The recent outbreak of cholera in some states across the country has further exposed the nation’s poor healthcare system and the need to enhance our disease surveillance operations. Between January and June this year, the country has recorded about 14, 343 suspected cases of the disease in 16 states and the Federal Capital Territory. The disease has reportedly killed 325 people. Plateau, Bauchi, Gombe, Kano, Zamfara, Kaduna, Bayelsa are the most affected states. It has also been reported that 27 per cent of suspected cases across the country fall within the age bracket of 5-14 years.
It is commendable that the Nigeria Centre for Disease Control (NCDC) is assisting the affected states and the FCT to contain the disease. We also applaud the deployment of rapid response teams to the states as well as providing them with the needed medical and laboratory supplies. The cholera epidemic has raised serious health concerns in a country still grappling with the COVID-19 pandemic. Since 2017, cholera outbreak had occurred in Kwara, Borno, and in about 87 local government areas in 20 states across the country.
Early in 2018, there were 210 suspected cases of cholera, including two-laboratory confirmed cased and 16 deaths from 28 local government areas in nine states. The North East region has recorded more cholera outbreaks in the country than any other region, with three states: Adamawa, Borno, and Yobe always having active transmission of the disease. Since February 2018, the three states have had a total of 1,664 suspected cholera cases and 31 deaths.
Since 1970s, when the country reportedly had its first cholera outbreak, the disease has sadly reoccurred almost every year. Despite concerted efforts to control it, the disease continues to occur as a major health challenge on a yearly basis, especially in its identified epicenters. Those in charge of controlling the disease and experts should come up with adequate measures to check cholera outbreak in the country. The resurgence of the disease recently has shown that Nigeria is endemic for cholera and demand commensurate measures to control and even eradicate it.
Cholera, according to medical experts, is caused by ingestion of food and water contaminated with the bacterium, Vibrio Cholera. The disease may occur during any season and affects all ages without exception. Currently, it is confined to developing countries in the tropics and subtropics and occurs mainly when war or civil unrest disrupts public sanitation services. The disease can occur in areas having natural disasters like earthquake, tsunami, volcanoes, landslides and floods because food and water supplies are contaminated by parasites and bacteria.
Developing countries like Nigeria and others are affected mostly because of their lack of resources, infrastructure and disaster preparedness status. The infected patients excrete the bacteria in stool and the spread becomes rapid, mostly in areas where human waste is not treated. With the insurrection in the northern part of the country, it is not surprising that the disease has become highly endemic in the area. Most of the states in the north depend on hand-dug wells and contaminated ponds as source of drinking water. The 2010 outbreak in Jigawa, Bauchi, Gombe, Yobe, Borno, Adamawa and Taraba states led to many deaths. The rains of that year reportedly washed sewage into open wells and ponds, where people fetch water for drinking and other household needs.
Although, the recent outbreak is located in these areas, the entire country is at risk since the outbreak is caused by highly virulent strain of the organism. Since open defecation is still high in the country and access to potable water scarce, government should address the issue of public hygiene without delay. To control the disease, there is need for adequate diagnosis and treatment. The government must prioritise the nation’s primary healthcare system. Having a workable primary healthcare system will go a long way in reducing the nation’s disease burden. Adequate primary healthcare system can actually take care of 70 per cent of the country’s disease burden. Unfortunately, most rural areas in the country cannot boast of functional health centres.
Let members of the public observe personal hygiene and do away with self-medication. The government should not wait for disease outbreaks before responding adequately. More attention should be given to disease prevention and control. Regular and compulsory environmental sanitation must be encouraged. The health authorities in the affected states should do more to contain the disease and avert its further spread to other states in the country. The federal, state and local governments must work as a team to halt the cholera epidemic.