Resurgence of cholera in Kosti City, Sudan: impact of armed conflict and water supply disruption.

OBJECTIVES

This study assesses the magnitude and epidemiological characteristics of the recent cholera resurgence in Kosti City, Sudan, amid ongoing armed conflict and water supply disruptions.

METHODS

This was a retrospective cross-sectional study based on hospital records that analyzed cholera surveillance data from Kosti Teaching Hospital from February 20, 2025, to February 24, 2025 (peak period). Epidemiological measures included case fatality rate (CFR) based on the following factors: age, sex, and displacement status. We analyzed the data using R software version 4.2.2.

RESULTS

During the peak period, 1714 cholera cases and 69 fatalities were reported (CFR: 4.02%). 136 individuals were internally displaced, and age groups 1-4 and ≥65 years demonstrated the highest CFRs of 9.7% and 9.9%, respectively. By March 5, 2025, 1004 new cases had overwhelmed Kosti Teaching Hospital, with a lower fatality rate (2.3%) compared to the peak period's CFR.

CONCLUSIONS

The resurgence of cholera in Kosti underscores the critical need for strengthened water, sanitation, and hygiene interventions and coordinated outbreak response strategies. Addressing underlying vulnerabilities is essential to prevent future outbreaks, especially in conflict-affected settings.