Covid-19 and Cholera Co-Infection and Comorbidity in Africa and Asia: A Systematic Review and Meta Analysis

Abstract

In Africa and Asia, the interplay between COVID-19 and cholera has manifested as a dual burden on healthcare systems and economies and as a potential public health threat, necessitating effective intervention. Cholera outbreaks have surged, especially in Africa, compounded by the recent COVID-19 pandemic. Due to a shift in focus towards combating COVID-19 and the consequent weakening of healthcare systems, data on cholera outbreaks are limited in many Asian and African nations in recent times. Here, we conducted a systematic review using available data from published articles on the impact of COVID-19 pandemic on cholera cases in Africa and Asia. Using the keywords “COVID-19”, “Cholera”, and “Endemic region”, we gathered articles from electronic databases while adhering to the established syntax. As a result, 642 articles were identified from PubMed, 4 from the Cochrane Library, and 7 from the Global Index Medicine. Eighteen studies met the inclusion criteria. The meta-analysis showed that COVID-19 and cholera comorbidity and coinfection in both Africa and Asia were strongly positively correlated (95% CI = 0.80, 0.99). These findings suggest that cholera incidence and mortality were elevated during the COVID-19 pandemic in Africa and Asia. The development of measures to prevent cholera outbreaks, especially those strengthening healthcare systems, which were largely overwhelmed during the COVID-19 pandemic, is necessary to bolster public health.