Awareness And Practices Regarding Cholera Preparedness And prevention

The cholera pandemic started in 1961, reaching West Africa and Nigeria late 1970. The first recorded cases of cholera in Nigeria occurred in a village near Lagos, on 26 December 1970 leading to an important epidemic of 22 931 cases and 2945 deaths (CFR 12.8%) during 1971. Between 1972 and 1990, Nigeria reported only very few cases. By 1991, 59’478 cases and 7’654 deaths have been reported with CFR of 12.9% which remains the highest rate reported by the country to date. Cases started to be recorded in January 1991 and among the first affected States were Kano, Akwa Ibom, Bauchi, Niger and Oyo. By September, the disease had spread to 19 of the 21 States including the Federal Capital. In March 1999, an outbreak of cholera was reported in Kano Municipal Local Government Area (LGA), Kano State. The outbreak was traced to the interruption of the domestic water supply for some days which forced people to use any water available. The outbreak also spread to Tofa LGA where 182 cases with 19 deaths were recorded over two weeks beginning in late April and further to Adamawa State (76 cases, 18 deaths) and Edo State (49 cases 24 deaths). Kano State seems to be particularly affected by cholera outbreaks in November 2001, 2050 cases including 80 deaths were reported by 18 LGAs. During the first week of January 2007, suspected cholera cases were reported in Delta State affecting the following Local Government Areas (LGAs): Ughelli South, Bomadi, Oshimili South and Burutu. In October 2007, the Obi LGA in Benue State reported 60 cases of gastroenteritis including one death. In December 2007, Gbajimba, in Guma LGA (Benue State) reported 36 cases including 9 deaths of “suspected” cholera cases. In 2008, Nigeria reported 5,140 cases including 247 deaths and in 2009, Nigeria reported 13,691 cases including 431 deaths affecting mostly the eastern states of the country (WHO, 2012). In the last quarter of 2009, it was speculated that more than 260 people died of cholera in four Northern states with over 96 people in Maiduguri, Biu, Gwoza, Dikwa and Jere council areas of Borno state (Igomu, 2011). Most of the Northern states of Nigeria rely on hand dug wells and contaminated ponds as source of drinking water.

The 2010 outbreak of cholera and gastroenteritis and the attendant deaths in some regions in Nigeria brought to the forefront the vulnerability of poor communities and most especially children to the infection. The outbreak was attributed to rain which washed sewage into open wells and ponds, where people obtain water for drinking and household needs. From January to December 2010, Nigeria reported 41,787 cases including 1,716 deaths (CFR 4.1%) from 222 LGAs in 18 States of the country. The regions ravaged by the scourge included Jigawa, Bauchi, Gombe, Yobe, Borno, Adamawa, Taraba, FCT, Cross River, Kaduna, Osun and Rivers. Even though the epidemic was recorded in these areas, epidemiological evidence indicated that the entire country was at risk, with the postulation that the outbreak was due to hyper-virulent strains of the organism, (Gyoh, 2011).

The most recent cholera in Nigeria was reported in 126 local Government areas of 23 states including Oyo State (FMOH, 2011). In 2011, the number of cholera cases started to increase during week 8 to reach a peak of 1200 weekly cases at the beginning of April. As of 23 October, 22,454 cases including 715 deaths (CFR 3.2%) were reported in 25states (195 LGAs) (WHO, 2012).