SEMINAR PRESENTATION ON CHOLERA OUTBREAKS IN NIGERIA

1.1 Introduction

Cholera is an epidemic prone diseases that causes watery diarrhea, lives naturally in brackish-fresh water, without quick response or untreated, may lead to dehydration and possible human deaths. Cholera an infectious disease caused by a bacterium known as Vibrio cholerae usually found in contaminated food and water. Cholera continues to be a significant threat to global public health with an estimated 2.86 million cases and 95,000 associated deaths occurring annually, of which, only a fraction is reported due to inadequate surveillance systems and inconsistencies in case definitions as well as economic, political, and social disincentives (Ali et al. 2015).

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.

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1.2 Background of Study

Globally, cholera is currently prevalent in Africa, Asia, and parts of the Middle East, where Yemen reported recently the most cholera cases in a single country (World Health Organization 2018). It has been accepted that the best form of defense against cholera remains prevention by ensuring that hygienic condition in living surroundings are maintained in order to stop the proliferation of the causative bacterium. A second important aspect to cholera control is the prompt, accurate and effective identification and management of outbreaks when they occur. In these two aspects, health workers play a critical role in several communities as they are regarded as verified sources of health education while their job function includes disease outbreak surveillance and notification (Bhattacharya et al., 2009; Global Workforce Alliance, 2008).

The prevalence of cholera has been associated to occurrence and numerous undiagnosed cases and regular cholera upsurge in Nigeria. According to (Chaignat, n. d), WHO cholera response group coordinator in Nigeria, - 13,000 cases of cholera was reported in 2009- and has spread rapidly in some places than in other areas especially in the northern cities and rural communities- Zaria, Jos, Kano, Maidugiri, Sokoto, and Ilorin- all these local and state have no microscope and trained health workers to diagnose cholera incidence as it occurs. The outbreak and severity of cholera infections has been reported in the northern region of Nigeria causing 781 human deaths, and Katsina state alone recorded highest number of cholera cases- 3,310 with 175 human deaths The epidemic did not spare the southern region of the country where most of the populations leaves around the lagoons, wetlands and dilapidated rural communities with no health care centers.

Cholera is an infection of the small intestine that is caused by the bacterium Vibrio cholerae 01 and 0139 (Riyan 2004 & WHO 2010). The main symptoms are profuse watery diarrhea and vomiting. Transmission is primarily through consuming contaminated drinking water or food. The severity of the diarrhea and vomiting can lead to rapid dehydration and electrolyte imbalance. Every year there is an estimated 3-5 million cholera cases and 100,000-120,000 deaths due cholera. The short incubation period of two to five days, enhance the potentially explosive pattern of out breaks (Faruque 2008 and WHO 2010).

Cholera transmission is closely linked to inadequate environmental management. Typical at-risk areas include peri-urban slums, where basic infrastructure is not available, as well as camps for internally displaced people or refugees, where minimum requirements of clean water and sanitation are not met. The consequences of a disaster such as disruption of water and sanitation systems, or the displacement of populations to inadequate and overcrowded camps can increase the risk of cholera transmission should the bacteria be present or introduced. Epidemics have never arisen from dead bodies. Cholera remains a global threat to public health and a key indicator of lack of social development. Recently, the reemergence of cholera has been noted in parallel with the ever-increasing size of vulnerable populations living in unsanitary conditions (Emch 2008 and WHO, 2010).

Cholera infections are commonly severe, and highly virulent (Tutu et al., 2019). Additionally, cholera outbreaks usually occur in areas which have contaminated water or food because of poor sanitary measures (Alkhaledi, 2016). The bacteria are transmitted along the gastrointestinal tract through contaminated food or water (Deen et al., 2020).

In addition to the watery diarrhea, other symptoms included vomiting and abdominal colic. Furthermore, the infection affects all age groups (Orimbo et al., 2020). Diagnosis of cholera depends mainly on culturing the causative bacteria from a stool sample of the patient (Talaei et al., 2015). Rapid testing can also provide a preliminary result to start a targeted treatment plan (Mutreja et al., 2020). The management of cholera consists of antibiotics for the infection, and rehydrating measures for the vomiting and diarrhea through electrolytes and fluids administration (Taylor et al., 2015).

Therefore, in Edo State where the research was carried out, the activities that was conducted is to know the Cholera Outbreaks in Nigeria.

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1.3 Statement of Problems

Investigation revealed that the threat of cholera rampaging through Nigeria has long been of concern to many. The crowded settings coupled with minimal water, sanitation, hygiene and health services, present a fearsome breeding ground for cholera to quickly escalate beyond control. In an attempt to avoid this worse-case scenario, a massive response needs to be mounted by the Government to enlighten the general public about the causes of this deadly disease and also ways to avoid the outbreak. Hygiene promoters should be employed to work every day, sharing information on how to avoid contracting the illness and the signs and symptoms of the disease.

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1.4 Aim and Objectives of Study

The aim of the study is to determine the Cholera Outbreaks in Nigeria. In achieving this aim, the following specific objectives were laid out as follows:

1. To identify the cause of cholera in Nigeria;
2. To identify the problems associated with the prevention of cholera in Nigeria;
3. To determine the ways of preventing cholera outbreak in Nigeria; and
4. To ascertain if cholera outbreak is usually rampant during the rainy season among children in Nigeria.

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1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• Does poor environmental sanitation lead cholera outbreak?
• Does washing of hands before eating help to prevent cholera infection?
• Can drinking and bathing with contaminated water lead to cholera outbreak?
• Does poorly kept toilet cause cholera outbreak?
• Is cholera outbreak rampant during the rainy season?
• Does the use of pipe borne water for drinking and cooking help reduce cholera outbreak?
• Does boiling of water reduce the risk of cholera infection?

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1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: There are no significant cholera transmission and prevention information measures towards the knowledge and practices among Children
• H1: There are significant cholera transmission and prevention information measures towards the knowledge and practices among Children

Hypothesis Two

• H0: There are no significant factors inhibiting the prevention of cholera among Children
• H1: There are significant factors inhibiting the prevention of cholera among Children

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1.7 Significance of Study

The research work is important in several ways both to the health personnel and the individual within the society. Firstly, this study will expose to us some of the causes of cholera outbreak in Nigeria and also proffer ways of preventing cholera outbreak within our community.

This study will also be of importance to the health personnel and our local community health workers in the sense that it will expose to them the various preventive measures to put in place to avoid cholera outbreak in our community and Benin City at large.

This study is also be relevant to the government by providing the number of cholera outbreak within the Nigeria economy and also presenting the figures of victims who dies as a result of this disease, by this the government will swing into action by providing various measures in other to prevent further outbreak of the disease.

This study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

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1.8 Scope of Study

The scope of the research is focused on the Cholera Outbreaks in Nigeria.

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1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Research material: availability of research material is a major setback to the scope of the study.
3. Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
4. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).