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Nigeria And Preventable Epidemics



Prof Adewole, Health Minister

Cholera is an acute diarrhoea infection caused by ingestion of food or water contaminated with the bacterium, Vibrio cholera. Choleragenic V. cholera O1 and O139 are the only causative agents of the disease. The two most distinguishing epidemiological features of the disease are its tendency to appear in explosive outbreaks and its predisposition to causing pandemics that may progressively affect many countries and spread into continents.

In Nigeria, since the first appearance of epidemic cholera in 1972, intermittent outbreaks have been occurring. For some time now, this disease has plagued certain sections of the country and, as expected, with devastating effect.

According to the fourth situation report of the Nigerian Centre for Disease Control (NCDC), as at 22 June, 2018, a total of 13,009 suspected cases and 116 deaths were reported from 12 states: Adamawa, Anambra, Bauchi, Borno, Kano, Kaduna, Kogi, Nasarawa, Niger, Plateau, Yobe and Zamfara. From available line-lists, the first reported cases were from Kano (01-Jan-2018), Anambra (04-Jan-2018), Borno (13-Feb-2018), Bauchi (27-Feb-2018), Kogi (04-June-2018) and Niger (03-June-2018).

In March, cholera also killed one person in Bauchi State. In June, it killed one person in Nasarawa while 20 others were afflicted.  The same month, one inmate of Gombe prison was killed by cholera with many others in the same facility hit by the pandemic. In July, 20 deaths had already been recorded from cholera while 181 cases were recorded. Adamawa State also recorded 1,564 cases of the disease during the same period under review.

The NCDC weekly epidemic report (week 20) on cholera shows that there were 190 suspected cases with 17 laboratory confirmed cases and 17 deaths reported from 11 LGAs in seven states. Adawama had 100 cases, Bauchi had 22, Borno had 20, FCT had only one case while Kaduna had two. Kano had 44 cases and Zamfara only one case in week 20, 2018 compared with three suspected cases reported from Kaduna South LGA, Kaduna State, during the same period in 2017.

In Katsina State 20 deaths were recorded from cholera. According to the centre, between weeks one and 20, 2018, 4827 suspected cholera cases with 154 laboratory confirmed and 76 deaths from 56 LGAs in 18 states were reported compared with 83 suspected cases and four deaths from 15 LGAs in 11 states during the same period in 2017. The statistics above confirms that actually there are rising cases of the disease in Nigeria.

Unfortunately, this was after the United Nations, through the Nigeria Humanitarian Fund (NHF), allocated $2million to support the response to cholera outbreak in parts of northeast Nigeria. The federal government and her global partners had put a lot of machinery in motion to halt the scourge.

It is also unfortunate that despite these interventions, some of the known and established causes of the infection, open defecation, poor water supply, poor sanitation, are sadly on the rise in the country. Researchers have estimated that every year, there are roughly 1.3 to 4.0 million cases, and 21, 000 to 143, 000 deaths worldwide due to cholera.Nigeria ranks among  the top three countries in the world with the largest number of people practising open defecation (OD).

The country is not free of other epidemics like Lassa fever and Cerebrospinal Meningitis. NCDC in its Weekly Epidemic Report, May 20, 2018, claimed that 19 suspected Cerebrospinal Meningitis (CSM) cases were reported from 12 local government areas (LGAs) in five states; Borno with five cases, Ebonyi with two, Katsina with 10 , Nasarawa and Yobe with one case respectively, while there were 128 suspected cases with six laboratory confirmed and four deaths from 45 LGAs (12 states) at the same period in 2017.

Also in the report, between weeks one and 20, 2018, 2970 suspected meningitis cases with 79 laboratory confirmed and 184 deaths from 242 LGAs (29 states) were reported compared with 9472 suspected cases and 596 deaths from 288 LGAs (31 States) during the same period in 2017. On Lassa fever, the epidemic  report  indicates that  between weeks 1 and 20, 2018, there were 1968 suspected cases with 431 laboratory confirmed cases and 118 deaths  from 141 LGAs in 29 states compared with 286 cases with 60 laboratory confirmed cases and 48 deaths  from 55 LGAs in 21 states during the same period in 2017. IIt is time the three tiers of government, and other international aid agencies including friendly donors, moved to halt and obliterate these diseases through the uplifting of the people’s economic power which in turn would aid the provision and consumption of safe water and general improvement in the hygiene and sanitation level in the country.