WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 15: 4 – 10 April 2022
Data as reported by: 17:00; 10 April 2022
...
Cholera Nigeria
112 420 cases
3 635 Deaths
3.2% CFR
EVENT DESCRIPTION
The current cholera outbreak was declared on 20 December 2020.
By the end of 2021, Nigeria had hit its highest number of cholera
cases ever reported: 111 062 cases with 3 604 deaths (CFR 3.2%),
from 33 states plus the Federal capital territory in the country. In
2021 alone, 115 deaths were recorded from 19 states.
From epidemiological weeks 1-12 2022, a cumulative number of
1 358 cases and 31 deaths have been notified (CFR 2.3%) from
15 States and 60 Local Government Areas (LGAs). Of these cases,
27% (n=367) are aged 5-14 years and 52% (n=706) are males.
Specifically, during epi week 12 (ending on 27 March 2022), 14
cases and two deaths were reported from two LGAs in two States;
no new state has reported a case.
The majority of States with international borders and ongoing
humanitarian crises are currently inactive with no cases reported
in the last 3 weeks. Cross River State is the current hotspot for
the outbreak and has reported 42% (n=569 cases) of the national
total in 2022. These cases have been reported in 50% (n=9) of its
LGAs, with more than half of cases originating from Ogoja and
Ikom LGAs. Furthermore, from epi weeks 1-12 2022, a total of
264 samples have been tested by rapid diagnostic tests and 61
samples cultured, with a test positivity rate of 14.8%. Laboratory
confirmation by culture has been from four states: Taraba, Cross
River, Ondo and Akwa Ibom.
Current figures indicate that the outbreak is in a declining trend.
Indeed, as compared to the same period of 2021, the number of
cases has reduced by 74.9% (5 403 vs 1 358 cases) and the number
of deaths by 84.1% (195 vs 31 deaths) with a substantial reduction
in CFR, from 3.6% to 2.3%. In addition, the geographic extension
of the epidemic has also reduced by 28.6%, from 21 to 15 reporting
States. Cases being currently reported are from poorly accessible
areas either due to remote location or security compromised areas.
PUBLIC HEALTH ACTIONS
The National Emergency Operations Centre was activated
in the beginning of the outbreak to coordinate and support
response interventions. With the progressive decline in
trend of cases and reduction in geographic spread, it was
deactivated by the Nigerian Centre for Disease Control
(NCDC) on 15 December 2021.
A joint WHO/NCDC team has been deployed to support the
Cross River State which is currently reporting the highest
number of cases.
A request has been sent for the reprogramming of CEF to
cover all 36 states and the Federal capital territory rather
than being limited to 10 states.
An integrated response is ongoing in all active States.
Accordingly, cholera treatment centres (CTC) and oral
rehydration points (ORP) have been identified and set up in
hard to reach active communities.
Overall, a total of 1 454 rapid response teams have been
deployed, 349 CTCs and 789 ORPs are functional, 6 245
clinical teams are operational, 7 297 volunteers and 663
WASH technicians have been trained, and over 6 100
communities have been reached by RCCE teams.
A reactive OCV campaign has been organized in five States of
Benue, Bauchi, Yobe, Jigawa and Zamfara. Pre-emptive OCV
campaigns are in preparation in the targeted hotspot LGAs.
SITUATION INTERPRETATION
Nigeria is endemic to cholera, with epidemic surges appearing,
the worst of which ever recorded was in 2021. Response efforts
put in place in 2021 and preparedness efforts in early 2022 have
significantly contributed to improve early detection, reporting
and clinical management of cases and consequently reducing
the number of new cases. However, there remains need for
improvement in areas such as health facility infrastructure, early
care seeking behaviour, safer sanitation and hygiene practices and
access to safe water. In fact, this decline should be interpreted
with caution as the major drivers of the outbreak are persistent
in communities, including poor access and inadequate safe water
supply, open defecation with less than 10% of LGAs certified
open defecation free in the country.
PROPOSED ACTIONS
Preparedness and readiness activities should be implemented
in all at-risk LGAs.
Response interventions should be maintained and reinforced
in all reporting States and LGAs, with particular focus on
Cross-River State.
Strong advocacy and fund raising should be conducted
towards Partners and Donors, accordingly.
The cholera elimination plan should be developed, funded
and implemented, to move towards elimination of the
disease in Nigeria.
View/Open
OEW15-0410042022.pdf (2.192Mb)
https://apps.who.int/iris/handle/10665/353065
