Cholera: Managing current challenges, mapping path forward

By: Chisom Ozoigbo

AS of mid-2024, Nigeria has experienced a concerning surge in cholera cases, posing a significant public health challenge.

Cholera is an acute diarrheal disease caused by the bacterium vibrio cholerae, typically spread through contaminated water and food. It is characterized by a sudden onset of profuse, watery diarrhea, fever, weakness, dehydration, muscle cramps and low blood pressure and typically spreads faster in areas with inadequate sanitation, poor hygiene, and limited access to clean water. The disease is endemic in the country, with periodic outbreaks that vary in severity depending on numerous factors such as climate, infrastructure, and public health responses. In 2024, the situation remains critical as Nigeria battles with both urban and rural outbreaks, highlighting disparities in healthcare access and infrastructure.

Between January and July 2024, the Nigeria Centre for Disease Control and Prevention (NCDC) recorded over 3,623 suspected cases resulting in 103 deaths across 34 states including the Federal Capital Territory (FCT), Lagos, Borno, Adamawa, Yobe, Bayelsa and 184 Local Governments. This boils down to a cumulative case fatality rate of 2.8 percent since the year began.

Dr Adaobi Nwosu, an epidemiologist in Lagos, pointed out that the urban slums and rural areas are most affected by cholera due to poor sanitation and limited access to clean water. “The root of the problem lies in infrastructure, without substantial investment in clean water supply and sanitation facilities, cholera will remain a recurring nightmare. We cannot treat cholera in isolation, it is linked to poverty, education, and infrastructure. Comprehensive development strategies that tackle these issues are needed to see a real decline in cholera cases.”

Also, Dr Ifeanyi Okoro, an environmental health scientist at the University of Ibadan, emphasized that “climate Change is not just an environmental issue; it’s a health crisis. The frequent flooding creates perfect breeding grounds for the bacteria, leading to higher transmission rates. When we understand the patterns of cholera outbreaks in relation to climatic conditions, we can allocate resources more efficiently and implement preventative measures.”

In response to the recent threat, health experts are advocating for a multi-faceted approach that combines immediate response measures with long-term solutions. Rapid response teams have been deployed to affected areas, providing rehydration solutions and antibiotics, while community health workers educate residents about prevention methods.

Community engagement is also crucial in the fight against cholera. Dr Fatima Suleiman, a public health consultant based in Abuja, emphasizes the importance of involving local communities in health initiatives. “Communities are the first line of defense,” she said. “When people understand the disease and how to prevent it, they become active participants in protecting their own health.”

There is a call for stronger government commitment and international support to combat cholera effectively on a long term.

The Nigerian Government, through the NCDC and in collaboration with various partners has activated a multi-sectoral National Cholera Technical Working Group (NCTWG) to manage the outbreak. This group includes the Federal Ministries of Environment and Water Resources, the National Primary Health Care Development Agency (NPHCDA), the World Health Organisation (WHO), among others.

To control and possibly eliminate cholera in Nigeria, we must emphasize the importance of continued vigilance, improved infrastructure and enhanced community engagement.

Most importantly, international organisations like WHO and UNICEF must continue to work with Nigerian authorities to implement the Global Roadmap to End Cholera, which aims to reduce cholera deaths by 90 percent by 2030.

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