A review of the occurrence, antimicrobial resistance and health implications of Vibrio cholerae in African aquatic milieus, and the analysis of the impact of climate change on cholera outbreaks in Southern Africa

Vibrio cholerae, especially serogroups O1 and O139, represent a serious public health risk in many African nations as it causes cholera, which accounts for numerous epidemics and significant mortality within the continent. The World Health Organization (WHO) reported approximately 86,330 cholera deaths in Africa between 1995 and 2016, with poor water quality usually being the most frequent transmission route. Like with many other infectious diseases, climate change is increasingly recognized as an influential factor contributing to these cholera outbreaks, notably affecting the distribution, frequency and seasonality of V. cholerae. However, evidence linking temperature variability and precipitation to cholera outbreaks is moderate, requiring more research to establish stronger connections between climate change and cholera incidence. This review reports the occurrence, antimicrobial resistance and health implications of V. cholerae in aquatic milieus in Africa. Furthermore, the review uses publicly available data to statistically infer any potential link between cholera outbreaks and climate change (rainfall and temperature) with Southern Africa as a case study. It concludes by suggesting potential solutions for the prevention of future outbreaks within the region.