Abstract, Introduction, Methods, Results, Discussion, Strengths and Limitations, Conclusion, References, Appendices

This systematic review investigates the link between environmental pollution and cholera outbreaks in Sub-Saharan Africa (SSA) and evaluates the effectiveness of public health interventions. Nineteen studies from 2015–2025 were synthesised, covering countries including Nigeria, Uganda, Mozambique, Zambia, Malawi, Ethiopia, Ghana, and the DRC. Findings revealed that contaminated water, poor sanitation infrastructure, open defecation, and flooding significantly contribute to cholera transmission, particularly in vulnerable communities such as peri-urban slums, refugee camps, and fishing settlements. While interventions such as case-area targeted interventions (CATIs), water chlorination, and oral cholera vaccines (OCVs) reduced transmission, the most effective outcomes were achieved through integrated strategies combining WASH improvements, vaccination, surveillance, and community engagement. The study concludes that sustainable cholera control requires long-term investments in water and sanitation systems, waste management, and behavioural change, shifting from reactive outbreak response to structural prevention.