{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:59:21Z","timestamp":1787068761350,"version":"build-2736575974"},"reference-count":79,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>\n                    Cholera is a virulent infectious disease caused by the Gram-negative, comma-shaped bacteria\n                    <jats:italic>Vibrio cholerae<\/jats:italic>\n                    , after ingesting contaminated food and\/or water. If left untreated, it can kill within 5 days. Since mid-2021 the world has recorded a notable increase in the seventh cholera pandemic, with high case fatality rate especially in Sub-Saharan Africa. Oral cholera vaccines are established but not readily available on the market, or if they are, they are not pocket friendly for low-resource-income countries. Hence, with the advent of green factory biotechnology, plant-derived edible vaccines are such a promising approach to supplement conventional vaccine methods. Human travellers are often the major transmitters as they move from region to region. Poor sanitation and inadequate clean water supply are services not readily available in most Sub-Saharan African countries, coupled with insufficient surveillance services, lack of early detection facilities, and the public not having ample awareness concerning sanitation and hygiene. This article highlights the epidemiology of cholera in Africa and expounds on what drives the outbreaks of cholera in this region. The discussion provides an in-depth analysis of the factors leading to the forsaken cholera drivers, emphasizing economic factors, culture, and environmental influences, particularly within the Sub-Saharan African communities. It presents a strategic blueprint approach that includes public health awareness, community participation, government involvement, and exploring emerging research tools. By merging these proposals into a unified context, a collective and practical methodology would be established to tackle the impact of cholera epidemiology that has been sidelined in Sub-Saharan Africa.\n                  <\/jats:p>","DOI":"10.1371\/journal.pntd.0013029","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T13:24:48Z","timestamp":1745414688000},"page":"e0013029","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["Cholera in Sub-Saharan Africa: Unveiling neglected drivers and pathways to elimination"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5040-4818","authenticated-orcid":true,"given":"Beenzu","family":"Siamalube","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Ehinmitan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Runo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maina","family":"Ngotho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justus","family":"Onguso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,4,23]]},"reference":[{"key":"pntd.0013029.ref001","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/s41182-021-00376-2","article-title":"Threats and outbreaks of cholera in Africa amidst COVID-19 pandemic: a double burden on Africa\u2019s health systems","volume":"49","author":"O Uwishema","year":"2021","journal-title":"Trop Med Health"},{"issue":"1","key":"pntd.0013029.ref002","doi-asserted-by":"crossref","first-page":"e016491","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":"EL Koua","year":"2025","journal-title":"BMJ Glob Health"},{"key":"pntd.0013029.ref003","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.ijid.2022.05.039","article-title":"Cholera outbreaks in sub-Saharan Africa during 2010-2019: a descriptive analysis","volume":"122","author":"Q Zheng","year":"2022","journal-title":"Int J Infect Dis"},{"key":"pntd.0013029.ref004","doi-asserted-by":"crossref","first-page":"32","DOI":"10.4314\/rphb.v5i4.4","article-title":"The persistent challenge of cholera in Africa: a complex interplay of factors","volume":"5","author":"S Beenzu","year":"2024","journal-title":"Rwanda Public Health Bulletin"},{"key":"pntd.0013029.ref005","doi-asserted-by":"crossref","first-page":"1607990","DOI":"10.3389\/ijph.2024.1607990","article-title":"Unmasking the neglected cholera outbreaks in Sub-Saharan Africa","volume":"69","author":"B Siamalube","year":"2025","journal-title":"Int J Public Health"},{"key":"pntd.0013029.ref006","unstructured":"World Health Organization International. 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