The Nigeria Centre for Disease Control and Prevention (NCDC) has released its latest cholera situation report, revealing a sharp increase in suspected cases and fatalities as the country grapples with the outbreak. The report, covering the epidemiological week 29 (July 15-21, 2024), shows that Lagos State remains the epicenter of the epidemic, contributing significantly to the national totals.
As of July 21, 2024, Nigeria has reported a cumulative total of 4,809 suspected cholera cases, including 156 deaths. This marks a 76% increase in suspected cases compared to the same period last year, where 2,740 cases were reported. Similarly, the death toll has surged by 88% from 83 to 156 over the same period, reflecting the severity of the outbreak.
Lagos State alone accounts for 65% of all suspected cases in the country, with 3,126 reported cases. The state’s capital, Lagos Island LGA, has emerged as a particularly hard-hit area, reporting 496 cases, which represents 10% of the national total.
During the most recent epidemiological week, Nigeria recorded 170 new suspected cholera cases and three deaths, resulting in a case fatality ratio (CFR) of 1.8%. These new cases were predominantly reported from Lagos (162), with smaller numbers from Kogi (5) and Zamfara (3).
The NCDC also noted that in July alone, there were 1,144 suspected cases across 23 states, with 36 fatalities. Lagos continues to lead with 1,011 cases, followed by Katsina (37), Zamfara (19), and Rivers (17).
The outbreak has disproportionately affected children under five years old, followed by adults aged 25-34 years. Males account for 53% of the cases, while females make up 47%.
Response and Challenges
NCDC said the national multi-sectoral Cholera Technical Working Group (TWG) coordinated by the centre has been actively monitoring and responding to the outbreak. Key activities include the deployment of rapid diagnostic tests (RDTs) and stool culture tests, with 27 RDTs conducted recently, yielding 14 positive results, and 20 stool cultures yielding four positive results.
Despite these efforts, several challenges impede effective management of the outbreak. These include poor hygiene practices, open defecation, lack of potable water in rural and urban areas, inadequate health infrastructure, and insufficient trained personnel for case management. The late reporting of cases and inadequate logistics for active case searches further complicate the situation.
Government and Community Efforts
To combat the outbreak, NCDC said it and its partners have engaged in various activities, such as hygiene promotion, water chlorination, and sensitization campaigns in high-risk communities. The distribution of hygiene kits, construction of sanitation facilities, and advocacy visits to community leaders are ongoing.
In Lagos State, multi-sectoral emergency operation centers have been activated to coordinate local responses. However, the need for more substantial investments in water, sanitation, and hygiene (WASH) infrastructure remains critical.
The NCDC has outlined several next steps to address the outbreak, including continued training on cholera surveillance, enhancing community-based active case searches, improving data reporting and harmonization, and scaling up risk communication strategies.
