An Overview of Cholera Epidemiology: A Focus on Africa; with a Keen Interest on Nigeria

Abstract

Cholera is still a problem in the world today. A huge population of deaths due to cholera disease still occur in Sub-Saharan Africa (Nigeria most especially), Asia, the Americas and other developing countries, where approximately 1.7 billion inhabitants are still served by faecally polluted water sources. Approximately, 2.4 billion inhabitants of these areas of the world lack the majorly required sanitary conditions of living. Legros, asserts that, as of 2019, about forty-seven countries of the globe, are still affected by cholera. Raw or undercooked, contaminated seafood, serves as a vehicle for the transmission (especially to non-endemic areas). A Case Fatality Rate of 4.87% was recorded from 34 Local Government Areas of Bauchi, Borno, Kaduna, Kano and Zamfara state in Nigeria by the 34th week, in 2018, while 298 confirmed cases and 38 deaths (CFR 1.5%) were recorded from three Local Government Areas in two States (Adamawa & Borno) by Epidemiological week 41 in 2019. Cholera in some cases is regarded as a “disease of the poor” because the populations most affected are those that cannot afford to provide the basic health facilities for themselves. For example, waste management systems, and good accommodation with toilet facilities (the living and health conditions of the people) are wanting. In 2017, A Global Roadmap to 2030 was launched by the Global Task Force on Cholera Control (GTFCC Ending Cholera) to decrease the death rate due to cholera by 90%. By so doing, the disease can be eradicated from at least half of the 47 cholera-affected countries. The objectives of this roadmap are: to fortify health systems, water, sanitation and hygiene (WASH), and to coordinate different ways by which cholera can be controlled in these countries by 2030 (ensuring early detection and prompt response to contain outbreaks). This review aimed to understand the epidemiology of cholera in Nigeria, Africa and the world at large, to access the level of spread, management and preventive measures so far implemented in the endemic regions.

Cholera Prevention and Control Strategies; A Global Overview

“…Still in this report, it was recorded that an annual increase in the number of doses shipped was observed to be in the following order; from about 200,000 in 2013 to 1.5 million in 2014, 2.5 million in 2015, 4.6 million in 2016, and 4 million in July 2017. These OCVs were deployed to Cameroon, DRC, Ethiopia, Guinea, Haiti, Iraq, Malawi, Mozambique, Nepal, Niger, Somalia, South Sudan, Sudan, Tanzania, and Zambia, with Haiti receiving largest number of doses (2,517,815), followed by Somalia (2,101,400), and South Sudan (1,969,660).…”

“…Cholera remains a public health threat especially in the less developed countries (Sub-Saharan Africa inclusive) [1], where there are limited resources that can help facilitate diagnosis, prevention and control Islam MT et al [2] Since the onset of 2019, a bulk of the Eastern and Southern Africa region (ESAR) have been facing cholera rampage from an outbreak that affected about 9,494 people and left 34 dead with a mean case Fatality Rate of 0.4%, from Angola, Burundi, Kenya, Malawi, Mozambique, Tanzania, Somalia, Uganda, Zambia and Zimbabwe. Out of these 10 affected countries of the region, 6,382 (67.2%) of the total number of cases were recorded from Mozambique, while 1, 7359 (18.3%), were reported from Kenya.…”

“…Tarh JE, [1] The disease is caused by a Toxigenic strain of a comma-shaped, gramnegative, facultative anaerobe (V. cholera), which measures about 1.4-2.6 µm x 0.5-0.8 µm in diameter [5,6]. It is contracted by people who eat food or drink water that has been contaminated by the faecal material, containing V. cholera from infected individuals.…”

“…Since most regions in the world, Africa inclusive and Nigeria in particular belong to the group of major current cholera foci, It became imperative that the Global Roadmap (Global Task Force on Cholera Control (GTFCC Ending Cholera]) to reduce the number of cholera deaths by at least 90%, in more than 50% of the cholera-affected countries by 2030, be launched and this was done [1].…”

A Review on Diagnostic Methods for the Identification of Vibrio cholerae

“…Cholera is an important life-threatening diarrheal disease, transmitted through contaminated water and food (especially contaminated sea foods) [1]. The causative agent of this disease is the toxigenic strain of Vibrio cholerae.…”