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BAY_Cholera Response Prevention and Preparedness 2019_draft_v2_180719


Millions of people have been affected by cholera pandemics since the 19th century while the latest is striking since 1961. It is estimated that 2.8 million cases and 91,000 deaths occur annually due to cholera in 51 endemic countries around the world, where children under 5 account for more than half of the global incidence and deaths. In addition, the global burden of cholera remains high and Sub-Saharan Africa accounts for most of this burden.

Cholera is a water and foodborne disease highly contagious and its transmission results from inadequate access to safe water, limited or zero access to sanitation facilities, and poor hygiene practices. It appeared in 1970 in West Africa, initially in Guinea Conakry and then followed the West African coast through the south reaching Ivory Coast, Ghana, Togo and Nigeria in 1971. The first reported cases in Nigeria were in Lagos in December, from where it spread to the interior of the country with the city of Kaduna reporting cases in April 1972.

In Nigeria, UN plan and the report JMP 2019  reports that 71% of the total population have access to improved water sources, and 40% have access to improved sanitation. Where 24% of the total population practice open defecation, which is the accepted social norm in different rural areas.

The cholera Burden in Nigeria remains high despite its strong economic annual growth, thus highlighting significant inequalities. For example, 21.2% of the total reported cholera cases in West Arica between 2012 and 2017, occurred in Nigeria. Being only surpassed by the Democratic Republic of Congo with the 60%. During the most recent cholera outbreak in 2018, The Nigerian Centre for Disease Control reported an estimate of 44,000 suspected cases and 836 deaths. Around 90% of these reported cases came from northern Nigeria sates with twenty States reporting cases around the country, being Adamawa, Borno and Yobe, some of the most severely affected. Cross border infections between Cameroon and Niger cannot be neglected.

Access to safe water and improved sanitation facilities, as well as correct hygiene practices, allow for the contain, control and elimination of cholera transmission, as it’s been historically demonstrated in high-income countries.

The purpose of this plan is to provide a basic framework for best preparedness and effective response in case of outbreaks of acute diarrheal diseases (AWD), such as cholera or dysentery for example, amongst population in the states of Adamawa, Borno and Yobe. This plan comprises information on response activities, roles and responsibilities in the event of an outbreak and determines needs.

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