Cholera epidemic: 54 years of recurrence, disease exposes Nigeria’s poor preventive measure
…Nigeria records 2,102 cases, 63 deaths across 33 states
…Southern States contribute 90% of cases — NCDC Director
By Rauf Oyewole
Cholera, a preventable and treatable disease, has continued to plague Nigeria for decades, causing unnecessary loss of life. Since the first reported case in 1970 and subsequent resurgence in 1990, cholera has remained a significant public health concern in the country. According to a 2009 report by the United States’ National Library of Medicine, titled “Cholera Epidemiology in Nigeria:
According to health experts, cholera is caused by vibrio cholera and it continues to be a global threat to public health and a key indicator of lack of social development. Once common throughout the world, the infection is now largely confined to developing countries in the tropics and subtropics. It is endemic in Africa, parts of Asia, the Middle East, and South and Central America. In endemic areas, outbreaks usually occur when war or civil unrest disrupts public sanitation services.
In 2010, the outbreak was severe which started from the northern part of Nigeria, spreading to the other parts and involving approximately 3,000 cases and 781 deaths.
In Nigeria, the infection is endemic and outbreaks are not unusual. In the last quarter of 2009, it was speculated that more than 260 people died of cholera in four Northern states with over 96 people in Maiduguri, Biu, Gwoza, Dikwa and Jere council Borno state. Most of the Northern communities of Nigeria rely on hand dug wells and contaminated ponds as sources of drinking water. Usually, the source of the contamination is other cholera patients when their untreated diarrhoea discharge is allowed to get into water supplies.
According to the NLM, about 75 percent of people infected with V. cholera do not develop any symptoms, although the bacteria are present in their faeces for 7-14 days after infection and are shed back into the environment, potentially infecting other people. Among people who develop symptoms, 80 percent have mild or moderate symptoms, while around 20 percent develop acute watery diarrhoea with severe dehydration.
Speaking in Abuja on Tuesday, the Director General of the Nigeria Centre for Disease Control and Prevention, Jide Idris said that a total of 2,102 suspected cholera cases and 63 deaths have been recorded across 33 states and 122 local government areas since the beginning of the year as of June 30, 2024.
He noted that the case fatality rate is at 3.0 percent. He said seven of the top 10 states (Lagos, Bayelsa, Abia, Zamfara, Bauchi, Katsina, Cross River, Ebonyi, Rivers and Delta) that contribute about 90 percent of the cases are Southern States.
Jide said, “As of 30th June 2024, a total of 2,102 suspected cases and 63 deaths have been recorded across 33 states and 122 LGAs with a case fatality rate of 3.0 percent since the beginning of the year. Of the top 10 States (Lagos, Bayelsa, Abia, Zamfara, Bauchi, Katsina, Cross River, Ebonyi, Rivers and Delta) that contribute about 90 per cent of the cases, seven of them are Southern States.
“The National Cholera Multisectoral Emergency Operation Centre activates an array of subject matter experts and provides strategic coordination, meets daily and provides periodic situation reports for stakeholders.
“This also ensures effective mobilisation, harmonisation and distribution of resources to support the affected states. This is done through the relevant thematic areas of response that cover coordination, surveillance, case management, infection prevention and control, risk communication and community engagement, Water Sanitation and Hygiene, Vaccination, Logistics, Research with a costed Incidence Action Plan for the response developed and being implemented.”
He added, “These will help facilitate rapid communication, data analysis, and decision-making. It will also ensure that we deploy resources efficiently, strengthen surveillance and diagnostic capacity, enhance treatment of affected persons, and intensify public awareness and community engagement activities.”
In 2022, of the 4,153 cases, 80 Nigerians lost their lives – mostly in the North. In 2023, the nation recorded 3,683 suspected cases with 128 deaths.
The NCDC DG, Dr. Jide had earlier hinted that the country ran out of vaccine, he said that Nigeria has placed an order for more cholera vaccines from donor agencies, even though the date of delivery is still unknown.
No fewer than 4,364 people have died out of the 139,730 Nigerians suspected to have been infected with the disease across the country in the last four years. The incidence rate was derived from an analysis of the weekly cholera situation reports released by the Nigeria Centre for Disease Control between 2021 and 2024.
While speaking with NewsDirect, an Infectious Disease Consultant at the Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH), Dr. Ibrahim Maigari, warned of indiscriminate consumption of contaminated food, water and fruits on streets.
Speaking on the prevention of cholera, Maigari said that to control the infection, “We need to separate the organisms that cause cholera and then, the food and water that we consume. When these are clean, we are far from cholera. We have to ensure constant clean potable water, free from any germs –especially cholera micro organisms.
“Secondly, our environment needs to be cleaned. The third prevention is personal hygiene. There communities where they largely depend on unsafe sources of water like well water, contaminated streams and even government water are exposed to contamination.”
He said that one of the challenges of ending cholera is communities where open defecation is being practised.
“When defecation is done in the open, it allows the agents of cholera organisms to spread. In fact, they spread it to where it is not expected.
“Look at the people who sell fruits and expose them to flies. People need to wash them properly before consuming them. The worst is watermelon that has been cut without protection from flies and people take them. It’s the easiest way of taking cholera. We advise people to take precautions,” he said.
This recent outbreak underscores the ongoing public health challenge posed by cholera in Nigeria, necessitating coordinated efforts to mitigate its impact and prevent further spread.
Cholera outbreak recurrence in Nigeria and rate of casualties puts Nigeria as a nation with poor precautionary measures.
