By Ben Ogbemudia, Keturah Elijah and Olusegun Olanrewaju
No fewer than 479 persons have lost their lives to cholera between January and July 2021 in the country, the Nigeria Centre for Disease Control (NCDC) has revealed.

This comes as no fewer than 19, 305 persons contracted the disease within the period.

The NCDC, which made these known in its Cholera Situation Report as of July 11, noted that 52 per cent of the suspected cases were recorded among males, while 48 per cent others were females.

Of the reported cases, 11 per cent of them, the centre added, were youngsters aged between five and 14.

The figure is besides the 14 deaths recorded in Enugu State as well as other unconfirmed reports from across the country in the last few days.

Meanwhile, the NCDC, which admitted that the disease has increased in the country, noted that the suspected cases were recorded in 18 states and the Federal Capital Territory (FCT) Abuja.

The affected states are Benue, Delta, Zamfara, Gombe, Bayelsa, Kogi, Sokoto, Bauchi, Kano, Kaduna and Plateau.

Others are Kebbi, Cross River, Nasarawa, Niger, Jigawa, Yobe, Kwara and the FCT.

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The centre in its report added, “There has been an increase in the number of new cases in the last two weeks. Bauchi (2, 660), Kano (441), Jigawa (321) and Kwara (143) account for the 92 per cent of the 3, 878 cases reported in the last two weeks”.

Recall that as of June 27 this year, 325 deaths as well as 14, 343 suspected cases were recorded in the country.

In a related development, no fewer than 300 persons were admitted to a hospital for the disease in Bauchi last Friday, forcing a call for the declaration of state of emergency in the state.
A team of medical experts from the Bauchi State Primary Health Care Development Agency (BSPHCDA) and ActionAid Nigeria the previous day, visited Dass, the headquarters of the affected local government area on an assessment tour.

Speaking during the tour, the BSPHCDA Director of Programmes, Hajia Suwaiba Jibrin, lamented that despite the reporting of 591 suspected cholera cases between May and July, the NCDC had yet to intervene in the crisis.

Jibrin said there was an urgent need for the centre to assist the state to tackle the disease, which he attributed to poor personal hygiene habits among the people.

Also, in the FCT as of Friday, it was reported that the fatalities rose to 60, whereas suspected cases rose from 604 to 698.

Though the authorities have yet to declare the outbreak a national disaster, medical experts are urging the NCDC to scale up its response to ensure that lives are saved.
Appraising the development, the spokesperson for the Federal Medical Centre in the FCT, Kayode Olomofe, said the centre was on top of the situation.

He attributed the cause of the deaths to the ignorance.

Olomofe said though the hospital was currently receiving referral from different Primary Healthcare Centres (PHCs) across the six area councils, he could not immediately confirm the mortality toll so far.

When our correspondents visited the FMC, some victims of disease were seen at the emergency care unit of the hospital.

Officials of the unit, who refused to speak to our correspondents, only referred our correspondents to the Public Relations department for detailed information.

Olomofe said, “As I speak with you, I don’t have the total figure of the cholera patients in our hospital.’’

Promising to make the record available next week, Olomofe, however, admitted that some patients were receiving treatment at the facility.
At the Primary Healthcare Centre, Area 2, Abuja, the Officer-in-Charge, John Lucy Ogada, said she was just returning from an awareness enlightenment meeting on the cholera outbreak with the Director, Healthcare Services.

She added that they were on top of the situation to save lives from the disease.

Though she said they had not recorded any case at their centre, Ogada added that they were prepared to attend to any case.

Confirming this, a medic at the centre, Dr. Chike Ezekpeazu, said they had not had any case of cholera since the outbreak.

“Yes, no case has been recorded at this centre. We have placed everyone on the alert. If it is above our capacity, we shall refer the case to the FMC. For now, we have yet to witness any case.

Nigeria’s cholera cases rise
“Again, we have set up committees on awareness campaign because many people don’t know that cholera is deadly.

Meanwhile, the Federal Capital Territory Administration (FCTA) has placed its residents on the alert following a reported outbreak of the disease in Abuja and its environs.

The FCTA Executive Secretary, Primary Healthcare Board, Dr. Iwot Ndaeyo, said no fewer than 514 suspected cases had been recorded and were currently hospitalised.

Also, findings by our correspondents showed that 45 deaths had been recorded so far in Gwagwalada, Bwari, Kwali and Abaji.

The Senior Special Assistant (SSA) on Media to the FCT Minister, Abubakar Sani, said, “Of this number, eight laboratory investigations were confirmed to be cholera.”

Sani said continuous surveillance on communities with suspected cases were being conducted in all the communities in the six area councils of the FCT to confirm the prevalence of the disease.

The FCTA, Sani said, had taken some measures to stop the spread of the disease, as well as to provide care to those affected by the cholera.

He added, “As of July 8, 2021, the FCT has recorded 514 suspected cases. Out of this number, eight laboratory investigations were confirmed to be cholera.

“The FCT administration is also working very closely with the National Primary Healthcare Development Agency on all the important interventions to end the scourge of the disease in the territory.”

On what FCTA was further doing to contain the spread, he said, “Some of the measures already taken from early May 2021 when we started having the diarrhoeal disease in the FCT are: Formation of Cholera Emergency Operation Centres and appointment of an Incidence Managers and other relevant medical personnel along with stakeholders from the FCT Water Board, Abuja Environmental Protection Board, Rural Water and Sanitation Agency [RUWASA), among others, who are also in the team.

“Prepositioning of drugs and consumables for the free treatment of all identified cases in both secondary and primary care facilities of the FCT, and provision of free potable water through water tankers from the FCT Water Board to all affected communities.

“Training and sensitisation of health care providers in both secondary and primary healthcare facilities, including some private ones.”

Although Lagos has yet to record any case of cholera, an official of the health ministry, told one of our correspondents that he would only get a response from him if the commissioner approved it.

He, consequently, urged our correspondent to first write to the health commissioner.

Causes of infection
Vitamin B12 deficiency and gastritis have been recorded to be one of the risk factors for infection.

Experts say the bacteria causing the ailment are often expelled through human faeces for nearly two weeks after infection. These can then be shed into the environment to infect other people.

Another identified as the basic causal factors are lack of access to safe drinking water and poor personal and environmental hygiene.

Infection, the experts add, also occurs when people eat or drink things that were already contaminated by bacteria.

From a research carried out between 1995 and 1996 for an outbreak in Kano State, experts said they found evidence that poor hand hygiene before meals and vended water played a role.

Population congestion is also identified as a factor in the spread of cholera. This, according to findings, can happen through migration to commercial hubs such as big cities.

Humanitarian disasters often force displaced people to live in camps, where they often have inadequate water supply and face inability to observe good sanitary practices.

The disaster
Over 2.9 million people are said currently living as internally displaced persons in North-Eastern Nigeria.

No fewer than 10,000 cholera cases and 175 related deaths were reported in Yobe, Adamawa and Borno states predominantly in crowded camps in 2018.

Living in urban and semi-urban slums promotes cholera too. This is because regular water supply and toilet facilities are not adequately available.

Only 26.5 per cent of the Nigerian population use improved drinking water sources and sanitation facilities, and 23.5 per cent defecate in the open.

Further action point
According to the authorities, much remains to be done to contain the rampaging disease since cholera has not been completely conquered.
Cholera has been described as a “disease of poverty” because social risk factors play significant roles in its transmission.

To contain the spread, many of the causal factors have to be addressed in a joint collaboration with relevant agencies and governments.