Once again Nigeria as a nation is struggling to battle with the outbreak of an epidemic disease called Cholera which is caused by a bacterium known as “Vibrio cholera” and it has continued to be a global threat to public health and a key indicator of lack of social development. Once common throughout the world, the infection is now largely confined to developing countries. Developing countries are disproportionately affected because of their lack of resources, infrastructure and disaster preparedness systems. In newly affected areas, outbreaks may occur during any season and affect all ages equally. The bacterium normally lives in aquatic environments along the coast. People acquire its infection by consuming contaminated water, seafood, or other foods. Once infected, they excrete the bacteria in stool. Thus, the infection can spread rapidly, particularly in areas where human waste is untreated.
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WHY CHOLERA SPREADS LIKE WILD-FIRE IN NIGERIA
It is believe that lot of factors are contributors to the wild-spread and re-occurrence of cholera infection in Nigeria. Researchers are of the opinion that the major cause of cholera is by drinking of contaminated water, it has been found out that mostly the northern part of the country was depending on hand dug wells and contaminated ponds for their drinking water source, meanwhile efforts should have been made to provide them with good drinking water. In regards to this a family health physician, Dr. Ibrahim Ogunbi stated that, cholera is an intestinal infection characterized by watery stool and diarrhea which is caused by the bacterium, which release toxins in the human intestine. This toxin is said to activate excess secretion of water from the intestinal lumen that often leads to severe dehydration and sometimes death. The major reasons for the consistent outbreak of cholera in the country, Ibrahim Ogunbi explained is poverty, dirty environment and lack of social amenities like water.
“Many Nigerians have no access to safe water. Many depend on dug well for their water supply which is mostly contaminated by heavy flood which can cause the movement of water from one place to another contaminating the source of water. It is also known that flooding can cause septic tanks to contaminate water resources. This is why cholera outbreak increases during the rainy season”.
Also studies have shown that people who develop symptoms, 80 percent have mild or moderate symptoms, while around 20 percent develop acute watery diarrhea with severe dehydration. In severe infections, more than one quarter of water and salts is lost per hour. Within hours, dehydration can become severe, causing intense thirst, muscle cramps and weakness. Very little urine is produced and the eyes may become sunken, and the skin on the fingers may become much wrinkled. If dehydration is not treated, loss of water and salts can lead to kidney failure, shock, coma and death.
Another factor that can greatly spread cholera in Nigeria is population movement this increases the spread of the infectious agent to others and to different location. It is really bad that conditions such as the disruption in water supply, poor basic sanitation and poor hygiene have persisted and have contributed greatly to cholera infections in Nigeria. In other to reduce the level of risk in spreading cholera Dr. Ogunbi advised that the government must tackle the factors that cause flooding. It must also take decisive steps to relocate residents from flood prone areas and improve on environmental sanitation and public health campaigns. He stressed that;
“Educating Nigerians first about cholera is important. There is a need for them to understand the symptoms and seek medical help on time”, there is need for Niger to pay attention to a cleaner environment. There is also the need for government to make available vaccination for cholera. Government should assist in providing vaccines to those areas affected so that they don’t spread the disease, oral vaccination can be given and treatment should also be free”.
He also called on government to investigate outbreaks and find a lasting solution to the causes. He further explained that to break the chain of outbreaks, there is a need for the ministries of health to establish treatment centres in areas where the outbreaks are common. Studies also show that eradicating cholera and other diarrhea diseases in Nigeria will require a multi-sectoral approach. The ministries of water resources, rural development, urban planning and health must contribute. Also government must show the political will to invest in infrastructure as well as health sector development.
HOW TO CONTROL CHOLERA SPREAD IN NIGERIA
Various studies have utilized geographic and mathematical information systems to assess spatial distribution of cholera at local levels, demonstrating case clustering and disease risk areas. Modeling techniques using climate data, remote monitoring, and geographic information systems also provide new techniques that may contribute to the prediction of cholera epidemics. We propose that such models can aid understanding of epidemic processes and help design effective control strategies. Due to its wide spread in Nigeria, surveillance systems can provide early alerts to outbreaks, therefore leading to coordinated response.
It is also necessary to introduce intervention measures that address the root problems of poor sanitation and unsafe water supplies in order to prevent future cholera epidemics. In this regards, perhaps, prevention of the disease is the best way to counter subsequent outbreaks. Simple measures as boiling the water for drinking, washing and cooking purposes, treatment of infected facilities, sewages and drainage systems, proper disposal of infected materials such as waste products, clothing, and beddings, treatment of infected waste water produced by cholera victims and sterilization of utensils either by boiling or by using chlorine bleach. Understanding the seasonality and location of outbreaks may also provide guidance for improving cholera control activities for vulnerable areas.
Vigorous health promotion activities in terms of continuous public enlightenment on cholera are evidently essential to controlling the infection. Health systems need to be strengthened with the provision of adequate manpower, equipment, drugs and consumables. There should also be an improvement on surveillance systems, communication and transport. Mechanisms for quick intervention should be put in place.