Impact of COVID-19 on Cholera Outbreaks in Kenya: A Study of Mavoko Sub-County, 2019-2023

Background: The global impact of COVID-19 on healthcare affected cholera prevention in Africa. Despite being an endemic area, Mavoko, Kenya, experienced a surprising decrease in cholera cases during the pandemic. This study analyzes the dynamics of cholera outbreaks in Mavoko before, during, and after COVID-19, aiming to refine public health strategies for cholera prevention, with broader implications for future pandemics. Method: This study retrospectively analyzed cholera in Mavoko Sub-County during pre-COVID-19 (2019), COVID-19 (2020-2021), and post-COVID-19 (2022-2023). Participants seeking cholera-related medical care were included. Data from Mavoko’s Disease Surveillance and Response Unit, supplemented by 2019 Kenya Census data, were analyzed using descriptive statistics, chi-square, and logistic regression to explore cholera’s association with factors like sanitation, water access, wealth, urban/rural settings, and handwashing facilities. Results: The study of 1,786 individuals revealed gender and age correlations, urban-rural variations, and wealth disparities. Mortality rates were higher in men, while cholera cases were evenly distributed between genders. Cholera prevalence was high pre- and post-COVID-19, lower during COVID-19. Insanitary sanitation significantly increased cholera risk (AOR=1.28, p=0.047), water source type showed potential association but not significance (AOR=1.43, p=0.064). Pre- and post-COVID-19 periods had higher cholera risks than during COVID-19 (AOR=3.38, p 0.05). For cholera severity, poor sanitation (AOR=4.56, p