The Burden of Diarrheal Diseases in West Africa: Challenges and Solutions

Diarrheal diseases remain a major cause of preventable morbidity and mortality in West Africa, disproportionately affecting children under five, malnourished populations, displaced communities, and residents of rapidly growing urban settlements. While global diarrheal deaths have declined, the region continues to experience high incidence, recurrent outbreaks (notably cholera), and significant indirect impacts on nutrition, cognition, school attendance, household income, and health-system capacity. Key drivers include inadequate water, sanitation and hygiene (WASH) services, food safety gaps, weak surveillance and laboratory confirmation, delayed care-seeking, limited access to oral rehydration therapy (ORT), and compounding shocks from climate variability, flooding, conflict, and population mobility. Evidence-based solutions exist: scaled ORS + zinc, rotavirus vaccination, targeted oral cholera vaccine (OCV) use during outbreaks and in hotspots, integrated WASH and nutrition programming, and strengthened primary healthcare and surveillance. This review synthesizes current evidence on burden, determinants, and high-impact interventions, and proposes a pragmatic, implementation-oriented roadmap for West African settings. Keywords: diarrheal diseases; West Africa; cholera; rotavirus; ORS; zinc; WASH; child mortality; health systems