Association between Conflict and Cholera in Nigeria and the Democratic Republic of the Congo

Cholera outbreaks significantly contribute to disease mortality and morbidity in low- and middle-income countries. Cholera outbreaks have several social and environmental risk factors and extreme conditions can act as catalysts. A social extreme with known links to infectious disease outbreaks is conflict, causing disruption to services, loss of income and displacement. Here, we used the self-controlled case series method in a novel application and found that conflict increased the risk of cholera in Nigeria by 3.6 times and 19.7% of cholera outbreaks were attributable to conflict. In the Democratic Republic of Congo (DRC), conflict increased the risk of cholera by 2.6 times and 12.3% of ch…