Outbreak of cholera at Dutsen-Abba Ward Zaria local government area, Kaduna State Nigeria 2015: the importance of hygienic practices

Abstract

Background: Cholera is an infection caused by Vibrio cholerae, which may lead to severe dehydration and death if not treated promptly. On August 31, 2015, the Kaduna Ministry of Health received a notification of increase cases of vomiting and diarrhoea at Dusten-Abba in Zaria. A response Team was sent to confirm the outbreak, describe the socio-demographic characteristics and identify possible risk factors for the outbreak.Methods: We defined cases according to the world health organization (WHO) criteria. We conducted an unmatched case-control study and descriptive study. We retrieved line-listed cases at the ward facility. We interviewed cases at the facility and recruited controls from the community, and administered questionnaires to both cases and controls. We analysed data using Epi-Info7 and Microsoft Excel 2016.Results: A total of 50 cases were recorded, with a median age of 20years and age range of 1 – 50 years. There were more females (68%) than males. Majority of cases (52%) were under 20 years, while all cases are below 50 years. Seven (7) deaths were recorded giving a Case Fatality Rate (CFR) of 14%. The CFR was higher in females (14.7%) than in males (12.5%). Index case was seen on August 29, 2015. The outbreak lasted five days. Last cases were seen on September 2, 2015. Highest number of cases seen in a day (23) was on third day of the outbreak. Only two cases (4%) had their samples tested using cholera RDT, and both tested positive. Drinking un-boiled water (OR: 12.67, 95%CI: 2.33–68.93), regular hand washing (OR: 0.22, 95% CI: 0.06–0.90) and proper waste disposal practices (OR: 0.07, 95% CI: 0.02–0.36) are factors we found to affect cholera infection during the outbreak.Conclusions: Our investigation confirmed a cholera outbreak with a high CFR, especially among females. Poor hygienic practices among the populace seem to be the drivers for this outbreak.

Descriptive epidemiology of cholera outbreak in Nigeria, January–November, 2018: implications for the global roadmap strategy

“…In general, the distribution of cholera cases by age and sex in Nigeria is dynamic given the mixed available evidence. For instance, some studies have reported higher number of cholera cases in adults than in children [11–16] and vice-versa [17, 18], and some studies have similarly reported higher number of cholera cases in females than in males [4, 12, 19] and vice-versa [20, 21].…”

“…The lack of a homogenous definition of cholera especially in an endemic setting such as Nigeria made the direct comparison of our findings with similar studies challenging. For example, studies in Nigeria have used 5 years [12, 17, 40], 2 years [21, 41, 42], and no age restrictions [14, 19] for the definition of suspected cholera cases. Thus, this challenge should be prioritised by the GTFCC given the relevance to cholera case management and assessment of cholera burden, which would be strategic in the objective assessment of the global roadmap goals of cholera elimination by 2030.…”

Retrospective Analysis of the Serovars and Antibiogram of Vibrio cholerae Isolates of the 2017 Ilorin Cholera Outbreak, Nigeria

“…The distribution pattern of cholera cases by age and sex is largely dynamic in Nigeria, as there are mixed available reports. A study reported higher number of cholera cases in adults than in children [ 16 ], whereas more cholera cases were reported in children than adults by another study [ 17 ]. Furthermore, some studies have reported higher number of cholera cases in females than in males [ 16 ] and vice-versa [ 18 ].…”

“…A study reported higher number of cholera cases in adults than in children [ 16 ], whereas more cholera cases were reported in children than adults by another study [ 17 ]. Furthermore, some studies have reported higher number of cholera cases in females than in males [ 16 ] and vice-versa [ 18 ]. In conformity with the findings of Nnaji et al [ 18 ], our study showed significant association between the number of cholera cases and the sex of patients.…”

Outbreak investigation of cholera in a rural community, Rivers State Nigeria: an interventional epidemiological study

“…6,31,35,36 Contrarily, studies carried out in Nigeria, Ethiopia, Bangladesh, and Malta revealed that cases of acute watery diarrhoea were observed more among patients in their middle adolescence, early adulthood and older age groups as opposed to younger children. 25,28,[37][38][39][40][41] Additionally, a greater proportion of all line-listed patients were slightly more males than females. This is in agreement with the previous studies done in Nigeria, South Africa, Ethiopia, and India.…”