Nigeria
Cholera overview in country
Cholera was first reported in Nigeria in 1970. Since 1990, large outbreaks were reported in 1991, 1996, 1999 and from 2009 to 2011.
Between 2004 and 2016, a total of 154,910 cases and 5,127 deaths were reported (CFR ≈ 3.3%).
The largest outbreaks were reported in the northern states of the country. In the north, outbreaks often spread from Nigeria to neighbouring countries around Lake Chad (Niger, Chad and Cameroon) and in the south along the Gulf of Guinea.
A multi-sectoral study, linking water, sanitation, hygiene and health sectors, was carried out in the four countries of the Lake Chad basin, and especially Nigeria. This study aimed to propose an integrated WASH and Health response by first describing the epidemiology of cholera in the Chad Lake Basin and secondly by suggesting actions of prevention, preparedness and response to cholera epidemics. The Lake Chad Basin is a specific area with a climate typical of Sudan and the Sahel. The lakeside area and the lake’s tributaries as well as a marked seasonality structure the agriculture, pastoral and transhumance activities that take place here. In this essentially rural space, cross-border communication channels attract commercial activities. Population displacements occur between the several major agglomerations where dense neighbourhoods have structural difficulties with water conveyance and sanitation.
According to data from Nigeria notably, the presence of open wells on a large scale is significantly associated with cholera. The local transmission mechanisms are less well known, but late access to care, combined with population displacements (particularly across borders) and funeral traditions are factors of vulnerability in the spread of the disease that have been described since the first epidemics. The analysis of the epidemiological surveillance system led to the proposal of a set of national as well as sub-regional focuses for work on early warning systems. Community surveillance and cross-border cooperation are the two main issues.
Hence, based on the analysis, recommendations were proposed in the most at-risk areas. The suggested solutions shall build bridges between the emergency/outbreak response and development programs. The study and its findings are accessible online: “Water, Sanitation and Hygiene, and cholera epidemiology: An integrated evaluation in the countries of the Lake Chad basin (2011) (UNICEF)”.
Finally, understanding cholera epidemiology and being informed on outbreaks and dynamics is critical for the neighbouring countries. Nigeria is both in the Lake Chad epidemiological basin (Niger, Cameroon and Chad), and in the South Guinea Gulf epidemiological basin (Bénin, Ghana, Togo).
Find out more : Cholera Fact Sheet - Nigeria
REPUBLIC OF NIGERIA-CHOLERA ELIMINATION OPERATIONAL STEPS
Step 1 - Expression of commitment :
Step 2 - Situation analysis :
- Nigeria - High priority area / hotspot
- Nigeria -High priority area / hotspot by state
- Nigeria-Factsheet cholera map incidence
Step 3 - Establishment of national cholera coordination mechanism or program :
STEP 4 - DEVELOP THE NATIONAL CHOLERA PLAN FOR CONTROL OR ELIMINATION :
- Nigeria - 5 years National Plan for Cholera Preparedness, Prevention and Control for 2014 to 2019
- Nigeria - Cholera Reponse and Prevention Plan - 2017
- Nigeria - Preparedness and Response to Acute Watery Diarrhoea Outbreaks
- Nigeria - WASH strategic framework for cholera risk reduction and response during the rainy season in North East Nigeria - 2017
- Nigeria - Outbreak preparedness response plan for cholera and diarrheal diseases in North East Nigeria - 2017
- Nigeria - Rainy Season Contingency Plan, North-east Nigeria (April 2018)
STEP 5 - IMPLEMENTATION AND MONITORING & EVALUATION OF THE NCP AT COUNTRY LEVEL :
Other resources :
WASH as a Cornerstone for Conquering the 2017 Cholera Outbreak in Borno State, Northeast Nigeria
Cross-border collaboration (Lake Chad basin meetings)
BAY_Cholera Response Prevention and Preparedness 2019_draft_v2_180719
IEC Material: