Cholera: Poor Reporting of Cases from States Major Challenge to Control —NCDC


Cholera outbreak. Illustrative file photo of patients in a makeshift hospital ward

The Nigeria Centre for Disease Control and Prevention has blamed poor and inconsistent reporting of cholera cases from states as one of the major challenges to the country’s response to the cholera outbreak.

The NCDC said this in its latest weekly Cholera situation report for weeks 44–47, on Tuesday via its official website.

The News Agency of Nigeria, reports that Cholera is a highly contagious disease that occurs in environments without clean water and proper sanitation.

It causes profuse diarrhoea and vomiting, and without treatment can quickly lead to death by intense dehydration. For most states, the current surge of cholera is due to specific, local conditions.

The public health agency said that the difficulty in accessing some communities due to security concerns, open defecation and poor hygiene practices in many communities were responsible for the surge in the disease.

The NCDC also highlighted inadequate health facility infrastructure, medication for the management of patients and inadequately trained personnel in states for case management posed a challenge.

It said that at the moment it’s tackling cholera outbreaks in 32 states and the Federal Capital Territory.

The NCDC said that a total of 583 deaths have been recorded due to cholera, while 23,550 people were suspected to have been infected with the disease between January and November 27, 2022.

According to the centre, suspected cases of cholera had been reported across 270 local government areas in the 32 states and the FCT.

The NCDC also said that of the suspected cases since the beginning of the year, the age group 5–14 years is the most affected; 49 per cent are males and 51 per cent are females.

“32 states and the FCT have reported suspected cholera cases in 2022. These are Abia, Adamawa, Akwa Ibom, Anambra, Bauchi, Bayelsa, Benue, Borno, Cross River, Delta, and Ekiti,

Others are FCT, Gombe, Imo, Jigawa, Kaduna, Kano, Katsina, Kebbi, Kogi, Kwara, Lagos, Nasarawa, Niger, Ondo, Osun, Oyo, Plateau, Rivers, Sokoto, Taraba, Yobe, and Zamfara.

“In the reporting month, six states reported 1,393 suspected cases: Borno (1,124), Gombe (165), Bauchi (61), Katsina (16), Adamawa (14), and Kano (13).

“There was a 78 per cent decrease in the number of new suspected cases in November Epi weeks 44–47 (1393) compared with October Epi weeks 40–43 (6306).

“In the reporting week, Borno (24), Gombe (14), Bauchi (13), Kano (5), Katsina (1), and Adamawa (1), reported 58 suspected cases.

“Borno, Gombe, and Bauchi states account for 88% of the 58 suspected cases reported in week 47.

“During the reporting week, two Cholera Rapid Diagnostic tests were conducted in Gombe 2 (100% positive).

“Two stool culture tests were conducted from Gombe, 1(100 per cent positive) and Bauchi 1(0 per cent positive) in epi week 47.

“Of the cases reported, there were two deaths with a weekly case fatality ratio (CFR) of 3.4 per cent,” it said.

The Public Health Agency said that there were no new state-reported cases in week 47.

It, however, said that the National Multi-Sectoral Cholera Technical Working Group continues to monitor response across states.

It added that six states—Borno (1,2459 cases), Yobe (1,888 cases), Katsina (1,632 cases), Gombe (1,407 cases), Taraba (1,142 cases), and Kano (1,131 cases) —account for 84 per cent of all cumulative cases and 15 LGAs across five states Borno (7), Yobe (4), Taraba (2), Gombe (1), and Zamfara (1)—reported more than 200 cases each this year.

The NCDC said that Cholera was easy to treat, with oral rehydration for most patients, and intravenous rehydration for more severe cases.

“If treated in time, more than 99 per cent of patients will survive the disease.

“An effective response to cholera involves engaging on several different fronts at the same time—and as fast as possible—to treat sick patients and to stop transmission within communities,” it said.

The NCDC, however, said that in the country, cholera was an endemic and seasonal disease, and occurred annually mostly during the rainy season and more often in areas with poor sanitation.

Meanwhile, some public health experts told NAN that the treatment and prevention of cholera come with considerable logistic challenges.

They said that setting up cholera treatment centres in affected states would require a lot of supplies, and so do water and sanitation projects.

“In places that are unsafe or otherwise difficult to access, that is a huge constraint. The number of outbreaks this year makes it very challenging.

“There’s already a shortage of cholera vaccines and the supply of other essential materials, like the fluid for intravenous rehydration, is also under pressure.

According to them, for political reasons, some state governments do not officially declare cholera outbreaks.

“This makes it very difficult to adequately inform people about how they can protect themselves, and impossible to do cholera vaccination campaigns,’’ one of the experts, who craved anonymity said.

NAN recalls that cholera is notoriously underreported and reliable global figures about the number of cases aren’t available.

The best estimates are between 1.5 and 4 million cases every year, this is according to Doctors Without Borders/Médecins Sans Frontières (MSF).



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