In the past few weeks, there has been increasing awareness from the federal government of Nigeria and state governments for citizens and residents to protect themselves from getting affected by cholera due to the increasing number of cholera cases recorded in the country. However, the recent awareness of the outbreak of this diarrhoeal infection seems to have been caused by the focus of different governments on the COVID-19 pandemic.
The new outbreak of cholera and overshadowing nature of COVID-19
The recent surge or outbreak of cholera started around the 13th of March, 2021 with Zamfara State being responsible for 100% of the cases recorded according to the Nigeria Centre for Disease Control (NCDC). A look at this date shows that it was two days before the commencement of COVID-19 Vaccination in the country as Nigeria started vaccinating its population against corona on the 15th of March 2021. Hence, there was much fanfare and newly found optimism across the country concerning the health sector, thus resulting in a lack of attention to the rising cases of cholera. As of the end of March, 1,746 suspected cases including 50 deaths had been reported from eight states (Benue, Delta, Zamfara, Gombe, Bayelsa, Kogi, Sokoto, and Nasarawa) since the beginning of 2021.
Between the start of the recent cholera outbreak in March to July 9, 2021; the day Nigeria recorded its index case of COVID-19 Delta variant, cholera cases had spread to 18 States with 20,939 recorded. Whereas in the same period, 7,905 COVID-19 cases were recorded, with 106 deaths. As of 5th September 2021, a total of 69,925 suspected cholera cases including 2,323 deaths have been recorded with a case fatality 0f 3.3%, whereas since the recording of the index case of COVID-19 in February 2020, the country has a 1.3% case fatality rate in Nigeria. Nevertheless, more attention is still being given to the virus.
Response to the cholera outbreak
The response to the cholera outbreak by the Nigerian government has been lethargic hence the continued increase in the number of cases. Indeed, following an increase in the number of cholera cases, the National Cholera Emergency Operations Centre (EOC) was activated on the 22nd of June 2021. However, as of then the cases had risen to 14, 343 in 16 states. The EOC which is hosted at NCDC, includes representation from the Federal Ministries of Environment and Water Resources, National Primary Health Care Development Agency (NPHCDA), World Health Organization (WHO), and partners.
The National Cholera EOC initiated the deployment of Rapid Response Teams to support the most affected states -– Benue, Kano, Kaduna, Zamfara, Bauchi, and the Plateau States. Additionally, NCDC and its partners have provided states with commodities for case management and laboratory diagnosis, materials for risk communications, response guidelines among other support. A reactive oral cholera vaccine (OCV) campaign led by NPHCDA was reportedly conducted in Bauchi LGA, Bauchi State from 24th to 28th July 2021; a one-off campaign.
Severity of cholera outbreak in 2021
The current outbreak of cholera is more severe than in previous years with a higher case fatality rate than the previous four years. It can be argued that this situation was created by the lack of prioritisation of the fight against the disease with more focus on the COVID-19 pandemic.
Indeed Nigeria’s delicate health sector is fighting multiple diseases and being overstretched with the resurgent cases driven by the Delta variant, and low vaccination rate with less than 1% of the population has been fully vaccinated. However, there are other diseases more fatal than COVID-19 and one of such diseases is cholera.