Uganda Has Eliminated Endogenous Cholera, New Study Finds
Results of a new study conducted by researchers at the Makerere School of Public Health (MakSPH) show that Uganda has eliminated cholera outbreaks or transmission that originates completely from within the country, referred to as endogenous cholera.
Details of this study, titled ‘Uganda’s Cholera Elimination Journey in a Cholera Endemic Region of Africa’, show that even as Uganda has eliminated the disease, the country still remains vulnerable to outbreaks linked to cross-border transmission. The researchers led by Dr Godfrey Bwire analysed national cholera surveillance data from 2018 to 2024, reviewed cholera prevention and control policies, assessed oral cholera vaccine campaigns implemented between 2018 and 2021, and examined cholera trends across the East African Community.
Uganda has had cholera endemicity since 1971, but the authors found that the number of cholera-endemic districts declined from 36 in 2018 to 6 in 2024 following 16 oral cholera vaccine campaigns that targeted more than 2.26 million people in high-risk sub-counties.
Since 2021, the researchers found, all cholera outbreaks reported in Uganda have been epidemiologically linked to cross-border spread from neighbouring countries. To understand risks from cross-border cholera transmission, the report shows they reviewed cholera reports from the other countries in the East African Community including DRC, South Sudan and Burundi and found that they are still recording large numbers of cholera cases and yet some are experiencing civil conflicts which lead their nationals to Uganda, putting the country at risk.
The study suggests that targeted vaccination, strengthened surveillance, rapid outbreak response, and the use of single-dose doxycycline for cholera patients and their household contacts may have contributed to Uganda’s progress towards cholera elimination.
However, while Uganda appears to have eliminated the disease locally and despite advances and innovations in public health, including efforts toward improved water, sanitation, and hygiene (WASH), and efficacious oral vaccine and therapeutics, cholera remains a major threat, leading to high morbidity and mortality in many low-income countries.
According to World Health Organization data, from January to August 2025, a cumulative total of 462,890 cholera cases and 5,869 deaths were reported from 32 countries across five WHO regions, with Africa Region recording the second highest numbers, only better off that the East Mediterranean region.
The study results have been published in a scientific journal PLOS Global Public Health.
Details of this study, titled ‘Uganda’s Cholera Elimination Journey in a Cholera Endemic Region of Africa’, show that even as Uganda has eliminated the disease, the country still remains vulnerable to outbreaks linked to cross-border transmission. The researchers led by Dr Godfrey Bwire analysed national cholera surveillance data from 2018 to 2024, reviewed cholera prevention and control policies, assessed oral cholera vaccine campaigns implemented between 2018 and 2021, and examined cholera trends across the East African Community.
Uganda has had cholera endemicity since 1971, but the authors found that the number of cholera-endemic districts declined from 36 in 2018 to 6 in 2024 following 16 oral cholera vaccine campaigns that targeted more than 2.26 million people in high-risk sub-counties.
Since 2021, the researchers found, all cholera outbreaks reported in Uganda have been epidemiologically linked to cross-border spread from neighbouring countries. To understand risks from cross-border cholera transmission, the report shows they reviewed cholera reports from the other countries in the East African Community including DRC, South Sudan and Burundi and found that they are still recording large numbers of cholera cases and yet some are experiencing civil conflicts which lead their nationals to Uganda, putting the country at risk.
The study suggests that targeted vaccination, strengthened surveillance, rapid outbreak response, and the use of single-dose doxycycline for cholera patients and their household contacts may have contributed to Uganda’s progress towards cholera elimination.
However, while Uganda appears to have eliminated the disease locally and despite advances and innovations in public health, including efforts toward improved water, sanitation, and hygiene (WASH), and efficacious oral vaccine and therapeutics, cholera remains a major threat, leading to high morbidity and mortality in many low-income countries.
According to World Health Organization data, from January to August 2025, a cumulative total of 462,890 cholera cases and 5,869 deaths were reported from 32 countries across five WHO regions, with Africa Region recording the second highest numbers, only better off that the East Mediterranean region.
The study results have been published in a scientific journal PLOS Global Public Health.
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