Cholera, a potentially life-threatening and primarily water-borne disease, is taking an epidemic status in Nigeria, having ravaged all the 19 northern states and the Federal Capital Territory (FCT) with four other southern states in the country.

In Nigeria, cholera is an endemic and seasonal disease, occurring annually during the rainy season and more often in areas with poor sanitation. However, major epidemics occurred in 1992, 1995 to 1996, and 1997.

The Federal Ministry of Health reported 37,289 cases and 1,434 deaths between January and October 2010, while a total of 22,797 cases of cholera with 728 deaths and case-fatality rate of 3.2 per cent were recorded in 2011.

Outbreaks were also recorded in 2018 with the Nigeria Centre for Disease Control (NCDC) reporting 42,466 suspected cases, including 830 deaths with a case fatality rate of 1.95 per cent from 20 out of 36 states from the beginning of 2018 to October 2018.

In 2021, despite the ravaging COVID-19 pandemic, Nigeria is battling with another scourge that had claimed 1,178 lives from 37,819 cases, according to the NCDC data released on August 13, 2021.

All the 19 northern states, according to the cholera situation report released on August 13, 2021 by the NCDC, had been ravaged by the disease.

In the last report released on August 6, 2021, there was no recorded incident of any suspected case in Taraba State.

Benue, Zamfara, Gombe, Kogi, Sokoto, Bauchi, Kano, Kaduna, Plateau, Kebbi, Nasarawa, Niger, Jigawa, Yobe, Kwara, Adamawa, Katsina, Borno and the Federal Capital Territory (FCT) have reported cases and fatalities, while Taraba State recorded 41 suspected cases with three deaths.

In the southern part of the country, Delta, Bayelsa, Cross River and Enugu states are listed among infected states. In the week of August 2 to August 8, 30 deaths were recorded in Niger (10), Katsina (eight), Jigawa (six), Kebbi (two), Kogi (two), Sokoto and Zamfara, one each. In the reporting week, 10 states reported 774 suspected cases – Zamfara (218), Jigawa (136), Kebbi (100), Niger (99), Katsina (97), Yobe (60), Sokoto (43), Kano (15), Kogi (four) and Adamawa (two).

Of this, there were 16 confirmed cases from Yobe (14), Niger (one) and Kebbi (one), with the most affected ages are five to 14 years.

The report, however, said there was a decrease in the number of new cases in the last two weeks, with Bauchi (773), Niger (284), Zamfara (253) and Katsina (217) accounting for 78.1 per cent of 1,956 cases reported. Bauchi is leading in the reported cumulative suspected cases in the country, having recorded 11,357 cases with 133 deaths, followed by Kano, having 6,197 cases with 188 deaths and Sokoto, 4,254 cases with 199 deaths. Of the 23 states and FCT, only Cross River, with 31 cumulative suspected cases, have not recorded any death from the epidemic.

Reacting to the widespread of the disease, the NCDC activated the cholera emergency operations centre on June 22, 2021 to coordinate the national response. It lamented poor access to clean water, open defecation, poor sanitation and hygiene in the affected states.

Reports from states

Findings by the Nigerian Tribune revealed that no fewer than 93 people have died of cholera in Kaduna between March and July, while two persons are currently on admission. Director, Disease Control, State Primary Health Care Board, Dr Hamza Ibrahim Kaura, disclosed this in an interview. He attributed the outbreak of the disease to ‘poor hygiene, poor environmental condition, lack of potable water, poor disposal of solid and other wastes’

He said, “We have 1,100 cases of cholera in 19 local government areas of the state, 93 people have lost their lives to it since March 2021. We didn’t get a report from four local governments. “Currently, we have only two cases of cholera and diarrhoea under admission in the state.” In Zamfara, no fewer than 30 people have reportedly died so far as a result of cholera while over 2,000 people are believed to have received first aid treatment on the disease in the state.

An official source from the state Ministry of Health who pleaded anonymity, said, “I’m not in a position to tell the exact figures of those who died, or are affected and admitted for cholera in the state, but on confidence and I don’t want my name in print, I know there are more than 2,000 people that were infected in the state.”

He said at least 30 people had been confirmed dead as a result of the outbreak of the disease in the state, adding that health officials and local health authorities were treating victims in health facilities at Bakura, Bungudu, Tsafe, Gusau, Zurmi, Kaura Namoda and Birnin Magaji local government areas.

Briefing Kebbi State governor, Atiku Bagudu, on the situation of the disease in the state, Kebbi State Epidemic Rapid Response Team (ERRT) confirmed that between January and August, cases of diarrhea and vomiting were reported in 20 out of the 21 local government areas of the state, out of which 55 samples were tested and 21 turned out to be positive to cholera. In a statement made available to newsmen by the Senior Assistant to the Governor on Media and Publicity, Malam Yahaya Sarki, shortly after the meeting, a total of 146 deaths had been reported across the state.

The outbreak of the disease claimed 30 lives in two months with more than 1,440 cases recorded in Plateau State.

Nigerian Tribune findings revealed that the outbreak was reported in 16 local government areas of the state, except for Mikang, which has not recorded any outbreak. Commissioner of Health, Dr Nimkong Lar, said the state had been recording cases of cholera since April, with the situation becoming more worrisome in June, before it was tackled by the state government.

“So far, the state has lost 30 people to cholera and recorded 1,446 cases. Most of those admitted in major hospitals in the state had since been discharged.

“We are not relenting in our efforts towards taming this disease, the NCDC has been working with us. Apart from effective monitoring of the situation, the state is also engaging in awareness and sensitisation campaigns on the need for personal hygiene and environment sanitation,” he said.

After the Enugu State government had stepped up preventive measures, after a surge of cholera in three northern local government areas of the state in the first quarter of the year, with, the state had enjoyed a near zero status of the disease.

However, in May, the mystery death of many people, mostly those from northern Nigeria at the Artesan Livestock Market, Enugu, put the health authorities on the spot to find out the cause. Commissioner for Health, Dr Ikechukwu Obi, who briefed newsmen on the matter, said the deaths were due to cholera outbreak.

Though Dr Obi could not be reached for an update on the matter on Sunday, a senior health official, who spoke on condition of anonymity, disclosed that there had not been any report of cholera from any of the primary health centres and hospitals in the state.

Adamawa State has recorded 60 suspected cholera cases, according to the coordinator, Cholera Containment Committee, Dr Selin La,ori. La,ori, who disclosed this at the Primary Healthcare Development Agency stakeholders’ meeting held in Yola, on Sunday, added that the meeting was to map out strategies to contain the spread of the disease.

She identified the affected local governments areas to include Yola North, Yola South, Girea, Gombi, Mubi North and Guyuk, adding that all the 60 cases had been treated and discharged. She said that three cholera treatment centres had been set up in Yola, Gombi and Guyuk, while the agency was intensifying efforts to contain the spread of the killer disease. Osun seems to be the first South-West states to record a case on cholera outbreak, with two persons reported to have lost their lives last week in Kuta, Ayedire Local Government Area of the state.

Nigerian Tribune gathered that three suspected cases were brought to the hospital before two eventually died.

Commissioner for Health, Rafiu Isamotu, confirmed the development and added that the state government promptly responded to a call from the traditional ruler in the town, Oba Maikaima Lalude, by taking the victims to hospital for proper medical attention. Isamotu affirmed that there was no case of the disease in the state until last week.

Commissioner for Health in Imo State, Dr Barth Okorochukwu, confirmed there is no case of cholera in the state. Okorochukwu told Nigerian Tribune in Owerri on Sunday that though the epidemic is not yet reported in any hospital in Imo State, the ministry of health had embarked on health campaigns on regular hand washing, among other health rules.

Also in Akwa Ibom State, Commissioner for Health, Professor Vincent Umoh, speaking to Nigerian Tribune on phone, said, “no such case has been reported anywhere in the state,” as he assured that adequate interventionist programmes had been put in place to contain the problem should it happen anywhere in the state.

The Ogun State Epidemiologist, Dr Hakeem Yusuff, said there was no single case of cholera in the state yet. In a telephone conversation with Nigerian Tribune, Yusuff hinted that the surveillance team of the state was active to ensure that any incident was tackled headlong. He noted that the state was monitoring situation report on cholera in the neighbouring states, adding that there were no cases in states that bordered Ogun.

Similarly, the Ondo State Ministry of Health said no single case of cholera has been recorded within the confines of the state. Though the Special Adviser on Health to the Governor, Dr Jibayo Adeyeye, could not be reached for comment, an official of the health ministry who spoke on condition of anonymity, said the disease is still alien to the state. The official said the state government had taken proactive steps to prevent the disease and keep it at bay in the state. She also disclosed that officials of the Primary Health Care Development Board had been traversing local government areas in the state to talk to locals on the need for cleanliness.

Ekiti State Commissioner for Health and Human Services, Dr Oyebanji Filani, affirmed that there was no case of cholera in the state at the moment, but added that government was being proactive with measures that would help in tackling it, “should there be any suspected case.” Filani noted that the government had designed cholera incident operational readiness plan and constituted a committee which would work in the area of surveillance, laboratory and sample transport and the management of the case, if any. On the epidemiology and surveillance strategy, he disclosed that government would intensify surveillance for early detection and reporting of all suspected and confirmed cholera cases.

In Oyo State, the Incident Manager, Emergency Operation Centre, Dr Taiwo Ladipo, said the state had not recorded any case of cholera, adding, however, that the disease is mostly prevalent at the start of rainy season and at peak of dry season when there is dearth of potable water. During a visit by Nigerian Tribune to the cholera ward at the Oyo State government-owned Jericho Specialist Hospital, Ibadan, the ward was seen to have been shut down for a while as no patient was on admission. During the visit, all the doors and entry points were under lock and key, just as beds, washing basins, chairs, table and other facilities were dusty.

One of the medical doctors at the hospital said “we have no cholera patient here. You can see that the cholera ward is closed. This is because we don’t have any patient. For now, there is no recorded case or cases in Oyo State.”

(Nigerian Tribune)

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