By Adémólá Òrúnbon
In Nigeria, cholera has been on the rise since the 1970s majorly due to extreme poverty and lack of good potable drinking water. The probable reasons are the result of government negligence in embarking on initiatives that will improve the lives of an ordinary citizen. The majority of the people in Benue State, Nigeria, are rural dwellers who have little or no access to basic modern facilities; hence, the outbreak of diseases is inevitable.
Cholera was first reported in Nigeria in 1970. Since 1990, large outbreaks were reported in 1991, 1996, 1999 and from 2009 to 2011. Between 2004 and 2016, a total of 154,910 cases and 5,127 deaths were reported (CFR ≈ 3.3%). The largest outbreaks were reported in the northern states of the country. In the north, outbreaks often spread from Nigeria to neighbouring countries around Lake Chad (Niger, Chad and Cameroon) and in the south along the Gulf of Guinea.
A multi-sectoral study, linking water, sanitation, hygiene and health sectors, was carried out in the four countries of the Lake Chad basin, and especially Nigeria. This study aimed to propose an integrated WASH and Health response by first describing the epidemiology of cholera in the Chad Lake Basin and secondly by suggesting actions of prevention, preparedness and response to cholera epidemics. The Lake Chad Basin is a specific area with a climate typical of Sudan and the Sahel. The lakeside area and the lake’s tributaries as well as a marked seasonality structure the agriculture, pastoral and transhumance activities that take place here. In this essentially rural space, cross-border communication channels attract commercial activities. Population displacements occur between the several major agglomerations where dense neighbourhoods have structural difficulties with water conveyance and sanitation.
Cholera is an infection caused by the bacteria vibrio cholerae. More often than not, the bacteria is transmitted via contaminated water or food that has come into contact with contaminated water. The most common symptoms of cholera include extensive watery diarrhoea, severe vomiting, nausea, dehydration, loss of electrolytes, and muscle cramps. Severe cases may result in death, especially among children and the elderly.
The bacteria that causes cholera is usually passed out of the body of an infected person via the faeces. These bacteria may then contaminate a common source of drinking water and become widespread among populations. Poor water hygiene and sanitation are therefore important factors in the spread of the disease.
Cholera has been almost eradicated in most developed nations worldwide. It is, however, still a major health hazard in sub-Saharan Africa, south and south-east Asia, some parts of the Middle East and South America. Outbreaks of cholera may occur after natural disasters such as earthquakes or after war when there is overcrowding and lack of sanitation. Travellers are also susceptible to catching cholera, especially if they are travelling to areas where cholera is still endemic.
Good hygiene, access to clean drinking water, adequate sanitation facilities, and hand washing before eating and after using the toilet are simple measures taken that have reduced the incidence of cholera worldwide. Travellers are also advised to avoid ice creams and fruit juices offered by street vendors who display their sales goods in the open where they are exposed to flies and contaminants. In addition, travellers should not eat raw, unwashed vegetables, fruits, salads, or shellfish.
There is an oral vaccine that can help prevent cholera and is estimated to be 85% effective. Vaccination is recommended for travelling to areas where cholera is endemic, such as refuge camps and war zones.
The severe dehydration and loss of electrolytes from the body through vomiting and diarrhoea can cause death among victims of cholera. The first and foremost therapy is, therefore, replenishment of fluids and electrolytes in the form of Oral Rehydration Solution (ORS), as recommended by the World Health Organization (WHO). An ORS sachet contains a powder made up of salts and glucose, which can be dissolved in clean drinking water. Antibiotics are also useful in reducing symptoms and treating the disease.
Although cholera can be life-threatening, it is easily prevented and treated. In the United States, because of advanced water and sanitation systems, cholera is not a major threat; however, everyone, especially travelers, should be aware of how the disease is transmitted and what can be done to prevent it. Cholera has been very rare in industrialized nations for the last 100 years; however, the disease is still common today in other parts of the world, including the Indian subcontinent and sub-Saharan Africa.
The National Biosafety Management Agency has called on the general public to exercise caution over the recent cholera outbreak in some states across Nigeria, as the outbreak has now trying to become an epidemic as it is spreading across the state, just last week or thereabouts, it was recorded in Ogun state as announced by the state Commissioner for Health, Dr. Tomi Coker, which occurred in Ijebu-Igbo, Ijebu North Local Government Area of the state.
Head, Information and Communications for NBMA, Mrs. Gloria Ogbaki, in a statement recently in Abuja, quoted the Director- General, NBMA, Dr. Agnes Asagbra, as saying there was need for carefulness, “Asagbra said Nigerians must exercise caution as Nigeria records over 30 deaths and 1,141 suspected cases from the disease.
“Cholera, a highly contagious bacterial infection caused by the ingestion of contaminated food or water, has been reported in Bayelsa, Zamfara, Abia, Cross River, Bauchi, Delta, Katsina, Imo, Nasarawa, and Lagos States.’’
Asagbra said NBMA, in collaboration with health authorities, was actively monitoring the situation and implementing measures to contain the spread of the disease. She also called on Nigerians to imbibe various hygiene practices such as boiling drinking water or using certified water purification methods. According to her, there is a need to wash hands thoroughly with soap and water, especially before eating or preparing food.
The Director-General also urged Nigerians to always wash hands with soap and water after using the toilet, cook food thoroughly, and consume it while it was hot, advised that Nigerians to avoid raw foods, such as fruits and vegetables, unless they could be peeled or washed with safe water and to always keep the environment clean and dispose of waste properly to prevent contamination
It is now imperative to all Nigerians to be vigilant and adhere to these hygiene practices to protect themselves and their loved ones from cholera. Nigerians should also to be on red alert and report any case of cholera to the nearest hospital to aviod or avert the spread of the dearly disease.
- Òrúnbon, an opinion writer, poet, journalist and public affairs analyst, writes in from Federal Housing Estate, Olomore, Abeokuta, Ogun State. He can be reached via: orunbonibrahimademola@gmail.com, or 08034493944, 08029301122.
