DOI: https://doi.org/10.36347/sjams.2025.v13i04.018

Pages: 946-956

Background and Methods: Cholera outbreaks remain a leading global health threat to public health particularly in Sub Saharan Africa with 1.4 million cases and 25.000 to 142.000 deaths occurring every year (CDC, 2022). A total of 692 cholera outbreaks have been reported in Sub Saharan Africa nearly every year in a span of 20 years from 2010 – 2025 contributing to 90% global burden of cholera (ECDE, 2024). Health educational interventions are often times applied to harness prevention and preparedness for cholera outbreaks (Child et al., 2016; Denue et al., 2017; Dan-Nwafor et al., 2019). Despite of this, evidence –base regarding their effectiveness for preparedness for cholera is habitually missing. This paper presents a systematic literature review investigating the determinants of knowledge level, and, determinants of hygiene practices for cholera outbreak preparedness before health education and after health education. Results: The review yielded 40 studies, with 26 focusing on cholera knowledge level and 14 looked at hand hygiene preventive practices. These studies generally point to a knowledge –practice gap. While the reporting of cholera knowledge and prevention has become more common in recent publications, no study has focused on preparedness for cholera outbreaks. Hence, the reviewed studies indicate a less attention to cholera outbreak preparedness. The majority of papers 26(65%) reported on cholera knowledge, with a pattern of evidence about higher knowledge on virulence, signs and symptoms, preventive methods, modes of transmission, its ability to spread in areas with poor water, sanitation and hygiene conditions. Despite this high cholera knowledge attainment after health education, knowledge –practice gap is noticeable in 14 (35%) reviewed studies about hand hygiene preventive practices. Even when studies about cholera in all the 40 reviewed studies, none (0%) of them was focusing on cholera outbreaks preparedness. Hence, a lack of research in this part