Cholera: Physician tasks govt. on zero tolerance for open defecation

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A Public Health Physician, Prof. Tanimola Akande, says recurring cholera outbreaks can be prevented through zero tolerance for open defecation and the provision of a good sewage disposal system by the government.

Akande, of the University of Ilorin, Kwara, stated this in an interview with the Newsmen on Friday in Lagos.

Cholera is an infectious and often fatal bacterial disease of the small intestine, typically contracted through ingestion of infected water or food, causing severe vomiting and diarrhoea.

According to World Health Organisation (WHO), there are 1.3 to four million cases of cholera, with attendant 21,000 to 143,000 deaths worldwide, arising from cholera.

Also, Nigeria Centre for Disease Control (NCDC) said that between January 2021 and June 27, a total of 14,343 suspected cases of cholera were reported from 15 states and FCT, with 325 deaths.

Akande, a former National Chairman of the Association of Public Health Physicians of Nigeria, said that cholera would continue to be endemic in Nigeria, as a large percentage of its citizens still practised open defecation.

“Cholera is a disease of poor hygiene. If everyone can pass out their faeces without contaminating water and food sources, there will be no cholera.

“It is a situation where a large percentage of Nigerians still practise open defecation and it washes downstream, while someone else is waiting there to fetch the same water to drink or prepare food.

“We have to ensure that we are good in environmental hygiene. Everyone must have a good sewage disposal system.

“Ensure that faeces are not open to allow flies to move around; cover your food so that flies don’t perch on it and contaminate it. It is only then that we are serious about preventing cholera,” he said.

According to the consultant public health physician, state governments have major roles to play in preventing open defecation by establishing public toilets across communities.

“Government should also provide clean water because if people have to source water from polluted sources, cholera scourge will remain,” he said.

Akande called for a good surveillance system to monitor the occurrence of the disease, adding that states should not wait until it was severe before addressing and controlling it.

“What we are doing now is responding to serious outbreaks, instead of preventing it early enough, and this is because our reporting system is not good enough,” he said.

Akande, who noted that the risk of death from cholera was higher when treatment was delayed, advised that a quick report be made to appropriate authorities to reduce case fatalities.

The medical expert also advised that public health facilities be made to function effectively in order to enhance their preparedness to rehydrate and administer antibiotics to infected persons.

Akande urged state ministries of health to that ensure environmental health officers constantly checked the activities of food vendors to ensure that food being sold were hygienically prepared and not exposed to flies to perch on and contaminate.

According to him, vaccination is one way, but not the most important measure of preventing cholera.

Akande also advised Nigerians to boil and store water in clean and safe containers before drinking, as part of the preventive measures against cholera.

He stressed the need to thoroughly wash hands with soap and water to prevent infectious diseases like cholera, especially after defecation and before handling food or eating.