1
|
Amisu BO, Okesanya OJ, Adigun OA, Manirambona E, Ukoaka BM, Lawal OA, Idris NB, Olaleke NO, Okon II, Ogaya JB, Prisno DEL. Cholera resurgence in Africa: assessing progress, challenges, and public health response towards the 2030 global elimination target. LE INFEZIONI IN MEDICINA 2024; 32:148-156. [PMID: 38827826 PMCID: PMC11142410 DOI: 10.53854/liim-3202-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/14/2024] [Indexed: 06/05/2024]
Abstract
Global efforts to combat epidemic cholera outbreaks have witnessed tremendous feats over the decades. However, sporadic outbreaks in regions, particularly across African states, mask these advancements. This regressive trend is frequently fuelled by factors retarding efforts towards optimal environmental sanitation and personal hygiene, which include ingesting infected food, drinking contaminated waters, and engaging in unhealthy environmental practices such as indiscriminate waste and sewage disposal and poor toilet practices. The ongoing efforts to achieve the Global Taskforce on Cholera Control (GTFCC) targets of a 90% reduction in cases and deaths by 2030, even in the wake of continuous outbreaks across various African regions, as reported by the World Health Organization (WHO) face a significant threat. One such effort, among others, is the AFRICHOL project, an enhanced cholera surveillance consortium launched in Africa over a decade ago as part of the GTFCC at WHO to monitor and fast-track the GTFCC's 2030 targets. It is tasked with supporting the implementation of research-based strategies for combating cholera in Africa. The prequalified oral cholera vaccines - Dukoral, Shanchol, and Euvichol - and those with recombinant DNA technology have also emerged as remarkable strides. In the face of this progress, challenges persist. Climate change, including extreme weather events and the lack of safe water, sanitation, and hygiene facilities, acts as a multiplier, amplifying existing challenges and hindering progress. Porous borders with inefficient disease surveillance networks among member states also facilitate the inter-territorial spread of the disease. Despite ongoing challenges, global targets are achievable provided strong institutional infrastructure and additional evidence-based public health initiatives are promulgated and enacted. The Global Roadmap to Ending Cholera Outbreaks by 2030 is a resourceful tool for advancing this fight and eradicating cholera.
Collapse
Affiliation(s)
- Blessing Olawunmi Amisu
- Department of Medical Laboratory Science, Uniosun Teaching Hospital, Osogbo, Osun state, Nigeria
| | - Olalekan John Okesanya
- Department of Public Health and Maritime Transport, University of Thessaly, Volos, Greece
| | | | - Emery Manirambona
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | - Okikiola Azeez Lawal
- Department of Medical Laboratory Sciences, Kwara State University, Kwara State, Nigeria
| | - Nimat Bola Idris
- Department of Public Health, Al-Hikmah University, Ilorin, Kwara State, Nigeria
| | - Noah Olabode Olaleke
- Department of Medical Laboratory Science, Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Osun State, Nigeria
| | - Inibehe Ime Okon
- Department of Neurosurgery, Hospital of the Babcock University, Ogun State, Nigeria
| | | | - Don Eliseo Lucero Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
2
|
Lawrence Grant S, Lange S, Almeida S, Hoque B, Kjær Mackie Jensen P. Influence of Seasonal Hazards on Water, Sanitation, and Hygiene-Related Behavior and Implications for Cholera Transmission in Bangladesh. Am J Trop Med Hyg 2023; 108:518-523. [PMID: 36689946 PMCID: PMC9978562 DOI: 10.4269/ajtmh.21-0708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 11/01/2022] [Indexed: 01/24/2023] Open
Abstract
Most cholera outbreaks in Bangladesh are seasonal, peaking in the dry and post-monsoon periods. Therefore, we investigated whether changes in water, sanitation, and hygiene (WASH) behavior in three populations in Bangladesh during the year could help explain why these two periods are particular to cholera transmission. The study used a mixed-method design, including a repeated cross-sectional study, focus group discussions, and key informant interviews. Through a repeated cross-sectional study, WASH-related variables were assessed during the dry, monsoon, and control seasons in 600 households from coastal Satkhira, inland Sirajganj, and the Dhaka slums. Seasonal behavioral changes were observed in all study areas. Dhaka and Satkhira had an increased mean distance to water sources during the dry and monsoon seasons (Dhaka: control season, 12 m [95% CI, 11-13]; dry season, 36 m [95% CI, 18-55]; and monsoon season, 180 m [95% CI, 118-243]; Satkhira: control season, 334 m [95% CI, 258-411]; dry season, 669 m [95% CI, 515-822]; and monsoon season, 2,437 m [95% CI, 1,665-3,209]). The participants attributed this to pollution of the usual water source. Perceived water quantity was lowest during the dry season in Dhaka and Sirajganj, and during the monsoon season in Satkhira. Handwashing with soap declined in all areas during the dry and monsoon seasons. Open defecation was frequent among children younger than 5 years, increasing during seasonal climate hazards. Results show that WASH-related behavior changed seasonally, increasing the risk of cholera transmission through multiple hygiene-related transmission pathways. Future research would benefit by ensuring that the length of studies covers all seasons throughout the year and also by looking in more detail at people's behavior and hygiene practices.
Collapse
Affiliation(s)
- Stephen Lawrence Grant
- Copenhagen Center for Disaster Research, Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Sina Lange
- Copenhagen Center for Disaster Research, Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Sara Almeida
- Copenhagen Center for Disaster Research, Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Bilqis Hoque
- Environment and Population Research Centre, Dhaka, Bangladesh
| | - Peter Kjær Mackie Jensen
- Copenhagen Center for Disaster Research, Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
3
|
Christiana Cudjoe D, Balali GI, Titus OO, Osafo R, Taufiq M. Food Safety in Sub-Sahara Africa, An insight into Ghana and Nigeria. ENVIRONMENTAL HEALTH INSIGHTS 2022; 16:11786302221142484. [PMID: 36530486 PMCID: PMC9755555 DOI: 10.1177/11786302221142484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/14/2022] [Indexed: 06/17/2023]
Abstract
Food safety is a global concern in today's world, and harnessing food safety in Sub-Saharan Africa, especially Nigeria and Ghana are momentous. This review presents an insight into the situation of food safety in Nigeria and Ghana. Using a desktop review technique, research papers were evaluated to find major sources of food safety concerns. It was revealed that many studies reported on food contamination at the consumption level whereas few reported on the healthiness of the production chain. Improper handling of food at the local markets, vending sites hygiene practices of food vendors, and bad transportation and packing systems have all been implicated. Inadequate education is a major cause of food contamination, especially at the consumption level. Again, etiologic agents responsible for food-borne illness in Ghana and Nigeria range from viruses, fungi, parasites, and protozoans to bacteria. They include rotavirus, hepatitis A virus, Lassa fever (LHF), human noroviruses (HNoV), Aspergillus parasiticus, Aspergillus flavus, Aspergillus niger, Taenia solium, Ascaris spp., Toxoplasma gondii, Cryptosporidium spp. Enterobacter spp., Pseudomonas spp., Campylobacter spp., Escherichia coli. Staphylococcus spp., Salmonella spp., Vibrio cholerae and Listeria monocytogenes. Their toxins are responsible for numerous food contaminants. Some foods are contaminated with chemicals including pesticide residues, lead, mercury, etc. Laws of food safety are not well enforced leading to complications in the food production chain. Rigorous monitoring and evaluation coupled with surveillance and education to harness the situation and detect issues that compromise the right process is a necessity. Finally, intentional enforcement of regulations by regulatory agencies will go a long way to curb food contamination and food-borne illnesses within the region.
Collapse
Affiliation(s)
- Dapuliga Christiana Cudjoe
- Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Environmental Health Sciences, University of Ibadan, Ibadan, Nigeria
| | - Gadafi Iddrisu Balali
- Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Science, SDA College of Education, Agona, Ashanti, Ghana
| | - Okareh Oladapo Titus
- Department of Environmental Health Sciences, University of Ibadan, Ibadan, Nigeria
| | - Richard Osafo
- School of Health and Life Sciences, University of the West of Scotland, Paisley Campus, Scotland, UK
| | - Mohammed Taufiq
- Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| |
Collapse
|
4
|
Rahman Zuthi MF, Hossen MA, Pal SK, Mazumder MH, Hasan SMF, Hoque MM. Evaluating knowledge, awareness and associated water usage towards hand hygiene practices influenced by the current COVID-19 pandemic in Bangladesh. GROUNDWATER FOR SUSTAINABLE DEVELOPMENT 2022; 19:100848. [PMID: 36164324 PMCID: PMC9493147 DOI: 10.1016/j.gsd.2022.100848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 09/13/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
Hand hygiene is considered as one of the most effective ways for preventing transmissible diseases, especially for preventing virus-borne diseases. The study has been conducted to evaluate changes in knowledge, awareness and practices of hand hygiene due to the outbreak of the coronavirus disease (COVID-19) in Bangladesh. The potential factors influencing human behaviours for maintaining hand hygiene have also been explored. Moreover, a probable increase in daily water demand associated with the changed situation has been assessed. An online survey was performed among a total of 367 Bangladeshi residents about their practices of hand hygiene during pre-corona, corona, and of their perceived future practices at post-corona period. It has been observed that a significant percentage (62.1%) of the respondents have received basic hygiene education at any level of their academic education. Nevertheless, their hygiene practices were very poor before the COVID-19 pandemic. The outbreak of the COVID-19 has reinforced their previous knowledge and greatly influenced their behavioural changes towards practicing hand hygiene as per World Health Organization guidelines for preventing the virus outbreak. The changes, however, have created increased water demand. The estimated water usage is found to be 2.68 times (9.15 L/c/d) and 2.52 times (8.59 L/c/d) higher in the corona and post-corona period respectively than that of the pre-corona situation (3.41 L/c/d). The principal component analysis (PCA) elucidated that an individual's practice of hand hygiene was associated with income, level of academic and hygiene education, and the COVID-19 outbreak itself. Moreover, the influence of hygiene education and COVID-19 outbreak affecting the duration of handwashing are found highly significant (p-value < 0.001) from the regression analysis. Raising awareness towards behavioural change of an individual about water usage, improvement of academic curriculum regarding hand hygiene and provision of water pricing are recommended to attain sustainable development goals of the country.
Collapse
Affiliation(s)
- Mst Farzana Rahman Zuthi
- Center for Environmental Science & Engineering Research (CESER), Chittagong University of Engineering and Technology (CUET), Chattogram, 4349, Bangladesh
- Department of Civil Engineering, Chittagong University of Engineering and Technology (CUET), Chattogram, 4349, Bangladesh
| | - Md Arif Hossen
- Center for Environmental Science & Engineering Research (CESER), Chittagong University of Engineering and Technology (CUET), Chattogram, 4349, Bangladesh
| | - Sudip Kumar Pal
- Department of Civil Engineering, Chittagong University of Engineering and Technology (CUET), Chattogram, 4349, Bangladesh
| | - Maruful Hasan Mazumder
- Department of Disaster Engineering and Management, Chittagong University of Engineering and Technology (CUET), Chattogram, 4349, Bangladesh
| | - S M Farzin Hasan
- Department of Civil Engineering, Chittagong University of Engineering and Technology (CUET), Chattogram, 4349, Bangladesh
| | - Md Muzamamel Hoque
- Department of Civil Engineering, Chittagong University of Engineering and Technology (CUET), Chattogram, 4349, Bangladesh
- Southern University Bangladesh, Chattogram, 4000, Bangladesh
| |
Collapse
|
5
|
Elimian K, Yennan S, Musah A, Cheshi ID, King C, Dunkwu L, Mohammed AL, Ekeng E, Akande OW, Ayres S, Gandi B, Pembi E, Saleh F, Omar AN, Crawford E, Olopha OO, Nnaji R, Muhammad B, Luka-Lawal R, Ihueze AC, Olatunji D, Ojukwu C, Akinpelu AM, Adaga E, Abubakar Y, Nwadiuto I, Ngishe S, Alowooye AB, Nwogwugwu PC, Kamaldeen K, Abah HN, Chukwuebuka EH, Yusuff HA, Mamadu I, Mohammed AA, Peter S, Abbah OC, Oladotun PM, Oifoh S, Olugbile M, Agogo E, Ndodo N, Babatunde O, Mba N, Oladejo J, Ilori E, Alfvén T, Myles P, Ochu CL, Ihekweazu C, Adetifa I. Epidemiology, diagnostics and factors associated with mortality during a cholera epidemic in Nigeria, October 2020-October 2021: a retrospective analysis of national surveillance data. BMJ Open 2022; 12:e063703. [PMID: 36123095 PMCID: PMC9486350 DOI: 10.1136/bmjopen-2022-063703] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Nigeria reported an upsurge in cholera cases in October 2020, which then transitioned into a large, disseminated epidemic for most of 2021. This study aimed to describe the epidemiology, diagnostic performance of rapid diagnostic test (RDT) kits and the factors associated with mortality during the epidemic. DESIGN A retrospective analysis of national surveillance data. SETTING 33 of 37 states (including the Federal Capital Territory) in Nigeria. PARTICIPANTS Persons who met cholera case definition (a person of any age with acute watery diarrhoea, with or without vomiting) between October 2020 and October 2021 within the Nigeria Centre for Disease Control surveillance data. OUTCOME MEASURES Attack rate (AR; per 100 000 persons), case fatality rate (CFR; %) and accuracy of RDT performance compared with culture using area under the receiver operating characteristic curve (AUROC). Additionally, individual factors associated with cholera deaths and hospitalisation were presented as adjusted OR with 95% CIs. RESULTS Overall, 93 598 cholera cases and 3298 deaths (CFR: 3.5%) were reported across 33 of 37 states in Nigeria within the study period. The proportions of cholera cases were higher in men aged 5-14 years and women aged 25-44 years. The overall AR was 46.5 per 100 000 persons. The North-West region recorded the highest AR with 102 per 100 000. Older age, male gender, residency in the North-Central region and severe dehydration significantly increased the odds of cholera deaths. The cholera RDT had excellent diagnostic accuracy (AUROC=0.91; 95% CI 0.87 to 0.96). CONCLUSIONS Cholera remains a serious public health threat in Nigeria with a high mortality rate. Thus, we recommend making RDT kits more widely accessible for improved surveillance and prompt case management across the country.
Collapse
Affiliation(s)
- Kelly Elimian
- Nigeria Centre for Disease Control, Abuja, Nigeria
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | | | - Anwar Musah
- Department of Risk and Disaster Reduction, University College London, London, UK
| | | | - Carina King
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | | | | | - Eme Ekeng
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Oluwatosin Wuraola Akande
- Department of Epidemiology and Community Health, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Stephanie Ayres
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | | | | | - Fatima Saleh
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | | | | | | | | | | | | | | | | | | | - Ene Adaga
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Yusuf Abubakar
- Zamfara State Ministry of Health, Zamfara State, Nigeria
| | | | - Samuel Ngishe
- Public Health, Ministry of Health, Benue State, Makurdi, Nigeria
| | | | | | | | | | | | | | - Ibrahim Mamadu
- World Health Organization Country Office for Nigeria, Abuja, Nigeria
| | | | - Sarah Peter
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | | | | | | | | | | | | | | | - Nwando Mba
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - John Oladejo
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Elsie Ilori
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Tobias Alfvén
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Puja Myles
- Clinical Practice Research Datalink, London, UK
| | | | | | | |
Collapse
|
6
|
Challa JM, Getachew T, Debella A, Merid M, Atnafe G, Eyeberu A, Birhanu A, Regassa LD. Inadequate Hand Washing, Lack of Clean Drinking Water and Latrines as Major Determinants of Cholera Outbreak in Somali Region, Ethiopia in 2019. Front Public Health 2022; 10:845057. [PMID: 35602140 PMCID: PMC9120658 DOI: 10.3389/fpubh.2022.845057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Cholera remains a serious public health problem characterized by a large disease burden, frequent outbreaks, persistent endemicity, and high mortality, particularly in tropical and subtropical low-income countries including Ethiopia. The recent cholera outbreak in the Somali region began on 4 September to 1 November 2019. Cholera may spread rapidly through a population so that an early detection and reporting of the cases is mandatory. This study aimed to identify determinants of cholera infection among >5 years of age population in Somali region, Ethiopia. Methods A community-based unmatched case-control study was conducted among 228 (76 cases and 152 controls, 1:2 ratio) systematically selected population. Data were collected using a structured questionnaire administered by an interviewer and a record review. Descriptive statistics and multivariable logistic regression analysis was used to identify the determinants of the risk factors of cholera infection with a 95% confidence interval and statistical significance was declared a tap-value < 0.05. Results A total of 228 participants (33.3% cases and 66.7% controls) were enrolled in this study. The majority of the cases were in the range of 20–49 years of age (69.7%). The odds of acquiring cholera infection increased significantly by drinking unsafe pipe water (AOR 4.3, 95% CI 1.65–11.2), not having a household level toilet/latrine (AOR 3.25, 95% CI 1.57–6.76), hand washing only sometimes after the toilet (AOR 3.04, 95% CI 1.58–5.86) and not using water purification methods (AOR 2.3, 95% CI 1.13–4.54). Conclusion Major risk factors for cholera infection were related to drinking water and latrine hygiene. Improvement in awareness creation about cholera prevention and control methods, including water treatment, hygiene and sanitation were crucial in combating this cholera outbreak. Primary public health actions are ensuring clean drinking water, delivery of water purification tablets, soap and hand sanitizers and provision of health care and outbreak response. Long term goals in cholera affected areas include comprehensive water and sanitation strategies. Overall, the strategic role of a multi-sectoral approach in the design and implementation of public health interventions aimed at preventing and controlling cholera are essential to avert cholera outbreaks. Preparedness should be highlighted in cholera prone areas like Somali region especially after drought periods.
Collapse
Affiliation(s)
- Jemal Mussa Challa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- *Correspondence: Tamirat Getachew ; orcid.org/0000-0002-0057-9062
| | - Adera Debella
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Melkamu Merid
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Genanaw Atnafe
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abdi Birhanu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemma Demissie Regassa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| |
Collapse
|
7
|
Anderson-Carpenter KD, Tacy GS. Predictors of social distancing and hand washing among adults in five countries during COVID-19. PLoS One 2022; 17:e0264820. [PMID: 35298498 PMCID: PMC8929564 DOI: 10.1371/journal.pone.0264820] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 02/11/2022] [Indexed: 12/23/2022] Open
Abstract
The purpose of this cross-sectional study is to examine disparities in hand washing and social distancing among 2,509 adults from the United States, Italy, Spain, the Kingdom of Saudi Arabia, and India. Respondents were recruited via Qualtrics' participant pool and completed an online survey in the most common language spoken in each country. In hierarchical linear regression models, living in a rural area (β = -0.08, p = .001), older age (β = 0.07, p < .001), identifying as a woman (β = 0.07, p = .001), and greater educational attainment (β = 0.07, p = .017) were significantly associated with hand washing. Similar results were found regarding social distancing, in which living in a rural area (β = -0.10, p < .001), country of residence (β = 0.11, p < .001), older age (β = 0.17, p < .001), identifying as a woman (β = 0.11, p < .001), and greater educational attainment (β = 0.06, p = .019) were significant predictors. Results from the multivariable linear regression models demonstrate more nuanced findings with distinct and significant disparities across the five countries found with respect to hand washing and social distancing. Taken together, the results suggest multiple influencing factors that contribute to existing disparities regarding social distancing and hand washing among adults internationally. As such, more tailored public interventions are needed to promote preventive measures to mitigate existing COVID-related disparities.
Collapse
Affiliation(s)
| | - Garrett S. Tacy
- Department of Psychology, Michigan State University, East Lansing, Michigan, United States of America
| |
Collapse
|
8
|
Samuel Amoo O, Awoderu O, Yisau J, Oladele D, David AN, Raheem T, Uwandu M, Bamidele M, Fesobi TW, AbdusSalam A, Nduaga S, Oparaugo CT, Ajayi M, Ogbonna F, Musa AZ, Adedeji A, Ige F, Ihemanma O, Nuhu B, Okebugwu U, Bello IW, Onuigbo TI, Ikemefuna AS, Oraegbu JI, Agboola H, Idris J, Ajayi A, Salako BL, Smith SI. Assessment of potential factors that support the endemicity of cholera in Nigeria from food handlers, health workers and the environment. MICROBIOLOGIA MEDICA 2021. [DOI: 10.4081/mm.2021.10058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background and Aims: Diarrheal diseases caused by bacterial pathogens are widespread and they result in morbidity and mortality of a lot of people yearly. The aim of this study was to assess the role of the environment, health workers and food handlers as reservoirs of Vibrio cholerae, and other diarrhea causing bacteria. Methods: Healthcare workers were proportionally selected and multistage sampling technique was adopted in selecting food handlers for the study. A total of 374 participants consisting of health workers and food handlers were recruited. Socio-demographic and clinical information were collected using questionnaires, while stool and environmental samples were also collected. Results: More female 55.9 % than male 44.1 % participated in the study and the mean age of participants was 38.7 ± 10.9. A significant number of participants identified poor hygiene practices as the major cause of diarrhea. V. cholerae O1 serotype was not detected in any of the environmental samples nor stool samples of both food handlers and health workers. However, V. cholerae (Non O1/Non O139) was isolated from the stool samples of food handlers and health workers in Kano State implying that they could be serving a source of the continuous dissemination of the pathogen. Other bacterial pathogens that are aetiology of diarrhea including Salmonella spp. Escherichia coli, Klebsiella oxytoca, and Enterobacter spp. were also isolated. Conclusion: It is therefore imperative that food handlers and health workers undergo periodic health checks to ensure they are free of pathogens they could easily transmit through food or to patients.
Collapse
|
9
|
Huong LTT, Hoang LT, Tuyet-Hanh TT, Anh NQ, Huong NT, Cuong DM, Quyen BTT. Reported handwashing practices of Vietnamese people during the COVID-19 pandemic and associated factors: a 2020 online survey. AIMS Public Health 2020; 7:650-663. [PMID: 32968684 PMCID: PMC7505781 DOI: 10.3934/publichealth.2020051] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/20/2020] [Indexed: 01/14/2023] Open
Abstract
COVID-19 pandemic currently affects nearly all countries and regions in the world. Washing hands, together with other preventive measures, to be considered one of the most important measures to prevent the disease. This study aimed to characterize reported handwashing practices of Vietnamese people during the COVID-19 pandemic and associated factors. Kobo Toolbox platform was used to design the online survey. There were 837 people participating in this survey. All independent variables were described by calculating frequencies and percentages. Univariate linear regression was used with a significant level of 0.05. Multiple linear regression was conducted to provide a theoretical model with collected predictors. Seventy-nine percent of the respondents used soap as the primary choice when washing their hands. Sixty percent of the participants washed their hands at all essential times, however, only 26.3% practiced washing their hands correctly, and only 28.4% washed their hands for at least 20 seconds. Although 92.1% washed hands after contacting with surfaces at public places (e.g., lifts, knob doors), only 66.3% practiced handwashing after removing masks. Females had better reported handwashing practices than male participants (OR = 1.88; 95% CI: 1.15–3.09). Better knowledge of handwashing contributed to improving reported handwashing practice (OR = 1.30; 95% CI: 1.20–1.41). Poorer handwashing practices were likely due, at least in part, to the COVID-19 pandemic information on the internet, social media, newspapers, and television. Although the number of people reported practicing their handwashing was rather high, only a quarter of them had corrected reported handwashing practices. Communication strategy on handwashing should emphasize on the minimum time required for handwashing as well as the six handwashing steps.
Collapse
Affiliation(s)
- Le Thi Thanh Huong
- Environmental Health Department, Hanoi University of Public Health, Hanoi, Vietnam
| | - Le Tu Hoang
- Biostatistics Department, Hanoi University of Public Health, Hanoi, Vietnam
| | - Tran Thi Tuyet-Hanh
- Environmental Health Department, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nguyen Quynh Anh
- Environmental Health Department, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nguyen Thi Huong
- Environmental Health Department, Hanoi University of Public Health, Hanoi, Vietnam
| | - Do Manh Cuong
- Vietnam Health Environment Management Agency, Ministry of Health, Hanoi, Vietnam
| | - Bui Thi Tu Quyen
- Biostatistics Department, Hanoi University of Public Health, Hanoi, Vietnam
| |
Collapse
|
10
|
Elimian KO, Mezue S, Musah A, Oyebanji O, Fall IS, Yennan S, Yao M, Abok PO, Williams N, Omar LH, Balde T, Ampah K, Okudo I, Ibrahim L, Jinadu A, Alemu W, Peter C, Ihekweazu C. What are the drivers of recurrent cholera transmission in Nigeria? Evidence from a scoping review. BMC Public Health 2020; 20:432. [PMID: 32245445 PMCID: PMC7118857 DOI: 10.1186/s12889-020-08521-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 03/12/2020] [Indexed: 01/31/2023] Open
Abstract
Background The 2018 cholera outbreak in Nigeria affected over half of the states in the country, and was characterised by high attack and case fatality rates. The country continues to record cholera cases and related deaths to date. However, there is a dearth of evidence on context-specific drivers and their operational mechanisms in mediating recurrent cholera transmission in Nigeria. This study therefore aimed to fill this important research gap, with a view to informing the design and implementation of appropriate preventive and control measures. Methods Four bibliographic literature sources (CINAHL (Plus with full text), Web of Science, Google Scholar and PubMed), and one journal (African Journals Online) were searched to retrieve documents relating to cholera transmission in Nigeria. Titles and abstracts of the identified documents were screened according to a predefined study protocol. Data extraction and bibliometric analysis of all eligible documents were conducted, which was followed by thematic and systematic analyses. Results Forty-five documents met the inclusion criteria and were included in the final analysis. The majority of the documents were peer-reviewed journal articles (89%) and conducted predominantly in the context of cholera epidemics (64%). The narrative analysis indicates that social, biological, environmental and climatic, health systems, and a combination of two or more factors appear to drive cholera transmission in Nigeria. Regarding operational dynamics, a substantial number of the identified drivers appear to be functionally interdependent of each other. Conclusion The drivers of recurring cholera transmission in Nigeria are diverse but functionally interdependent; thus, underlining the importance of adopting a multi-sectoral approach for cholera prevention and control.
Collapse
Affiliation(s)
- Kelly Osezele Elimian
- Nigeria Centre for Disease Control, Abuja, Nigeria. .,University of Benin, Benin, Nigeria.
| | | | | | | | - Ibrahima Soce Fall
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | | | - Michel Yao
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | - Patrick Okumu Abok
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | | | - Lynda Haj Omar
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | - Thieno Balde
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Ayenigbara IO, Ayenigbara GO, Adeleke RO. Contemporary Nigerian public health problem: prevention and surveillance are key to combating cholera. GMS HYGIENE AND INFECTION CONTROL 2019; 14:Doc16. [PMID: 31728269 PMCID: PMC6838734 DOI: 10.3205/dgkh000331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Cholera is a public health problem around the world, and it is endemic in Africa, parts of Asia, the Middle East as well as South and Central America. This review characterizes an cholera outbreak in Nigeria in 2017/2018. On the basis of own experiences and the analysis of historical outbreaks, the Vibrio cholera strains, mode of transmission, signs and symptoms, and most important the prevention and control measures are identified. Untreated, the lethality of cholera is up to 70%. Therefore, a multifaceted approach including public policy, surveillance, water purification and hygiene, community sensitization, and the use of oral cholera vaccination (OVC) is vital to prevent, control, and reduce the cholera mortality rate. It is recommended that the government pass legislation to implement preventive and surveillance measures, e.g., invest in drinking water systems, sanitation systems and sewage treatment, and promote public education on basic hygiene. The latter includes boiling and treating water before drinking, washing hands frequently with soap and clean water, thoroughly cooking food before consumption, avoiding open defecation, disposing of wastes properly, and immediately taking anyone with signs and symptoms of cholera such as watery diarrhea to the hospital for treatment.
Collapse
Affiliation(s)
- Israel Oluwasegun Ayenigbara
- Department of Human Kinetics and Health Education, University of Ibadan, Nigeria,*To whom correspondence should be addressed: Israel Oluwasegun Ayenigbara, Department of Human Kinetics and Health Education, University of Ibadan, Nigeria, Phone: +234 8139177538, E-mail:
| | - George Omoniyi Ayenigbara
- Department of Human Kinetics and Health Education, Adekunle Ajasin University Akungba-Akoko, Ondo State, Nigeria
| | - Rowland Olasunkanmi Adeleke
- Department of Human Kinetics and Health Education, Adekunle Ajasin University Akungba-Akoko, Ondo State, Nigeria
| |
Collapse
|
12
|
Elimian KO, Musah A, Mezue S, Oyebanji O, Yennan S, Jinadu A, Williams N, Ogunleye A, Fall IS, Yao M, Eteng WE, Abok P, Popoola M, Chukwuji M, Omar LH, Ekeng E, Balde T, Mamadu I, Adeyemo A, Namara G, Okudo I, Alemu W, Peter C, Ihekweazu C. Descriptive epidemiology of cholera outbreak in Nigeria, January-November, 2018: implications for the global roadmap strategy. BMC Public Health 2019; 19:1264. [PMID: 31519163 PMCID: PMC6743111 DOI: 10.1186/s12889-019-7559-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 08/28/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The cholera outbreak in 2018 in Nigeria reaffirms its public health threat to the country. Evidence on the current epidemiology of cholera required for the design and implementation of appropriate interventions towards attaining the global roadmap strategic goals for cholera elimination however seems lacking. Thus, this study aimed at addressing this gap by describing the epidemiology of the 2018 cholera outbreak in Nigeria. METHODS This was a retrospective analysis of surveillance data collected between January 1st and November 19th, 2018. A cholera case was defined as an individual aged 2 years or older presenting with acute watery diarrhoea and severe dehydration or dying from acute watery diarrhoea. Descriptive analyses were performed and presented with respect to person, time and place using appropriate statistics. RESULTS There were 43,996 cholera cases and 836 cholera deaths across 20 states in Nigeria during the outbreak period, with an attack rate (AR) of 127.43/100,000 population and a case fatality rate (CFR) of 1.90%. Individuals aged 15 years or older (47.76%) were the most affected age group, but the proportion of affected males and females was about the same (49.00 and 51.00% respectively). The outbreak was characterised by four distinct epidemic waves, with higher number of deaths recorded in the third and fourth waves. States from the north-west and north-east regions of the country recorded the highest ARs while those from the north-central recorded the highest CFRs. CONCLUSION The severity and wide-geographical distribution of cholera cases and deaths during the 2018 outbreak are indicative of an elevated burden, which was more notable in the northern region of the country. Overall, the findings reaffirm the strategic role of a multi-sectoral approach in the design and implementation of public health interventions aimed at preventing and controlling cholera in Nigeria.
Collapse
Affiliation(s)
- Kelly Osezele Elimian
- Nigeria Centre for Disease Control, Abuja, Nigeria.
- University of Benin, Benin City, Edo State, Nigeria.
| | | | - Somto Mezue
- University of Benin, Benin City, Edo State, Nigeria
| | | | | | | | | | | | - Ibrahima Soce Fall
- World Health Organization/ Regional Office for Africa, Brazzaville, Democratic Republic of Congo
| | - Michel Yao
- World Health Organization/ Regional Office for Africa, Brazzaville, Democratic Republic of Congo
| | | | - Patrick Abok
- World Health Organization/ Regional Office for Africa, Brazzaville, Democratic Republic of Congo
| | | | | | - Linda Haj Omar
- World Health Organization/ Regional Office for Africa, Brazzaville, Democratic Republic of Congo
| | - Eme Ekeng
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Thieno Balde
- World Health Organization/ Regional Office for Africa, Brazzaville, Democratic Republic of Congo
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Wichaidit W, Biswas S, Begum F, Yeasmin F, Nizame FA, Najnin N, Leontsini E, Winch PJ, Unicomb L, Luby SP, Ram PK. Effectiveness of a large‐scale handwashing promotion intervention on handwashing behaviour in Dhaka, Bangladesh. Trop Med Int Health 2019; 24:972-986. [DOI: 10.1111/tmi.13277] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Wit Wichaidit
- Department of Epidemiology and Environmental Health State University of New York Buffalo NY USA
| | - Shwapon Biswas
- Johns Hopkins University Baltimore MD USA
- International Centre for Diarrhoeal Disease Research Dhaka Bangladesh
| | - Farzana Begum
- International Centre for Diarrhoeal Disease Research Dhaka Bangladesh
| | - Farzana Yeasmin
- International Centre for Diarrhoeal Disease Research Dhaka Bangladesh
| | | | - Nusrat Najnin
- Department of Epidemiology and Preventive Medicine Monash University Melbourne Australia
| | - Elli Leontsini
- Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | | | - Leanne Unicomb
- International Centre for Diarrhoeal Disease Research Dhaka Bangladesh
| | | | - Pavani K. Ram
- Department of Epidemiology and Environmental Health State University of New York Buffalo NY USA
| |
Collapse
|