Cholera in North Kivu: impacts of armed conflict on the resurgence of the epidemic, a narrative review.

Cholera remains a major public health threat in the Democratic Republic of Congo, particularly in North Kivu, a province marked by chronic armed conflict and humanitarian crises. This review explores how insecurity, mass displacement, and the collapse of health and sanitation systems have contributed to the resurgence of cholera epidemics. Recurrent armed clashes have not only weakened local health structures but also created living conditions that facilitate the spread of waterborne diseases. Efforts by health authorities and humanitarian organizations have included emergency case management, vaccination campaigns, and water, sanitation, and hygiene interventions, but these have been hampered by persistent insecurity. Lessons learned highlight the need for an integrated, multisectoral response combining emergency measures with long-term investment in health infrastructure, water access, and conflict resolution. Stabilizing the security situation and improving living conditions are essential to sustainably reduce the cholera burden in North Kivu and similar conflict-affected regions.