Nigeria, 9 others worst-hit by cholera in Africa, as WHO decries ‘exponential rise’ of disease

World Health Organization (WHO) has reported an ‘exponential rise’ in cholera cases across Africa, with Nigeria and nine other countries on the continent topping the list of worst-hit nations.

The global health body also warned that if the current trend continues, reported cases could surpass the number recorded in 2021, which was the worst year for the disease in the continent in nearly a decade.

WHO further disclosed that as of January 29, this year, an estimated 26,000 cases and 660 deaths have been reported in the 10 countries.

In Nigeria, 583 people died from cholera in the country in 2022, according to the Nigeria Centre for Disease Control and Prevention (NCDC), which also added that 23,550 suspected cases of the disease were reported nationwide during the same year under review.

The agency further disclosed that Borno State topped reported figures with 12,459 cases in 2022.

Director-General of the NCDC, Dr Ifedayo Adetifa, who disclosed this, in January, this year, also informed that Yobe State placed second in reported cases with 1,888 cases, while Katsina State followed with 1,632 cases. Taraba had 1,142 cases; Gombe State had 1,407 cases, while Kano State recorded 1,131 cases.

According to the NCDC boss, ‘these six states accounted for 84 percent of all cases of cholera in Nigeria in 2022,’ adding also that 52 per cent of cholera victims in 2022 were female while males accounted for the balance of 48 per cent, as he put the fatality rate at 2.5 per cent of cases reported in 33 states of the federation.

According to WHO, reported cases of the disease in these 10 African countries in January were 30 per cent higher than for the whole of last year, with most new infections and deaths occurring in Malawi, which is facing its worst outbreak in 20 years.

“Overall, 10 African countries are affected by cholera.  The waterborne disease causes acute watery diarrhoea and can kill within hours but is easily treatable.

“Besides Malawi, cases have been reported in neighbouring Mozambique and Zambia, as well as in Burundi, Cameroon, the Democratic Republic of the Congo (DRC) and Nigeria.

“Ethiopia, Kenya and Somalia are also responding to outbreaks amid the historic drought in the Horn of Africa which has left millions in dire need of humanitarian assistance. 

“We are witnessing a worrying scenario where conflict and extreme climatic events are worsening the triggers of cholera and increasing its toll on lives,” said Dr. Matshidiso Moeti, WHO Regional Director for Africa. 

The average case fatality ratio is almost at three per cent, which is above the 2.3 per cent reached in 2022 and far exceeds the acceptable level of below one.

“It’s critical for African countries to scale up readiness to quickly detect cases and mount comprehensive and timely response,” said Dr. Moeti.

WHO is helping governments to fight back, including ramping up disease surveillance, prevention and treatment, and community engagement.

So far, the health body has deployed 65 experts to five countries, 40 alone to Malawi, where nearly 37,000 cholera cases and 1,210 deaths have been reported in all 29 districts since last March.

Additionally, WHO has distributed cholera kits and other supplies there, including oral rehydration salts, IV fluids, antibiotics, rapid diagnostic test kits, personal protective equipment, tents and cholera beds.

It has also helped to provide nearly 50 rehydration points in vulnerable communities, and supported the recruitment of dozens of doctors, nurses and clinical technicians across the country.

Furthermore, WHO also disbursed $6 million to kick-start emergency cholera response in Malawi, Kenya and Mozambique, through an international partnership on vaccines known as the ICG.

The increase in cholera outbreaks globally has put a huge strain on the availability of oral vaccines to treat the disease.

In October, the ICG temporarily suspended the standard two-dose regimen to a single dose approach.  A further surge in cholera risks deepening the shortage.

“Every death due to cholera is preventable.

“This disease is as much a health challenge as it is a development one. As such investments in better sanitation and access to safe water, formidably complement the public health initiatives to sustainably control and end cholera,” said Dr Moeti.

The NCDC in Nigeria lamented that cholera is largely associated with rural communities and among the poor with poor nutrition, poor water quality, and poor sanitation and had not gotten the desired attention from governments.