A Behavioral SIQR-B Model for Cholera Transmission: Impact of Adaptive Risk Perception on Disease Dynamics

Background/Objectives: Cholera remains a major public health problem, particularly in regions with limited access to safe drinking water and sanitation. Traditional compartmental models may underrepresent adaptive human behavioral responses during outbreaks. This study aims to investigate the epidemiological effects of adaptive risk perception within a deterministic SIQR-B framework for cholera transmission. Methods: We developed a deterministic SIQR-B model incorporating adaptive behavior through a nonlinear risk-perception function that modulates environmental transmission. The model includes susceptible, infected, quarantined, and recovered individuals together with the environmental concentration of Vibrio cholerae. Positivity, boundedness, equilibria, the basic reproduction number, and stability were analyzed, complemented by numerical simulations and robustness analysis across alternative transmission regimes. Results: Under the baseline parameter setting, adaptive behavior reduced the infected peak by 19.03% and delayed its occurrence by approximately 1.13 days. In contrast, cumulative incidence over the 200-day simulation horizon decreased by only approximately 0.033%. Additional simulations across alternative transmission regimes preserved the qualitative effect of adaptive behavior on peak mitigation and epidemic timing, although the magnitude of these effects varied with the transmission configuration and behavioral intensity. Conclusions: Within the proposed theoretical framework, adaptive behavioral feedback primarily mitigates short-term peak burden and alters epidemic timing rather than substantially reducing cumulative transmission. These findings highlight the importance of incorporating behavioral responses into mathematical models of cholera dynamics while recognizing that the quantitative effects depend on the assumed parameter regime.