Uganda’s Albertine region reports no cholera outbreaks since 2018 vaccination, study finds

A qualitative study from Uganda’s Albertine region reports no cholera outbreaks in participating districts since oral cholera vaccination campaigns in 2018, pointing to a combined impact of vaccination, preparedness, and water, sanitation, and hygiene (WASH) measures.

What the study did

Researchers conducted interviews and focus group discussions with community members, cholera survivors and caregivers, and health officials in Hoima, Kasese, and Kikuube districts, involving 87 participants in total. The study used content analysis to identify themes related to how communities and health systems prevent, detect, and respond to cholera shocks. Posted as a preprint on medRxiv, the paper presents early findings that have not yet undergone peer review.

Seven drivers of resilience

Participants credited oral cholera vaccination (OCV) campaigns as transformative, with districts in the study reporting no outbreaks since the 2018 campaigns. Preparedness and response planning enabled rapid resource mobilization when risks emerged, supporting faster action in communities. Health education efforts were described as improving hygiene practices, including handwashing and safe food handling.

WASH investments also played a role: protected water sources and increased latrine coverage were linked to reduced transmission risk in the communities studied. Rapid response systems and treatment centers helped minimize fatalities when suspected cases arose, according to participants. Community mobilization through Village Health Teams enhanced surveillance and reinforced health messages at the household level. Finally, cross-border surveillance—though limited by resource and coordination constraints—helped improve case detection in a region with frequent population movement.

What still needs work

The authors note that sustaining progress will require periodic OCV booster campaigns and continued reinforcement of hygiene and sanitation practices. They recommend strengthening cross-border coordination with neighboring countries to better manage population movement and disease surveillance. Longer-term infrastructure, including permanent isolation facilities and expanded access to safe water and sanitation, are also highlighted as priorities to consolidate gains toward elimination of cholera outbreaks.

How this fits into Uganda’s progress

Cholera has been endemic in Uganda for decades, with the Albertine region historically among the most affected, but the burden has declined since the introduction of integrated prevention measures that include OCV. The study’s findings align with a broader shift from reactive outbreak response to proactive risk reduction and resilience-building within local health systems.

Important context and caution

As a qualitative study, the findings reflect participants’ experiences in three districts and are intended to illuminate what has worked on the ground rather than to measure effects or establish causation. Because the paper is a medRxiv preprint, its conclusions may evolve following peer review.

Why this matters

Coordinated vaccination, WASH upgrades, and community preparedness in Uganda’s Albertine region show a scalable path to eliminating cholera outbreaks and building resilient health systems. The study’s emphasis on integrated action—vaccines alongside everyday hygiene, surveillance, and quick-response capability—offers practical lessons for districts with similar risks, especially where cross-border movement and limited infrastructure complicate disease control.

How we wrote this

This article was assisted by AI and reviewed by an editor for accuracy and policy compliance.