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War against Cholera: Vaccine shortages, poor hygiene worsen epidemic in Nigeria

…Experts warn of looming public health emergency, call for improved hygiene practices

…As street food vendors put consumers at risk

…Lassa Fever: Diagnosis and prompt treatment essential — WHO

By Sodiq Adelakun

Nigeria is facing a dire public health crisis as a widespread outbreak of cholera and other diseases has affected over 20 states, posing a significant threat to the health and well-being of its citizens.

In the past year alone, outbreaks of cholera have surged, leading to a worrying increase in both cases and fatalities. The country’s inadequate water and sanitation infrastructure has worsened the crisis, leaving millions of Nigerians vulnerable without access to clean water and proper hygiene facilities.

Recently, the Nigeria Centre for Disease Control (NCDC) issued dire warnings as the country races against time to contain the epidemic.

Driven by high costs of living and economic hardships, a significant portion of the population faces immense challenges in accessing basic necessities, further complicating efforts to combat the outbreak.

As the death toll from the latest cholera outbreak climbs to 40, the NCDC has acknowledged critical shortages of vaccines.

Director General of the NCDC, Dr. Jide Idris recently disclosed that Nigeria has urgently sought additional cholera vaccines from international donor agencies, although delivery timelines remain uncertain.

Health officials emphasised the importance of public awareness campaigns, enhanced surveillance measures, and swift deployment of resources to affected areas.

However, persistent challenges in healthcare infrastructure and economic disparities highlight the ongoing struggle to effectively mitigate the impact of cholera outbreaks.

With the NCDC identifying multiple states, including Lagos, as major hotspots for cholera transmission, local authorities are urged to intensify efforts in containment and prevention strategies.

…Cholera crisis grips Nigeria with over thousands dead and Infections soaring

With over 4,364 fatalities of cholera cases recorded out of 139,730  over the past four years, according to our investigation, the gravity of the situation has prompted urgent calls from health authorities, who warn of a looming state of emergency if immediate actions are not taken.

Cholera, a highly contagious diarrheal disease spread through contaminated food and water, poses a significant threat across the country.

The Nigeria Centre for Disease Control and Prevention (NCDC) has highlighted the disease’s transmission vectors, including inadequate water and sanitation infrastructure, challenges of open defecation, and climate-related flooding that contaminates water sources.

“This is a clear and present danger,” emphasised NCDC officials, emphasising the dire need for improved public health interventions and infrastructure investments to curb the epidemic. The crisis is worsened by widespread poverty and food insecurity, driving vulnerable populations to heightened risk.

The 2021 cholera outbreak stands as a stark example, with Nigeria recording its highest incidence in recent history: over 106,000 cases and more than 3,000 deaths.

Despite ongoing efforts to mitigate the spread, including vaccination campaigns and hygiene education, the disease continues to ravage communities, particularly affecting rural and economically disadvantaged Nigerians.

Health officials stress the urgent need for coordinated national and international support to strengthen healthcare infrastructure, ensure access to clean water, and promote hygiene practices critical in preventing cholera outbreaks.

Meanwhile, Lagos has emerged as the epicentre of a severe cholera outbreak, characterised by a highly aggressive and contagious strain, warned Prof. Akin Abayomi, the state Commissioner for Health.

With significant potential for widespread dissemination, the outbreak has prompted urgent measures to prevent further escalation, including a caution from the United Nations Children’s Fund (UNICEF) urging the Federal Government to safeguard schools from the epidemic.

According to the Nigeria Centre for Disease Control (NCDC), ten states, including Lagos, account for 90 percent of the country’s cholera burden.

In Lagos State alone, health authorities have reported 350 suspected cases across 29 wards, with 17 cases confirmed and 15 fatalities attributed to severe dehydration caused by delayed medical intervention.

Amidst the cholera crisis, Nigeria faces additional challenges linked to food safety culture, particularly concerning given its status as the most populous nation in Africa.

Research indicates widespread deficiencies in food handling practices and hygiene standards, exacerbated by the diverse cultural landscape of over 250 ethnic groups.

A study conducted by the Food and Agriculture Organisation (FAO) of the United Nations highlights the global prevalence of street food consumption, a staple in Nigerian urban settings valued for its convenience and affordability.

However, improper food handling practices among vendors pose significant health risks, contributing to the high incidence of foodborne illnesses.

The FAO and World Health Organisation (WHO) report that foodborne diseases cause an estimated 420,000 preventable deaths annually worldwide.

Factors such as poor sanitation, inadequate food safety regulations, and a lack of awareness further compound the risk, disproportionately affecting vulnerable populations such as young children.

Alarmingly, up to 60 percent of street food vendors in Nigeria operate in unhygienic environments, lacking basic hygiene training and proper storage practices for food leftovers.

…Health risks loom as flooded area threatens pupils in Ajah, Lagos

A visit to Gedegede area in Ikota, Ajah, Lagos has unveiled alarming conditions, with stagnant, contaminated water posing significant health risks, particularly in front of Bethesda Primary School.

The sight of children navigating through this polluted water has raised concerns about their safety and well-being.

Head Teacher, Onyeabor Ngozi Antonia in an interview with NewsDirect highlighted the dire situation, emphasising the longstanding challenges posed by the road conditions in Ikota.

She reiterated the impact of the flooded area on daily school activities, describing it as a critical issue affecting the entire community.

The flooded environment not only threatens the physical safety of students but also exacerbates health hazards associated with stagnant water, including the spread of waterborne diseases.

Residents and school authorities alike have expressed frustration over the persistent neglect of infrastructure maintenance in the area, urging government intervention to address the root causes of the ongoing crisis.

Local officials and community leaders are calling for urgent action to mitigate the risks posed by the contaminated water and improve road conditions to ensure safe access for residents and students alike.

“Whenever it rains, every one of us must swim through the bad water to come to school, including our children.So if they can put the road in order, it will go a long way to help us,” Anthonia said.

Observations by our correspondent in Ifo, Ogun State, and Lagos have highlighted the alarming state of hygiene in food preparation and sales in Nigeria.

In Ifo, a woman was seen selling pap and bean cakes in an unhygienic environment, with sweat dripping into the food as she prepared it.

The surrounding area was also filthy, raising concerns about the cleanliness of the food.

Similarly, Babatunde Ibrahim, a Lagos resident, witnessed a cafeteria owner preparing food with unclean water near Kola Agbado, despite his warnings.

These incidents not only put the health of school pupils at risk but also that of the wider community.

Ibrahim said, “I told her the water wasn’t safe for cooking, but she stubbornly replied that boiling it would kill the germs. I was shocked by her ignorance and lack of concern for customers’ health. It’s a breeding ground for cholera and other waterborne diseases.”

…Experts warn of looming public health emergency in Nigeria, call for improved hygiene practices

Also, an environmental health director, Abdullai Olawale has emphasised the need for a collaborative effort to combat the ongoing cholera outbreak in Nigeria.

According to Olawale, the root causes of the disease are poor sanitation, inadequate access to clean water, and lack of proper personal hygiene.

“Hand-washing is an important aspect of personal hygiene, especially after using the toilet and before handling food,” Olawale stressed.

Olawale urged all stakeholders, including the federal and state governments, agencies, local governments, and the community, to work together to address the issue.

“It’s a collective responsibility to fight this disease,” he emphasised.

Also, an Health Scientist, Adedieura Sunday said, “This cholera outbreak in Nigeria is a public health emergency! We need to act fast to improve access to clean water, sanitation, and hygiene practices. Vaccination, prompt treatment, and community engagement are crucial to contain this outbreak. Let’s work together to save lives.”

Unregistered tiger nut drink linked to cholera outbreak in Lagos – Official

Lagos State officials have identified an unregistered tiger nut drink as the source of a recent cholera outbreak affecting multiple local government areas, including Lagos Island, Eti-Osa, and Kosofe.

Hospitals in the state have reported a surge in cholera cases, with 24 deaths and 35 confirmed cases recorded as of June 21. Eti-Osa has been pinpointed as the epicentre of the outbreak in Nigeria’s bustling commercial capital.

In an interview on Saturday, Kemi Ogunyemi, Special Adviser to the Lagos State governor on health, explained that heightened suspicions arose in Eti-Osa LGA, prompting government teams to conduct a thorough assessment of the area.

The investigation revealed a common link among affected individuals: consumption of an unregistered tiger nut drink.

Ogunyemi emphasised that the tiger nut drink in question had not undergone registration with the National Agency for Food and Drug Administration and Control (NAFDAC), a critical oversight in ensuring food and beverage safety standards.

Subsequently, authorities mobilised to locate the tiger nut drink and collect samples for cholera testing. This proactive measure aims to identify and contain the contaminated source, preventing further spread of the disease across the state.

The Lagos State government has vowed to intensify efforts in monitoring and enforcing regulatory standards to protect public health and prevent future outbreaks linked to unregulated food products.

As investigations continue, health officials urge residents to exercise caution and avoid consuming unverified food and beverage products, emphasising the role of public awareness in maintaining community health and safety amidst ongoing health challenges in Lagos State.

In the same vein, Nigeria is also battling a significant outbreak of Lassa fever, with the NCDC reporting 6,704 suspected cases and 162 deaths across 125 Local Government Areas in 28 states.

The NCDC confirmed 911 cases from these suspicions between January and June 9, 2024, highlighting the severity of the ongoing public health crisis.

According to the NCDC’s Lassa fever situation report released on Friday, the disease, caused by the Lassa virus from the arenavirus family, continues to pose a grave threat.

Humans typically contract the virus through contact with contaminated food or household items tainted with urine or faeces of infected Mastomys rats, endemic in parts of West Africa.

The case fatality rate stands at 17.8 percent for the current period, a slight increase from 17.1 percent in 2023, underscoring the lethal nature of the disease.

Alarmingly, 33 healthcare workers have already been infected with the virus, highlighting the occupational risks faced by frontline health personnel.

Lassa fever is endemic in several West African countries, including Benin, Ghana, Guinea, Liberia, Mali, Sierra Leone, Togo, and Nigeria, with the potential for outbreaks in neighbouring regions.

…Lassa Fever: Diagnosis and prompt treatment essential — WHO

The World Health Organisation recognises Lassa fever as an acute viral hemorrhagic illness, necessitating swift and coordinated responses to prevent further spread and mitigate its impact on vulnerable populations.

Health officials stress the importance of heightened surveillance, community awareness campaigns, and strict adherence to infection control measures to curb the transmission of Lassa fever.

The Nigerian government, in collaboration with international health agencies, continues to implement measures to contain the outbreak and protect public health amidst the ongoing challenges posed by infectious diseases in the region.

“Person-to-person infections and laboratory transmission can also occur, particularly in healthcare settings in the absence of adequate infection prevention and control measures.

“Diagnosis and prompt treatment are essential. The overall case-fatality rate is one percent. Among patients who are hospitalised with severe clinical presentation of Lassa fever, case fatality is estimated at around 15 per cent. Early supportive care with rehydration and symptomatic treatment improves survival.

“About 80 percent of people who become infected with the Lassa virus have no symptoms. One in five infections result in severe disease, where the virus affects several organs such as the liver, spleen, and kidneys,” WHO said.

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