Vibrio cholerae: Understanding a persistent pathogen in Sub-Saharan Africa and the East Mediterranean Region.

Vibrio cholerae remains a significant public health threat in Sub-Saharan Africa and the East Mediterranean Region, where recurrent outbreaks are driven by inadequate water, sanitation, and hygiene infrastructure, climatic variability, and socio-political instability. This review explores the persistence of the pathogen in these regions, examining its epidemiology, environmental reservoirs, and genomic adaptations that enhance its survival and transmission. We highlight the impact of antimicrobial resistance and the role of climate change in cholera dynamics. Furthermore, we discuss current prevention and control strategies, including advancements in oral cholera vaccines, genomic surveillance, and microbiome-targeted interventions. Addressing these challenges requires a multifaceted approach that integrates sustainable sanitation improvements, strengthened disease surveillance, and innovative vaccination strategies. Understanding the persistence of V. cholerae in these high-risk regions is critical for developing effective, long-term mitigation strategies to reduce cholera morbidity and mortality.