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

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.