Cholera outbreak in Andoni Local Government Area, Rivers State, Nigeria; January 2015: the role of hand washing with soap

Background: In January 2015, an outbreak of cholera occurred in Andoni, Rivers State. We investigated to identify risk factors for infection and institute control measures.Methods: An un-matched case-control study with 62 cases and 62 neighborhood controls was conducted. A case was defined as an individual aged 5 years or more with three or more episodes of loose watery stool with or without vomiting residing in Andoni from 11th-18th January 2015. A control was a person without history of loose watery stool and vomiting, but residing in Andoni. A Semi-structured questionnaire was used to collect data on demographic characteristics, clinical information and risk factors. Univariate, bivariate and multivariate analysis was performed using Epi-info version 7. Twenty-one stool samples and 6 water samples from open wells and ponds were analyzed.Result: Median ages for cases and controls were 8.5 (range; 2– 65) and 18 (2–70) years respectively. Females were 32(51.6%) of cases and 36 (56.5%) of controls. The cases and controls did not differ in age and sex. Cases were less likely than controls to wash hands with soap after using the toilet (OR:0.4, Cl:0.17–0.96) and to drink from tap water (OR:0.09, 95% CI:0.01–0.69). Hand washing with soap and water remained protective of the disease after controlling for potential confounders. Eleven (52.4%) of the clinical samples and 6 (100%) of the water samples yielded vibrio cholera non O1/O139.Conclusion: Unhygienic hand washing practices was identified as a risk factor for cholera infection. The source of the outbreak possibly resulted from contaminated wells and ponds. We provided community health education on personal hygiene, with emphasis on hand washing with soap, and recommended super chlorination of wells

Methanol poisoning in South- South Nigeria: Reflections on the outbreak response

The methanol poisoning outbreak in Rivers State in May 2015, involved 84 persons in five local government areas. An incident management system comprised of an Emergency Preparedness and Response (EPR) committee and the Local Government Area Rapid Response Teams in an Emergency Operations Centre (EOC). The EOC teams conducted case finding activities, line listing, and descriptive analysis, a retrospective cohort study and collection of local gin samples for laboratory investigation. They also coordinated community mobilization and sensitization activities, intervention meetings with local gin sellers, trace back activities and case management. Those affected were male (72; 85.7%) aged between 20 and 79 years. Of the 55 persons whose socio-demographics were obtained, forty-one persons (74.6%) were married, and 23 (41.8%) had primary education. Case fatality rate was 83.3% with an attack rate of 16 per 100,000 persons. Those exposed to ingestion of adulterated gin were six times more likely to develop methanol poisoning than those not exposed RR=6 (1.0-38.5); P=0.0078. It is hoped that this experience has positioned the state for better preparedness towards future outbreaks

Epidemiology, diagnostics and factors associated with mortality during a cholera epidemic in Nigeria, October 2020-October 2021: a retrospective analysis of national surveillance data.

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

Weight status of adolescents in secondary schools in port Harcourt using Body Mass Index (BMI)

Abstract Background Adolescent weight status is a cumulative effect of health and nutritional problems. Adolescent weight problems often go unnoticed as weight assessment is not considered a priority in adolescents. Objectives To determine the weight status of adolescents using BMI and to identify the contributing factors to adolescent weight problems. Methods In April 2010, 960 adolescents aged 10–19 years in secondary schools in Port Harcourt were selected for the study using a stratified multi-staged sampling method. Structured questionnaires were filled by the investigators while weight and height were measured. BMI was calculated using the formula weight/height2 (kg/m2). Results The prevalence of underweight, overweight, obesity and stunting were 6.4%, 6.3%, 1.8% and 5.4% respectively. Factors which were commoner in overweight adolescents were high socioeconomic class, higher maternal education, spending > 3 hours a day watching television and frequent ingestion of snacks. Conclusion There is a need for periodic weight assessment of adolescents and health education to promote healthy eating habits and regular physical exercise as part of the School Health Programme.</p