Cholera Outbreak in Chad in 2025: Epidemiological, Clinical, and Outcome Profile of the First Patients Managed in Cholera Treatment Centers
Mahamat Ali Bolti *
Department of Infectious and Tropical Diseases, Faculty of Human Health Sciences, University Hospital Center La Renaissance, N’Djamena, Chad.
Marc Mbaitoloum Djerabé
Chad-China Friendship University Hospital Center, N’Djamena, Chad.
Oumaima Mahamat Djarma
University Hospital Center La Référence Nationale, N’Djamena, Chad.
Dissia Fitouin
Public Health Emergency Operations Center, N’Djamena, Chad.
Souleymane Adoum Fils
University Hospital Center La Renaissance, N’Djamena, Chad.
Djiddi Ali Sougoudi
University Hospital Center La Renaissance, N’Djamena, Chad.
Joseph Mad-Toingué
University Hospital Center La Référence Nationale, N’Djamena, Chad. and Faculty of Human Health Sciences, N’Djamena, Chad.
Guettora Nadjitolnan
Public Health Emergency Operations Center, N’Djamena, Chad.
*Author to whom correspondence should be addressed.
Abstract
Background: Cholera remains a public health emergency in sub-Saharan Africa, where access to safe drinking water and sanitation infrastructure is limited. Since July 2025, the eastern region of Chad has been facing a cholera outbreak. The objective of this study was to describe the epidemiological, clinical, and outcome profile of the first patients managed in cholera treatment centers.
Methods: This was a cross-sectional study based on data from the epidemiological situation report of the Ministry of Public Health, No. 34 dated August 30, 2025. All suspected cholera cases and those confirmed by microbiological tests were included in the study.
Results: During the study period (July–August 2025), 1,331 cholera cases were reported across three provinces in eastern Chad. Among the seven affected districts, Chokoyane and Hadjer Haddid accounted for 57.3% (n = 763) and 34.2% (n = 455) of cases, respectively. The median age was 23 years. The 5–14-year age group was the most represented (34.7%, n = 463). Females predominated (62.5%, n = 833), with a sex ratio of 0.6. Clinically, diarrhea was present in all patients, complicated by moderate to severe dehydration in 88% (n = 1173). Vomiting occurred in 76% (n = 1013). Laboratory analyses isolated Vibrio cholerae O1 Ogawa. The case fatality rate was 5.6% (n = 75). The response measures included case management in treatment centers, antibiotic prophylaxis for contacts, cholera vaccination, household disinfection, and chlorine distribution.
Conclusion: The current outbreak’s epidemiological and clinical profile is similar to that of previous years, with the particularity of a higher incidence among children. Its re-emergence is linked to the limited capacity of the health system and the massive influx of people displaced by armed conflict. Strengthening health system capacities and epidemiological surveillance is essential to control this epidemic.
Keywords: Outbreak, cholera, public health, Ouaddaï, Sila, Chad