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Nigeria Cholera Factsheet

CHOLERA OVERVIEW

Cholera was first reported in Nigeria in 1970. Since 1990, large-scale epidemics occurred in 1991, 1996, 1999, 2009-2011, 2014 and 20171. Large-scale epidemics have been more frequent over the last ten years (Fig. 1). Between 2010 and 2017, epidemiological surveillance reported   122,239 cases with 3,713 deaths (case fatality rate ≈ 3%)2. The majority of cases were reported in the central north region of the country, where the states of Bauchi, Kano, Kaduna, and Katsina reported 51.7% of all cholera cases2 (Table 1). Cross-border cholera outbreaks have occurred in the north, between Nigeria and other Lake Chad countries (Niger, Chad, and Cameroon), and the south along the Gulf of Guinea3.

 

STRATEGIC RECOMMENDATIONS

Cross-border outbreaks often occurred between Nigeria, Niger, Chad and Cameroon, involving northern Nigeria states (Zamfara, Katsina, Kano, Kaduna, Bauchi, Borno and Adamawa)3 (Table II and Table III), thus stressing the importance of a cross-border early warning system as well as coordinated control and prevention activities.

In regularly affected local government areas, preparedness and response plans should include (1) strengthened early warning and rapid response systems including community-based surveillance and cross-border alerts; (2) the establishment of cross-sectoral and cross-border coordination mechanisms; (3) epidemic management capacity building; (4) targeted supply prepositioning; and (5) communication plans and messages.

Sustainable access to water, sanitation and hygiene programs should be prioritized in Type 1 hotspots (Fig. 5, Table II, Table III). Due to the high CFR in some local governments, outbreak management training and pre-positioning of supplies are highly recommended (Table III).

A 2010 study showed that using water from open wells in the north was a cholera risk factor. The study proposed replacing open wells with boreholes or protected wells, developing household water treatment methods, expanding Community-Led Total Sanitation in rural areas, and monitoring free residual chlorine levels (i.e., public network water and water sold by street vendors) in northern cities such as Bauchi, Kastina, Kano, Maidugiri, Gombe, Gusau and Sokoto.3

 

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