Evidence map›Paper›PMID 41392247›Full record

ReviewConflict and health2025

The management of cholera in populations affected by conflict in Africa and the Middle-East: a scoping review.

Rayan Mohamed, Yosra AdamSabi, Saria Hassan, Anfal Mahmoud, Doaa Mohammadat, Eslam S Abdalla, Gawaher Mutawali, Ladin Ali, Lana Shabat, Lina Mohamedahmed and 5 more

Abstract readReview
In one paragraph

Review in Conflict and health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Rayan Mohamed *Faculty of Dentistry, University of Khartoum, Sustainable Development Response Organization (SuDRO), Khartoum, Sudan.
Yosra AdamSabi *Faculty of Medicine, Sudan International University, Sustainable Development Response Organization (SuDRO), Khartoum, Sudan.
Saria HassanDivision of General Medicine, Department of Medicine, Emory Global Diabetes Research Center, Hubert Department of Global Health, Emory University School of Medicine, Rollins School of Public Health, Atlanta, USA.
Anfal MahmoudFaculty of Pharmacy, Al Neelain University, Sustainable Development Response Organization (SuDRO), Khartoum, Sudan.
Doaa MohammadatDepartment of Pediatrics and Child Health, Sustainable Development Response Organization (SuDRO), University of Khartoum, Khartoum, Sudan. duaa.mohammadat@gmail.com.
Eslam S AbdallaFaculty of Pharmacy, Ahfad University for Women, Sustainable Development Response Organization (SuDRO), Khartoum, Sudan.
Gawaher MutawaliFaculty of Medicine, Cairo University, Sustainable Development Response Organization (SuDRO), Khartoum, Sudan.
Ladin AliFaculty of Medicine, University of Khartoum, Sustainable Development Response Organization (SuDRO), Khartoum, Sudan.
Lana ShabatFaculty of Medicine, National University, Sustainable Development Response Organization (SuDRO), Khartoum, Sudan.
Lina MohamedahmedFaculty of Medicine, University of Khartoum, Sustainable Development Response Organization (SuDRO), Khartoum, Sudan.
Maha QassimFaculty of Medicine, Sustainable Development Response Organization (SuDRO), University of Science and Technology, Khartoum, Sudan.
Monzer SeedahmedFaculty of Medicine/Sustainable Development Response Organization (SuDRO), Zagazig University, Khartoum, Sudan.
Mowafag H SalihFaculty of Medicine/Sustainable Development Response Organization (SuDRO), Ibn Sina University, Khartoum, Sudan.
Alrumaisa AlhassanFaculty of Medicine, University of Khartoum, Sustainable Development Response Organization (SuDRO), Khartoum, Sudan.ORCID http://orcid.org/0009-0001-5052-8933
Mohammed Hamed Ibrahium BadiUniversity of Khartoum Faculty of Medicine - EDC Khartoum, Khartoum, Sudan.ORCID http://orcid.org/0009-0001-8548-8476

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCholera is a life-threatening disease caused by ingesting food or water contaminated with V. cholerae. Armed conflicts disrupt healthcare infrastructure, limit access to clean water, and exacerbate population displacement, leading to increased vulnerability to cholera outbreaks. This scoping review aims to assess cholera control strategies in conflict settings in Africa and the Middle East, with the goal of identifying effective and feasible interventions.

methodsWe followed PRISMA guidelines and conducted a comprehensive search of peer-reviewed literature in PubMed, Web of Science, Scopus, and Cochrane in November 2024. We included all study types on public health interventions for cholera management in Africa and the Middle East during conflict that were published from 1st January 2009 to 15 November 2024.

resultTwenty-five studies were included in this review; the data were synthesized narratively following PRISMA guidance. The review identified various cholera control interventions implemented in conflict settings, categorized into four main themes: vaccination, water, sanitation, and hygiene (WASH) interventions, case management and clinical interventions, and multicomponent strategies. Oral cholera vaccine (OCV) campaigns significantly reduced cholera incidence (up to 80%), especially when achieving high coverage rates (70-90%). Vaccination campaigns were effective, but they faced logistical challenges, including vaccine shortages and limitations in the cold chain. WASH interventions, including water purification and hygiene promotion, were effective in lowering microbial contamination and improving health outcomes. WASH interventions were often disrupted by conflict-related damage to infrastructure. Case management approaches, such as oral rehydration therapy and antibiotic use, played a crucial role in reducing mortality, but they required improved accessibility and antibiotic stewardship. Multicomponent interventions integrating vaccination, WASH, and case management demonstrated the highest impact on cholera control.

conclusionCholera control in conflict settings demands a phased and evidence-based approach backed by flexible funding and prospective operational research. Prioritization should be given to immediate high-impact measures, short-term completion of two-dose vaccination and case area targeted interventions (CATIs), and long-term resilient WASH and vaccine reserves.

Indexed as

Africa and the middle eastCholera vaccinesCommunity participationDisease outbreaksHealth promotion campaignsPublic healthRefugee campsSanitation and hygiene (WASH)Vaccination programsVibrio choleraeWater

Identifiers

PMID41392247
PMCPMC12822156

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.