The Causes and Effect of Cholera Among Children.
CHAPTER ONE
OBJECTIVE OF THE STUDY
The purpose of this study is to determine the causes and effect of cholera during rainy season in Benin City.
The specific objectives of the study are:
- To identify the cause of cholera in Benin City.
- To ascertain if cholera outbreak is usually rampant during the rainy season among children in Benin City.
- To identify the problems associated with the prevention of cholera in Benin City
- To determine the ways of preventing cholera outbreak in Benin City.
Chapter Two
Literature Review
Conceptual Framework
Cholera
Cholera is an infection of the small intestine that is caused by bacterium Vibrio cholera 01 and 0139 (Riyan 2004 and WHO 2010). Cholera pandemic started in 1961, reaching West Africa and Nigeria in the late 1970.The first recorded cases of cholera in Nigeria occurred in a village near Lagos in December 1970 leading to an important epidemic of 22,931 cases and 2945 deaths with a case fatality rate (CFR) of 12.8% during 1971.Between 1972 and 1990, Nigeria reported few cases. In 1991, 59,478 cases were reported with the death toll of 7,654. The CFR was 12.9% ,the highest rate reported about the country to date. Cholera is endemic in Nigeria (Falade and Lawoyin 1999) and epidemiological features (Utsalo et al 1991; Eko et al 1994; Hutin 2003) have been reported from various parts of the country with investigation on possible sources of the outbreak. Cases started to be registered in January 1991 and among the first affected states were Kano, Akwa-Ibom, Bauchi, Niger and Oyo. By September of the same year the disease have spread to 19 of 21 states including the Federal Capital.Nigeria reported an outbreak of cholera in May 2013, and up until October 2014, a total of 40,608 suspected cholera cases were reported. With 898 deaths, that gave a case fatality rate (CFR) of 1.95%.
The outbreak has experienced a strong upsurge since early 2014, with more than 34,000 cases and 664 deaths reported betweenJanuary 2014 to October 2014. Suspected cholera cases were recorded in 19 of the country‟s 36 states (51%). Nine of the affectedstates include; Bauchi, Kaduna, Plateau, Kano, Borno, Adamawa, Katsina, Kebbi and Zamfara. Investigations of cholera outbreak in Nigeria have focused on epidemiological features, the probable source of contamination and the risk factors without spatial linkage of health data. However, advances in Geographical Information System (GIS) provides this opportunity and have become an indispensable tool for processing, analysing and visualizing spatial data with domains of environmental health, disease ecology and public health (Kristemann et al 2002). The World Health Organization (WHO) is continuing to support the ministries of health and health authorities in Local Government Areas (LGA‟s) as they respond to outbreaks.
Furthermore, the future of cholera prevention as well as any other infectious disease lies in the ability to develop effective and accurate climatic models which could serve as early warning systems for infectious disease outbreaks. This shift in containment to prevention in public health measures represents a positive step in the right direction towards minimizing the death rate during outbreaks such as the ones in Zimbabwe.
CHAPTER THREE
RESEARCH METHODS
Research Design
This study adopted a Descriptive/simple survey research design. A survey research design according to Osuala (2001) centers on individual and their opinion, belief, motivation and behavior. The design was considered suitable since the study will solicit information from respondents in Benin.
Area of the Study
The study is conducted in Benin the capital of Edo state in Nigeria. The reason for this area is based on the fact of numerous presence of Hospitals within the capital.
Population of the Study
The population of the study comprised all the staff Ministry of health Benin City, Edo State Nigeria as at the time of this study.
Sample and sampling techniques
The sample for the study was 300 staff drawn from the population using random sampling technique. The number of Medical practitioners (150) were randomly selected through simple random selection method. The sample was made up of both male and female staff.
CHAPTER FOUR
DATA ANALYSIS, RESULTS AND INTEPRETATION
Introduction
This chapter is predominantly concerned with the careful presentation and analysis of the data gotten from the questionnaires. Only responses considered more relevant in the questionnaires were presented and analyzed. The simple percentage ‘formula was used in the data presentation and analysis while the chi-square formula was used in the hypothesis testing.
DATA PRESENTATION
RESPONSE TO SEX OF STAFF IN MINISTRY OF HEALTH BENIN, EDO STATE.
The customers and staff of the Bank were asked to tick the age bracket they fall into as stated in the questionnaire. The results at analysis showed that 41 or 71.9% of the respondents were male while 16 01- 28.1% of the respondents were females.
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATIONS
Summary
The purpose of this study is to carry the causes and effect of cholera among children with respect to the traditional method of Cholera data handling and management using archive in the Ministry of health Benin city, Edo state. To analyze the causes and effect of cholera epidemic in the study area. Results showed that poor environment sanitation leads to cholera outbreak, washing of hands before eating helps to prevent or reduce the cholera outbreak, also drinking and bathing with contaminated water leads to cholera infection and a poorly kept toilet also causes cholera outbreak etc. recommendations were indicated which include that, government should swing into action by providing various measures in other to prevent and reduce cholera disease in the country and in Benin City. Our water should be properly treated by adding chlorine to it before drinking and bathing with it. We are also advice to keep clean areas where food are prepared and these food should be properly covered to avoid the cholera outbreak, mothers are also advice to wash their children clothes with soap and clean water and hands should be washed after taking care of sick people to avoid the risk of the disease.
Conclusion
In this study, we report the presence of Vibrio cholera can be found in some well, river and street-vended water samples analyzed Benin with a prevalence. The microorganism was not isolated from borehole and pipe borne water sources. Vibrio cholera was found to be predominant in river, followed by well water and lastly, street-vended water. Water samples from Benin River were the most contaminated followed by that from Ogba while the least contaminated water samples were from Benin City. The study also revealed that the use of PCR targeting species specific gene (ompW) in combination with conventional microbiological techniques is essential for proper identification of V. cholera.
From the results of this research, we can conclude that the environment and water plays an important role as a transmission vehicle for Vibrio cholera considering the presence of the pathogen in the water samples (well, street-vended and river) thus indicating that the environment may also be conducive for the survival of other serogroups such as O1 and O139 which are etiologic agents of cholera. This infers that consumption of water and poor environment may constitute a risk to public health and mothers should be very careful concerning these two factors so as to maintain the health of their children and save them for cholera.
Recommendation
The main contribution of the study is the detailing and capturing of costs associated with cholera incidence on Benin where a gap in literature exited.
Based on detailed findings, the following recommendations are made;
- Health-based targets and water quality improvement programmes in general should be implemented by government in the context of a broader public health policy, including initiatives to improve sanitation, waste disposal, personal hygiene and public education on mechanisms for reducing both personal exposure to hazards and the impact of personal activity on water quality.
- In combination with conventional methods which serve as gold standard for detection of V. cholerae, the use of PCR targeting ompW gene which is species specific should be encouraged for appropriate identification of the microorganism. iii. Surveillance studies should be conducted by health organizations including both State and Federal Ministry of Health, to prevent occurrence of outbreaks of Vibrio cholerae which could possibly result in an epidemic.
- Government should provide a means of ensuring proper distribution and management of municipal water supply to enhance accessibility of potable water to consumers.
- Local authorities should implement surveillance programmes for water provided by vendors and, where necessary, develop education programmes to improve the collection, treatment and distribution of water to prevent contamination.
References
- Ajoke, O. A., Solayide, A. O. N., Mary-Theresa, N. and Akitoye, O. C. (2012).Cholera Epidemiology in Nigeria: an overview. Pan African Medical Journal.
- Akyala, I. A., Bright, E. S., Olufemi, A., Adebola, O. and Patrick, N. (2014). Investigation of Cholera Outbreak in an Urban North Central Nigerian Community-The Akwanga Experience. Public Health Research, 4(1): 7-12 .
- Ali, M., Emch, M. and Sack, R. (2002); identifying environmental risk factor for epidemic cholera; a raster GIS- apporoach. Health place ,8: 201-210.
- Ali M., Emch, M., Donnay J. P, Yunus M. and Sack R. B. (2002): Identifying environmental risk factors for endemic cholera: a raster GIS approach.Health Place, 8:201–210.
- Barreto, M. L. Crescimento e tendência da produçãoscientíficaemepidemiologia no Brasil. Rev SaúdePública. 2006; 40(N Esp), 79-85.
- Bernstein, K.T., Curriero, F. C., Jennings, J. M., Olthoff, G., Erbelding, E. J. and Zenilman, J. (2004). Defining core gonorrhea transmission utilizing spatial data. Am. J. Epidemiol. 2004; [PubMed: 15229117], 160:51–58.
- Borroto and Martinez, P. (1996); Geographical pattern of cholera in mexico; internationalJournal for epidemiology.29(4)764-2000.
- Carpenter, C. (1971): Principle and practice of cholera control, Ann. Intern. Med, 74(6)10211050.
- Chang, K. T. (2008). Introduction to Geographic Information Systems (New York:TheMaGraw
