Dr. Chikwe Ihekweazu, is the Chief Executive Officer (CEO), Nigeria Centre for Disease Control (NCDC). In this interview with PATIENCE IVIE IHEJIRIKA, he stressed the role of Water, Sanitation and Hygiene (WASH) in tackling cholera Epidemic in the country.
Sir, could you give us the statistics of cholera disease in Nigeria in the past 5 years; the spread of the latest outbreak and the number of deaths recorded?
Over the last few years, Nigeria has recorded hundreds of cases of cholera. The disease continues to spread especially in areas with poor water, sanitation and hygiene conditions. Between January 2018 and the 14th of August, we have recorded 331 deaths, from suspected and confirmed cases of cholera.
Which states are most endemic?
We have recently worked with the World Health Organisation (WHO) to identify States that have the highest burden of cholera in Nigeria. Some of these include Kano, Kebbi, Borno, Kaduna, Bauchi, Zamfara, Plateau, Nasarawa, Kwara, Taraba, Katsina, Adamawa, Benue and Rivers. With this information, we are working with our sister agency NPHCDA to develop better intervention and control strategies, including a medium term oral cholera vaccination plan.
What are the key causative factors?
The bacteria that causes cholera is transmitted mostly through the consumption of contaminated food and water. This can be spread in dirty environments especially where there is open defecation and inadequate provision of clean and safe water. We need to ensure our environment is kept clean at all times, water is boiled and stored in a clean and safe container and food, especially fruits and vegetables, are well prepared and stored for consumption.
Why is Nigeria still not able to combat the menace?
The Nigeria Centre for Disease Control (NCDC) continues to support States in responding to outbreaks of cholera. However, we must increase the focus on water, sanitation and hygiene (WaSH). Without these, many communities continue to remain at risk of spread of cholera. In addition, it is important that people avoid self-medication and visit a health facility if they experience symptoms associated with cholera such as diarrhea and vomiting. Cholera is treatable and chances of survival are higher when treatment is initiated early.
How best can it be tackled?
The most effective solution to prevent cholera outbreaks is to provide clean and potable water, ensure proper sanitation and hygiene facilities are in place. This includes clean toilets especially in public places to prevent open defecation. At NCDC, we have ramped up our risk communications campaign so that people are better aware of the risk factors and ways to prevent cholera outbreaks. We are also strengthening the disease surveillance and laboratory systems so that cases are reported early, detected in time and response measures initiated.
Ebola is still present in part of DR Congo, are there measures put in place to ensure the disease is not imported into Nigeria?
Based on assessments carried out by NCDC as well as globally by WHO, Nigeria is not at an increased risk following the outbreak in the DRC. Notwithstanding, we have maintained close communication with colleagues in DRC through WHO and strengthened our surveillance alert systems. We continue to train personnel with the capacity to immediately respond in the event of an outbreak. We have also focused on strengthening our risk communications activities so that Nigerians are aware of what to do in the event of an outbreak.
Currently, there is measles outbreak in Benue IDP’s camps, is the NCDC responding to this?
NCDC continues to support States in the response to disease outbreaks. We have Technical Working Groups for the epidemic prone diseases in Nigeria, including measles. They continue to monitor the situation in the country and respond as required. However, remember that measles is preventable by a simple vaccine that is free at every immunization centre in public health facilities in Nigeria. We can prevent measles by vaccinations.
Heat period is approaching and as usual, there will be meningitis outbreak, how proactive is NCDC in the regard?
We continue to strengthen our capacity at NCDC to be better prepared for outbreaks.
We have just concluded an After Action Review meeting for the 2018 Meningitis outbreak. While the response this year was better compared to 2017, we continue to build on our experience to develop better outbreak preparedness and response plans.
Working with States and our partners, we are in the process of reviewing our preparedness plans based on lessons from this year’s response. In addition, we are improving the diagnostic capacity across the country so that Meningitis cases are detected and treated early. Critically, we are asking the State governments to take more responsibility, to prevent cases and ensure that early diagnosis and treatment is available.
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