Cholera: Outbreak Preparedness, Prevention and Control in Northern Nigeria

Cholera remains a seasonal epidemic in Nigeria, and the northern region is most affected. Poor sanitary and hygiene practices due to adverse socioeconomic, sociopolitical, and climatic conditions have led to recurrent and new outbreaks in many rural communities, especially in the northern region. Seasonal outbreaks are compounded by seasonal floods, nomadic culture of herders, illicit mining activities, and population displacement by banditry and environmental hazards. Other complicit factors include lack of waste and sewage management facilities, overcrowded refugee and internally displaced persons’ camps, prisons and schools, and unsafe drinking water. Despite successive efforts by the government, through the Nigerian Centre for Disease Control and its partners, towards preparedness, prevention, control and elimination of cholera outbreaks over the years, seasonal outbreaks in many northern communities remain a recurring challenge. A review of recent outbreak management strategy reveals systemic challenges such inadequate preparedness and response plan resulting from poor surveillance and early warning, constitution and coordination of the response team, poor mapping of resources and required logistical supports, and poor implementation of preventive actions such as the WaSH protocol. Addressing the recurrent cholera outbreaks in northern Nigeria requires adequate and strategic proactive preparedness planning and response measures, including community education and sensitization for good sanitary and cultural practices, pre-outbreak training of health personnel, and inventory management optimization for relevant health commodities. The author discusses implications and solutions to identified gaps in the existing operational approach to preventing cholera outbreaks in northern Nigeria.