Antimicrobial Resistance in Cholera: A Need for Quick Intervention in Nigeria, West Africa

Abstract

Following the discovery and identification of Vibrio cholerae, cholera disease continues to be a burden on the global community, including Nigeria. In this article, we provide an inclusive review on antimicrobial resistance (AMR) in cholera and the need for its quick interventions. Cholera spread over Asia and other continents, majorly because of poor hygiene practises since 1817, and still exists. This agent secretes a toxin called cholera toxin (CT) after ingestion of contaminated water and/or food, which adheres to the cells in the intestinal epithelial, leading to symptoms such as watery diarrhea, fever, and even death if not treated. Many antimicrobials such as tetracycline, trimethoprim/sulfamethoxazole, and ampicillin, previously effective in cholera therapy, are now reported ineffective due to emerging and developing AMR strains of V. cholerae. AMR in cholera continues to be a major public health concern. Various outbreaks have been reported in Nigeria since the 1970s. This is as a result of the acquisition of resistance genes and/or mutation. Also, irrational usage of antibiotics by people. Promising approaches such as probiotics, vaccines, phage therapy, provision of safe water and proper hygiene are ways to avert the outbreak of cholera and resistant strains in Nigeria.

Cholera rages in Africa and the Middle East: A narrative review on challenges and solutions

“…Misuse includes suboptimal dose and frequency of medication, overuse, and non‐adherence. The resistance profile of the pathogen appears to vary depending on the geographical location and year of the cholera outbreak 197 . The pathogen develops resistance through mechanisms such as drug uptake limitation, drug inactivation, drug target modification, and efflux of drugs 1 …”