Risk assessment of cholera outbreaks in Eastern Visayas, Philippines, 2024

Authors

  • Soonjong Bae World Health Organization Representative Office for the Philippines, Manila, Philippines https://orcid.org/0000-0002-9031-4825
  • Boyd Roderick Cerro Center for Health Development Eastern Visayas, Eastern Visayas, Philippines
  • Angelito Umali United Nations Children's Fund, Manila, Philippines
  • Lalaine Villasis Epidemiology Bureau, Department of Health, Manila, Philippines
  • Kathleen Ryan World Health Organization Representative Office for the Philippines, Manila, Philippines
  • Bonifacio Magtibay World Health Organization Representative Office for the Philippines, Manila, Philippines https://orcid.org/0009-0001-0747-3965
  • Albert John Enrico Dominguez World Health Organization Representative Office for the Philippines, Manila, Philippines
  • Harriette Linelle Cruz World Health Organization Representative Office for the Philippines, Manila, Philippines
  • Andrea Gail Palagbas Epidemiology Bureau, Department of Health, Manila, Philippines
  • Rez Dacoco Center for Health Development Eastern Visayas, Eastern Visayas, Philippines
  • Percival De Paz Center for Health Development Eastern Visayas, Eastern Visayas, Philippines
  • Ludina L Insigne Center for Health Development Eastern Visayas, Eastern Visayas, Philippines
  • Marvin Jed C Soledad Center for Health Development Eastern Visayas, Eastern Visayas, Philippines
  • Jody Nesus Center for Health Development Eastern Visayas, Eastern Visayas, Philippines
  • Nayco Yap United Nations Children's Fund, Manila, Philippines
  • Eleanor Salvador-Peña United Nations Children's Fund, Manila, Philippines
  • Katherine Gamiao United Nations Children's Fund, Manila, Philippines
  • Ian Christian Gonzales Epidemiology Bureau, Department of Health, Manila, Philippines https://orcid.org/0000-0003-3875-7431
  • Yui Sekitani World Health Organization Representative Office for the Philippines, Manila, Philippines https://orcid.org/0000-0002-4368-7688

DOI:

https://doi.org/10.5365/wpsar.2026.17.3.1271

Keywords:

cholera, risk assessment, disease outbreaks, epidemiology, RCCE, WASH, Philippines, cholera outbreak, risk factors

Abstract

Objective: This study presents the findings of a joint cholera risk assessment conducted in Eastern Visayas, the region in the Philippines with the highest incidence of the disease in 2022–2023. The study aimed to identify key risk factors, review progress since a 2016 assessment, and highlight persistent gaps in prevention, preparedness and response.

Methods: In July 2024, the World Health Organization, the United Nations Children’s Fund and the Philippine Department of Health conducted a joint assessment using a standardized checklist for focus group discussions and interviews across four technical areas: partnership and coordination; epidemiology and surveillance; water, sanitation and hygiene (WASH); and risk communication and community engagement. Epidemiological trends between 2022 and 2024 were analysed, and water samples from wells and refilling stations were tested for Escherichia coli and total coliforms.

Results: From 2022 to 2024, 12 284 cholera cases were reported in Eastern Visayas (case fatality rate: 0.5%). Testing showed 100% contamination in Level I and II sources, while 33% of Level III samples tested positive for total coliforms despite no E. coli detection. Partial progress has been made in implementing the 2016 assessment’s recommendations, with good practices in surveillance, water sampling and community awareness, although gaps remain in outbreak response, coordination and WASH access.

Discussion: This assessment identified both progress and persistent challenges across the four technical areas. Key limitations were found in the qualitative design and the limited geographical coverage. Conclusions focused on prioritizing the strengthening of national cholera strategies by embedding them within the broader Food and Waterborne Diseases Prevention and Control Program alongside local ownership and equity-focused WASH investments.

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Published

14-07-2026

Issue

Section

Risk Assessment

How to Cite

1.
Bae S, Cerro BR, Umali A, Villasis L, Ryan K, Magtibay B, et al. Risk assessment of cholera outbreaks in Eastern Visayas, Philippines, 2024. Western Pac Surveill Response J [Internet]. 2026 Jul. 14 [cited 2026 Jul. 14];17(3). Available from: https://ojs.wpro.who.int/ojs/index.php/wpsar/article/view/1271