Cholera-related deaths rise as Lagos, Jigawa, Kano lead in casualties

Lagos, Jigawa, Kano, Oyo and four other states are leading the number of deaths from cholera since the beginning of the year, Daily Trust reports.

According to the Nigeria Centre for Disease Control and Prevention (NCDC), a total of 10,837 suspected cases and 359 deaths from cholera have been reported.

An analysis of the latest situation report from the agency showed that the deaths recorded occurred in 21 states.

Nine states with the highest casualties are Lagos (134), Jigawa (52), Kano (46), Oyo (26), Ebonyi (16), Adamawa (16), Rivers (13), Katsina (12) and Bauchi (10).

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The NCDC’s report stated that cumulative deaths recorded from cholera this year increased by 239 per cent compared to the ones recorded last year. The report also said suspected cases in the current year increased by 220 per cent compared to those reported as at week 39 of 2023.

According to the report, last month alone, 87 deaths, 1,938 suspected cases were recorded from the disease and 254 Rapid Diagnostic Tests (RDT) were conducted with 175 positive results.

States that have recorded cases include: Lagos (4,667),  Jigawa (870), Kano (809), Borno (588), Katsina (559), Adamawa (553), Bayelsa (513), Bauchi (307), Ebonyi (244),  Zamfara (212), Rivers (166), Abia (159), Yobe (146), Ogun (133), Oyo (128), Imo (90), Delta (85), Kebbi (83), Kaduna (74), Edo (55), Cross River (54), Osun (49), Sokoto (46), Ondo (41), Akwa Ibom (30), Kogi (25), Benue (23), Nasarawa (23), FCT (23), Ekiti (19), Niger (17), Gombe (16) and Kwara (16).

Cholera is a food and water-borne disease caused by the ingestion of the organism, vibrio cholera, in contaminated water and food. Water is usually contaminated by the faeces of infected individuals.

“Once the bacterial is transmitted from either food, water or any other sources contaminated with the bacteria into the mouth, it then has the propensity of igniting the disease process in the individual,” Dr Dawal Kwande Solomon, a Consultant Family Physician said.

While there are numerous causes of vomiting and diarrhoea, in the case of cholera, the frequency of the passage of the watery stool is actually quite significant.

NCDC said the time between infection and the appearance of symptoms is two hours to five days.

“It has a higher risk of transmission in areas that lack adequate sanitation facilities and/or a regular supply of clean water. Unsafe practices such as improper disposal of refuse and open defecation endanger the safety of water used for drinking and personal use,” it said.

Children below 5 most affected

The latest situation report from the NCDC also showed that children five years and below were the most affected among the suspected cases followed by the age group 5-14 years in aggregate of both males and females.

It said, of all suspected cases, 52% are males and 48% are females, adding that Lagos (4,667 cases) accounts for 43% of all suspected cases in the country.

The Director-General of the NCDC, Dr Jide Idris,  had in August warned of an expected increase in the cases and deaths from cholera, especially with the rainy season  and  flooding already reported in some parts of the country.

NCDC blames rainfall, open defecation

The NCDC said the contributing factors to the cholera outbreak include high rates of open defecation, which lead to contamination of water sources through the runoff of faecal matter.

The NCDC DG said the trend analysis from previous outbreaks showed the peak of the outbreak usually coincides with the peak of the rainy season.

It said rainfall significantly impacts the spread of waterborne diseases by affecting water quality and availability.

How government is responding to outbreak 

The NCDC boss said the National multi-sectoral Cholera TWG comprising the Federal Ministries of Environment and Water Resources, the National Primary Health Care Development Agency (NPHCDA), the World Health Organisation (WHO), the United Nations Children’s Fund (UNICEF) and other partners, continued to monitor and support response across states.

“In response, we will enhance both prevention strategies and case management measures to effectively address and mitigate the outbreak”, he said.

Experts proffer solutions

Medical experts, who spoke to Daily Trust, said Nigeria had been majorly reactive in its response to epidemics, and not doing enough to prevent them.

Dr Emmanuel Alhassan, Nigeria Coordinator, Global Health Advocacy Incubator (GHAI), which funds the Prevent Epidemics Project, said efforts and funding are more channeled towards responding to outbreaks than preventing them in the country.

Dr Akor Godday, a family medicine physician, said while the government has its roles to play, the public has a more crucial role to play in protecting themselves against cholera.

“The government has roles to play in providing water. However, even when it makes the water available and the masses don’t follow the basic rules of washing hands, and avoiding passing stool in water bodies, among others, definitely, the disease will continue to ravage the country,” he said.

The Director of Public Health, Edo  State Ministry of Health, Dr Stephenson Ojeifo, advised the public to maintain hygiene, keep their environment clean and report any suspected case to the nearest health facility.

The World Health Organisation (WHO) said a multifaceted approach is key to controlling cholera and reducing deaths. A combination of surveillance, water, sanitation and hygiene, social mobilisation, treatment, and oral cholera vaccines are used, it added.

To reduce the risk of cholera, the NCDC DG advised the public to do the following:

-Ensure that water is boiled and stored in a clean and covered container before drinking.

-Practice good personal hand hygiene by washing hands frequently with soap under clean running water.

-Use alcohol-based hand sanitiser if soap and clean water are not available.

-Ensure that food is well-cooked before consumption.

Jide said: “Only consume raw food such as fruits and vegetables, after washing thoroughly with safe water. After cooking food or boiling water, protect against contamination by flies and unsanitary handling. Left over foods should be thoroughly reheated before ingestion. Persons with diarrhoea should not prepare or serve food or haul water for others.

“Avoid open defecation, indiscriminate refuse dumping. Ensure proper disposal of waste and frequent clearing of sewage.

“If you or anyone you know experiences sudden watery diarrhoea, please do not self-medicate, visit a healthcare facility immediately”, he further advised.