Cholera: Determinants of the Disease and Prospects for Control in the Congo-Ubangui River Corridor in the Republic of Congo

Medard Amona*, Yolande Voumbo Matoumona Mavoungou, Tatia Adoua Doukaga, Martin Ekat, Albert Mabiala, Michel Mankou, Hama Nemet Ondzotto, Armel Itoua, Gilius Axel Aloumba, Guy Roger Kinouani, Riha Lena Okamba Afissofo, Stevie Loundou, Albert Boungou, Jean Médard Nkankou, Guy Abel Bongo, Roland Bienvenu OSSIBI IBARA and Pascal Ibata

A major public health threat along the Congo-Ubangui river corridor, cholera is exacerbated by inadequate sanitation infrastructure and high population mobility. Our study analyzes the determinants of the disease in these riverside areas with a view to developing integrated control strategies.

A descriptive and analytical cross-sectional study was conducted from March 27 to April 14, 2026, in the Liranga health district. Households located within 50 meters of rivers were targeted using a two-stage cluster sampling method. The variables analyzed included socio-demographic profile, environmental determinants, and behaviors. Anonymity and confidentiality were maintained throughout the study.

The epidemic, with a case fatality rate of 8.62%, primarily affects men (66%) aged 18 to 29 (64%) living in households of more than 6 people (78%) with a primary education (46%). It is rampant in extremely precarious conditions: total lack of access to drinking water (100%), consumption of untreated water (78%, including 80% from the river and 70% rainwater), and a lack of latrines (92%) leading to open defecation (96%). The situation is exacerbated by the proximity of waterways, intense heat (70%), drought (30%), interdepartmental travel (88%), poor hygiene (92%), self-medication (81%) due to isolation (82%) and widespread rumors (88%), and mistrust of the authorities, particularly in Liranga (20%), Djoundou (18%), and Ngondola (16%). Health management is hampered by sociocultural barriers (82% citing witchcraft), a lack of awareness of symptoms (16%), refusal to perform ritual washing of the deceased (96%), and low vaccine acceptance (38%), with vaccinations administered in only 4 out of 20 localities.

The persistence of cholera in the Congo-Ubangui river corridor is not just a health problem, but the result of a complex system of vulnerability where structural flaws and deep cultural barriers intertwine.

The fight against cholera in this area cannot be limited to a medical response but requires taking into account the holistic and multidisciplinary dimension of the disease.

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Published on: Jun 2, 2026 Pages: 17-27

Full Text PDF Full Text HTML DOI: 10.17352/ijdcr.000058
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