[1]Medugu, N., 1Israel-Aliu, O., 1Jibril, I., [2]Egah, R., [3][4]Garba, R. D., 4Musa-Booth, T., and *1Adegboro, B.
1Department of Medical Microbiology and Immunology, Nile University of Nigeria, Abuja, Nigeria
2International Foundation against Infectious Disease in Nigeria, Abuja, Nigeria
3Department of Public Health, Nile University of Nigeria, Abuja, Nigeria
411928 Woodlawn Drive, Woodlawn, Maryland 21207, USA *Correspondence to: boaz.adegboro@nileuniversity.edu.ng
Abstract:
Background: Cholera remains recurrent in Nigeria, with outbreak location and magnitude varying over time in relation to population displacement, flooding, rapid urban growth, and constraints in water and sanitation services. Published microbiological and genomic studies describe circulation of seventh-pandemic Vibrio cholerae O1 El Tor lineages in Nigeria, with antimicrobial resistance (AMR) reported in multiple isolate series and occasional reports of non-O1/non-O139 strains.
Methodology: We conducted an integrative review combining Nigeria cholera surveillance reporting (January 1, 2017 to December 31, 2024) with microbiological and genomic literature relevant to Nigeria. State and year outbreak patterns were synthesized from national and partner reports. Microbiological characteristics, lineage assignments, and resistance mechanisms were summarized from peer reviewed literature and selected grey literature.
Results: Across 2017 to 2024, Nigeria experienced recurrent cholera surges with shifting geographic concentration. Northern states frequently contributed a large share of reported cases, particularly in conflict-affected and displacement settings, while recent reports also indicate risk in densely populated urban settlements. Microbiological evidence describes predominance of V. cholerae O1 El Tor, including atypical El Tor variants, with resistance patterns commonly involving trimethoprim-sulfamethoxazole and reduced fluoroquinolone susceptibility, linked to mobile genetic elements and target-site mutations in some isolate series. Genomic analyses that include Nigerian isolates place them within West African seventh-pandemic transmission clusters, including T12 and AFR12 lineage designations reported by study authors.
Conclusion: Available genomic literature supports sustained transmission of seventh-pandemic lineages and persistent AMR risks. Nigeria’s cholera control planning for 2025 to 2029 provides an opportunity to link surveillance, diagnostics, WASH, and targeted vaccination, but impact will depend on implementation capacity and sustained financing.
Keywords: Evolving dynamics, Antimicrobial resistance, Integrative epidemiology, Vibrio cholerae
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