Introduction: An effective fight against cholera requires an in-depth consideration of the knowledge, attitudes and social representations of cholera within a population. Cholera outbreaks persist in the Extreme North of Cameroon because of the inadequate integration of representations of cholera, water and hygiene in the fight against this disease. Through a constructivist intercultural approach not conflicting with the western ethnocentric model, socio-cultural/religious and historical ideologies can be reconciled to provide optimal and sustainable healthcare solutions to the repeated and long lasting cholera epidemics using participative research, intercultural mediation and dialogue in Cameroon.

Methods: Through a cross-sectional, ethnographic and participative study, data was generated using semi-directed in-depth interviews of key informants, collection of videos, pictures and the completion of 2 pre-tested questionnaire types in 3 communities (Maroua I, Maroua II and Mokolo). Quantitative data was entered using Ms Excel and Epi Info 7, and analysed using Epi Info 7. Qualitative data was analysed inductively using the concept of social representations.

Results: Results show evidence of the inadequate integration of cultural and socio-cultural factors favouring cholera spread and a respondent population majority unable to identify this (92.82%). Equally identifying environmental and cultural factors, the results bring out the impact of the on-going cholera combating strategy.

Conclusion: Representations of cholera, cultural and socio-cultural values are not adequately considered in the fight against cholera. We recommend policy-makers and health actors to improve on the integration of these through advocacy, in designing, communicating and implementing effective prevention strategies via participative research, intercultural mediation and dialogue.