to 2030. Ending cholera a global roadmap to 2030, 2017. Available: https:\/\/www.gtfcc.org\/wp-content\/uploads\/2019\/10\/gtfcc-ending-cholera-a-global-roadmap-to-2030.pdf [Accessed 13 Mar 2024]."},{"key":"2026041509051073000_4.2.e003743.2","doi-asserted-by":"crossref","first-page":"378","DOI":"10.2471\/BLT.19.233965","article-title":"Health systems research in fragile settings","volume":"97","author":"Ager","year":"2019","journal-title":"Bull World Health Organ"},{"key":"2026041509051073000_4.2.e003743.3","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1007\/s15010-018-1186-5","article-title":"Recurrent cholera epidemics in Africa: which way forward? A literature review","volume":"47","author":"Ajayi","year":"2019","journal-title":"Infection"},{"key":"2026041509051073000_4.2.e003743.4","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1093\/heapol\/czz142","article-title":"Understanding fragility: implications for global health research and practice","volume":"35","author":"Diaconu","year":"2020","journal-title":"Health Policy Plan"},{"key":"2026041509051073000_4.2.e003743.5","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1093\/heapol\/czae067","article-title":"Enablers and barriers to implementing cholera interventions in Nigeria: a community-based system dynamics approach","volume":"39","author":"Elimian","year":"2024","journal-title":"Health Policy Plan"},{"key":"2026041509051073000_4.2.e003743.6","unstructured":"UNICEF . UNICEF Yemen Humanitarian Situation Report. Yemen: UNICEF Yemen, 2021."},{"key":"2026041509051073000_4.2.e003743.7","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/S0140-6736(23)00386-0","article-title":"\u201cThings have gone seriously wrong\u201d: global cholera surges","volume":"401","author":"Burki","year":"2023","journal-title":"The Lancet"},{"key":"2026041509051073000_4.2.e003743.8","doi-asserted-by":"crossref","first-page":"973","DOI":"10.4269\/ajtmh.2006.75.973","article-title":"Review of reported cholera outbreaks worldwide, 1995-2005","volume":"75","author":"Griffith","year":"2006","journal-title":"Am J Trop Med Hyg"},{"key":"2026041509051073000_4.2.e003743.9","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiy444"},{"key":"2026041509051073000_4.2.e003743.10","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1004404","article-title":"Case-area targeted interventions during a large-scale cholera epidemic: A prospective cohort study in Northeast Nigeria","volume":"21","author":"OKeeffe","year":"2024","journal-title":"PLoS Med"},{"key":"2026041509051073000_4.2.e003743.11","doi-asserted-by":"crossref","unstructured":"Ali M , Nelson AR , Lopez AL , et al . n.d. Updated Global Burden of Cholera in Endemic Countries. PLoS Negl Trop Dis 9:e0003832. doi:10.1371\/journal.pntd.0003832","DOI":"10.1371\/journal.pntd.0003832"},{"key":"2026041509051073000_4.2.e003743.12","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2024-016491","article-title":"Exploring the burden of cholera in the WHO African region: patterns and trends from 2000 to 2023 cholera outbreak data","volume":"10","author":"Koua","year":"2025","journal-title":"BMJ Glob Health"},{"key":"2026041509051073000_4.2.e003743.13","unstructured":"World Health Organization . Community engagement: a health promotion guide for universal health coverage in the hands of the people. 2020."},{"key":"2026041509051073000_4.2.e003743.14","doi-asserted-by":"publisher","DOI":"10.1002\/hpm.2882"},{"key":"2026041509051073000_4.2.e003743.15","doi-asserted-by":"crossref","unstructured":"Workineh AA , Sasie SD , Mengesha S , et al . Enhancing community engagement in cholera response: a phenomenological study of health development army members in Sidama Region, Ethiopia. Journal of Global Health Economics and Policy 2025;5. doi:10.52872\/001c.143064","DOI":"10.7189\/001c.143064"},{"key":"2026041509051073000_4.2.e003743.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.inhe.2009.02.001"},{"key":"2026041509051073000_4.2.e003743.17","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1080\/09540121.2010.525812","article-title":"Towards a \u201cfourth generation\u201d of approaches to HIV\/AIDS management: creating contexts for effective community mobilisation","volume":"22 Suppl 2","author":"Campbell","year":"2010","journal-title":"AIDS Care"},{"key":"2026041509051073000_4.2.e003743.18","doi-asserted-by":"crossref","first-page":"79","DOI":"10.3310\/nihropenres.13983.1","article-title":"Community Resilience to Cholera Epidemics in Uganda: A Realist-informed review of Vulnerability and Intervention mechanisms","volume":"5","author":"Namakula","year":"2025","journal-title":"NIHR Open Res"},{"key":"2026041509051073000_4.2.e003743.19","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2024-017055","article-title":"Building resilience against cholera: lessons from the implementation of integrated community strategy for cholera control in Zambia","volume":"10","author":"Mwale","year":"2025","journal-title":"BMJ Glob Health"},{"key":"2026041509051073000_4.2.e003743.20","doi-asserted-by":"crossref","first-page":"3380","DOI":"10.1038\/s41591-025-03847-9","article-title":"Geographical shifting of cholera burden in Africa and its implications for disease control","volume":"31","author":"Perez-Saez","year":"2025","journal-title":"Nat Med"},{"key":"2026041509051073000_4.2.e003743.21","doi-asserted-by":"crossref","first-page":"643079","DOI":"10.3389\/fpubh.2021.643079","article-title":"Influence of Community-Led Total Sanitation and Water Coverages in the Control of Cholera in Madarounfa, Niger (2018)","volume":"9","author":"Graveleau","year":"2018","journal-title":"Front Public Health"},{"key":"2026041509051073000_4.2.e003743.22","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2024-016168","article-title":"An assessment of the progress made in the implementation of the regional framework for cholera prevention and control in the WHO African region","volume":"10","author":"Kapaya","year":"2025","journal-title":"BMJ Glob Health"},{"key":"2026041509051073000_4.2.e003743.23","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0005087","article-title":"Exploring barriers and associated factors in the preparedness for cholera outbreak response in Public Health Centres of Addis Ababa, Ethiopia","volume":"5","author":"Derese","year":"2025","journal-title":"PLOS Glob Public Health"},{"key":"2026041509051073000_4.2.e003743.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2021.02.003"},{"key":"2026041509051073000_4.2.e003743.25","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-4-1"},{"key":"2026041509051073000_4.2.e003743.26","unstructured":"World Health Organization . WHO guideline on health policy and system support to optimize community health worker programmes. Geneva; 2018."},{"key":"2026041509051073000_4.2.e003743.27","doi-asserted-by":"crossref","DOI":"10.1080\/16549716.2017.1272223","article-title":"Who is a community health worker? - a systematic review of definitions","volume":"10","author":"Olaniran","year":"2017","journal-title":"Glob Health Action"},{"key":"2026041509051073000_4.2.e003743.28","unstructured":"What works: Community engagement and empowerment to address health inequalities [Internet]. Health Equity Evidence Centre, 2025. Available: https:\/\/www.heec.co.uk\/resource\/what-works-community-engagement-and-empowerment-to-address-health-inequalities\/ [Accessed 22 Nov 2025]."},{"key":"2026041509051073000_4.2.e003743.29","doi-asserted-by":"crossref","first-page":"467","DOI":"10.11124\/JBIES-22-00224","article-title":"Assessing the risk of bias of quantitative analytical studies: introducing the vision for critical appraisal within JBI systematic reviews","volume":"21","author":"Munn","year":"2023","journal-title":"JBI Evid Synth"},{"key":"2026041509051073000_4.2.e003743.30","doi-asserted-by":"publisher","DOI":"10.3233\/EFI-180221"},{"key":"2026041509051073000_4.2.e003743.31","doi-asserted-by":"crossref","DOI":"10.1186\/s13012-017-0688-3","article-title":"Applying GRADE-CERQual to qualitative evidence synthesis findings: introduction to the series","volume":"13","author":"Lewin","year":"2018","journal-title":"Implement Sci"}],"container-title":["BMJ Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjph-2025-003743","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T16:05:20Z","timestamp":1776269120000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjpublichealth.bmj.com\/lookup\/doi\/10.1136\/bmjph-2025-003743"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":31,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4,15]]},"published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1136\/bmjph-2025-003743"],"URL":"https:\/\/doi.org\/10.1136\/bmjph-2025-003743","relation":{},"ISSN":["2753-4294"],"issn-type":[{"value":"2753-4294","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]}}}