Cholera: Death toll rises to 63 as 10 Nigerian states lead infection chart

The Nigerian government said on Tuesday that the death toll from the rampaging cholera outbreak has risen to 63, and 2,102 suspected cases.

The Director General of the Nigeria Centre for Disease Control (NCDC), Jide Idris, disclosed this while giving the situation report on the infectious disease, even as he said cases have now been recorded across 122 Local Government Areas in 33 states of the country’s 36 and the Federal Capital Territory.

Mr Idris added that about 90 per cent of the cases were recorded in 10 states of the federation, with seven of them in the southern region.

“Of the top 10 states, Lagos, Bayelsa, Abia, Zamfara, Bauchi, Katsina, Cross River, Ebonyi, Rivers and Delta that contribute about 90 per cent of the cases, seven of them are southern states,” Mr Idris said.

He attributed the outbreak to the ingestion of contaminated food and water, even as he expressed the country’s capacity to curtail further spread despite the challenges posed by the culture of open defecation.

Activation of Emergency Operation Centre

Earlier, Mr Idris had said his agency had already activated the National Cholera Multi-Sectoral Emergency Operations Centre (EOC) to coordinate what he described as a robust response to nationwide cholera cases.

He said the agency activated the EOC after conducting a dynamic risk assessment.

He said: “In response to the rapidly increasing cholera cases, a dynamic risk assessment was conducted by subject matter experts on the cholera outbreak situation in Nigeria last week.

“The subject matter experts were drawn from relevant Ministries (Health, Environment, Agriculture, Water Resources, etc.), Departments, Agencies, stakeholders, and major partners. The outcome of the risk assessment placed the country at “High Risk” of increased risk of cholera transmission and impact”.

Identified challenges

While addressing the president, the DG highlighted some of the challenges faced in the fight against cholera, including open defecation, inadequate toilet facilities, and poor sanitation.

He said the government has demonstrated strong political will to control the outbreak despite these challenges, with an inter-ministerial cabinet committee established to support the response efforts.

He said: “Only 123 (16 per cent) of 774 LGAs in Nigeria are open defecation free, with Jigawa being Nigeria’s only open defecation-free state—more than 48 million Nigerians practice open defecation. Inadequate and existing toilet facilities are not well maintained, even in many government facilities.

“Inadequate safe water and poor sanitation: 11 per cent of schools, six per cent of health facilities, four per cent of motor parks and markets, have access to basic water, sanitation and hygiene services.”

He also listed other challenges, including waste management practices, food, environmental and personal hygiene practices, and the capacity gap among healthcare workers at the state and LGA levels.

“Weak regulation on the construction of soak-away and boreholes (some sunk close to a water source and boreholes sunk in the wrong location). Inadequate implementation and enforcement of public nuisance law and other relevant public health laws are some other challenges,” he added.

Mr Idris further noted that the inadequate state-level capacity leads to delayed disease reporting and response at state and local levels.

“Additionally, poor regulation of food vendors and commercial water supply compromises hygiene standards, while weak regulation allows boreholes and wells to be situated near sewage or toilet pathways,” he added.

He emphasised that low knowledge and practice of basic hygiene practices, such as hand washing and the exacerbating effects of climate change and flooding, are hindering efforts to contain the outbreak.

Global re-emergence of cholera

In June, the World Health Organisation (WHO) announced the re-emergence of cholera cases across countries in Africa, East Asia, America, Europe, and the Eastern Mediterranean region.

Data made available by the organisation showed that about 195,00 cholera cases have been reported in the five regions between January and May.

Africa was ranked the region with the second-highest cholera cases, with 92,789 cases from 14 countries. It closely followed the Eastern Mediterranean region, with the highest number of cases, more than 98,000 cases from seven countries.

For deaths recorded, Africa ranks highest with 1,698 deaths. The Eastern Mediterranean region, on the other hand, had 256 deaths.

This data, WHO said, combines both suspected and confirmed cases of the disease.