Maisha Felicien Masanga, Mbasa Ndemo Mumbere, Ulikuwe Kennedy Mumbere, Kahatwa Serge, Mulligan Connie J, Morris J Glenn, Bardosh Kevin
Department of Sociology, College of Humanity and Social Sciences, University of Goma, Goma, Democratic Republic of Congo.
Emerging Pathogens Institute, University of Florida, Gainesville, USA.
BMC Public Health. 2025 May 15;25(1):1782. doi: 10.1186/s12889-025-22981-0.
Cholera remains a major and increasing global public health problem for all people without adequate access to safe water. Goma, in the eastern Democratic Republic of Congo (DRC), has been a major cholera hotspot in Africa since 1994 and is currently experiencing one of the largest outbreaks in the world. This article contributes to the existing scholarship on cholera risk by utilizing a variety of qualitative research methods. Goma offers several advantages to a study of cholera as a city on the shores of Kivu Lake, but where the majority of population does not have access to clean water and experiences recurrent cholera epidemic outbreaks.
Two local members of our research team are experts in public health and conducted all the interviews in Swahili and French. They also led transect walks and a participatory mapping workshop. Data were collected between 2021 and 2022 in six areas of Goma. Data were analysed using a qualitative software Open code 4.03 to generate codes for a thematic purpose.
Our results show that the lack of water infrastructure was the main issue with cholera risk in Goma as it prompted use of unsafe drinking water from Lake Kivu, the small Lake vert and Mubambiro River. Additionally, there were specific social groups with an increased risk based on age and gender, health status, some occupational risks, and socio-economic status. Cholera risks were framed in relation to broader life-threatening events, such as natural disasters, that occurred in the city. Cholera risk was also ascribed to challenges with care seeking and treatment, and issues with implementation of prevention strategies. Finally, the lack of empowerment of local communities in cholera prevention measures was considered a secondary source of risk due to the emphasis on the public health outreach practices and short-term emergency responses.
This work broadens our understanding of factors that contribute to cholera risk in Goma. These factors should be addressed by implementing diverse strategies that involve the affected communities rather than focusing on rapid public health outreach response interventions. In addition, the, development and the maintenance of a safe and reliable water infrastructures in the city is essential to reduce the chronic nature of cholera infection in the city of Goma.
霍乱仍然是一个严重且日益严峻的全球公共卫生问题，影响着所有无法获得充足安全饮用水的人群。自1994年以来，刚果民主共和国（DRC）东部的戈马一直是非洲主要的霍乱热点地区，目前正经历着全球最大规模的霍乱疫情之一。本文通过运用多种定性研究方法，为现有的霍乱风险学术研究做出了贡献。戈马作为基伍湖岸边的一座城市，为霍乱研究提供了诸多优势，但这里的大多数人口无法获得清洁水，且霍乱疫情反复爆发。
我们研究团队的两名当地成员是公共卫生专家，他们用斯瓦希里语和法语进行了所有访谈。他们还带领进行了横断面走访和一次参与式绘图研讨会。2021年至2022年期间在戈马的六个地区收集了数据。使用定性软件Open code 4.03对数据进行分析，以生成用于主题目的的代码。
我们的结果表明，缺乏供水基础设施是戈马霍乱风险的主要问题，因为这促使人们使用来自基伍湖、小韦尔湖和穆班比罗河的不安全饮用水。此外，基于年龄和性别、健康状况、一些职业风险以及社会经济地位，特定社会群体面临的风险增加。霍乱风险与城市中发生的更广泛的危及生命的事件（如自然灾害）相关联。霍乱风险还归因于寻求护理和治疗方面的挑战以及预防策略实施中的问题。最后，由于强调公共卫生外展实践和短期应急响应，当地社区在霍乱预防措施方面缺乏赋权被视为风险的次要来源。
这项工作拓宽了我们对导致戈马霍乱风险的因素的理解。应通过实施涉及受影响社区的多种策略来解决这些因素，而不是只专注于快速的公共卫生外展应对干预措施。此外，在该市开发和维护安全可靠的供水基础设施对于降低戈马市霍乱感染的长期性至关重要。
