20août2017

Cholera Platform

Against cholera

UNICEF Cholera factsheet

Nigeria Cholera Factsheet

CHOLERA OVERVIEW

Cholera was first reported in Nigeria in 1970. Since 1990, large outbreaks were reported in 1991, 1996, 1999 and from 2009 to 2011 (Fig. 1). Between 2004 and 2013, a total of 105,483 cases and 3,913 deaths were reported (CFR ≈ 3.7%)1. The largest outbreaks were reported in the northern states of the country .In the north, outbreaks often spread from Nigeria to neighboring countries around Lake Chad (Niger, Chad and Cameroon) and in the south along the Gulf of Guinea2.

STRATEGIC RECOMMENDATIONS

Outbreak onset and cross-border spread are fre-quently occurring in northern states (Zamfara, Katsina, Kano, Kaduna, Bauchi and Adamawa). High-risk cholera areas are located on corridors where outbreaks spread from and to neighbour­ing countries, mainly Niger, Chad and Cameroon, highlighting the importance of cross-border activities2.

In regularly affected states and LGAs, prepared­ness and response plans should be developed and implemented including:

  1. strengthening early detection and rapid response systems of which community based surveillance and cross-border alert;
  2. setting up coordination mechanisms across the sectors and borders;
  3. building capacity on outbreak management;
  4. targeted pre-positioning of supplies and
  5. preparing communications messages and plans (Fig. 4). Because of the high CFR, training on outbreak management and pre-positioning of supplies are highly recommended in targeted LGAs.

Sustainable Water, Sanitation and Hygiene activ­ities (WASH) should be carried out in regularly affected priority LGAs, especially those with and with outbreaks of long duration (Fig. 4, Type 1). A 2010 WASH and epidemiological study conducted in the four Lake Chad basin countries shows that the use of water from open wells in northern Nigerian states is a risk factor of cholera epidemics2. The study recommends the replacement of open wells by boreholes or protected wells, the development of household water treatment methods and the scaling up of Community-Led Total Sanitation (rural setting). Furthermore, testing and increasing the level of free residual chlorine (post chlorination dosing pump) of water from water networks and from the water sold by street vendors should be performed in major affected cities in northern Ni­geria (Bauchi, Kastina, Kano, Maidugiri, Gombe, Gusau and Sokoto).

The benefit and feasibility of using Oral Cholera Vaccines in identified cholera hotpots and high risk groups should be assessed (Fig. 4).

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