By Sola Ogundipe
FROM malnutrition, malaria and polio, to Non Communicable Disorders, NCDs, such as heart disease, kidney failure and cancer, 2012 holds a mixed bag of the good, the bad and the ugly. Good Health Weekly presents inside information on some of the major health issues of the outgoing year.
NON communicable Disorders, NCDs: Heart disease, stroke, cancer, diabetes and other chronic diseases are increasingly becoming public health problems of significance worldwide. In Nigeria, the global epidemic of NCDs manifested significantly in the form of cancer, diabetes, kidney failure High Blood Pressure , HPB, and stroke. The debilitating and often fatal complications such as blindness, renal failure, gangrene leading to lower limb amputations are projected to account for a quarter of all deaths by 2015.
Malaria: Malaria, infamously dubbed “the world’s most important infectious disease” remained a major public health problem in Nigeria in 2012. It killed mainly children and pregnant women.
Neglected Tropical Diseases (NTDs): The most common NTDs, such as the Soil-Transmitted Helminth infections, schistosomiasis, lymphatic filariasis, trachoma, and onchocerciasis remained widespread among the poor in Nigeria and other parts of sub-Saharan Africa. A group of chronic, disabling, and disfiguring conditions among the rural poor and disadvantaged urban populations, NTDs cause adverse effects on child development, pregnancy outcome, and agricultural worker productivity.
They represent a major reason why millions cannot escape poverty or achieve Africa’s Millennium Development Goals, MDGs to eradicate poverty (MDG 1), promote education (MDG 2), reduce child mortality (MDG 4), improve maternal health (MDG 5), and combat “other diseases” (MDG 6).
Lassa Fever: Like the proverbial bad coin, Lassa Fever turned up in Nigeria for the second time in four years. An outbreak of the disease within the first quarter of 2012 put the country at the edge. At least 15 States were affected with roughly 400 cases and 45 deaths recorded.
Insufficient information and ignorance coupled with poor disease surveillance at the grassroots and slow response to the epidemic resulted in the high infection and fatalities. The Lassa virus is carried by the soft-furred rat, Mastomys natalensis, which is widespread in Africa. Transmission of the virus from rats to humans is suspected through contamination of foodstuffs and water with rodent urine and faeces.
Yellow Fever: For several weeks in March and April 2012, there was concern about yellow fever in Nigeria. One of only two diseases (the other is polio) still subject to international rules concerning vaccination requirement for international travel, yellow fever is a deadly adversary.
All travellers to countries with yellow fever must be vaccinated according to a World Health organization, WHO, recommendation. Although there was no outbreak of the viral infection, there was a face-off between Nigeria and South Africa over yellow fever vaccination.
In the eye of the storm was the yellow fever certificate. Nigeria still requests a valid yellow fever vaccination certificate upon entry. In countries where there is no yellow fever, but where there is a risk of introducing the disease, a valid vaccination certificate is demanded from travelers arriving from Nigeria and other countries with yellow fever.
Pneumococcal disorders: Widely described as the forgotten killer of children, pneumococcal diseases, which include pneumonia, meningitis, and sepsis – are is currently the leading cause of vaccine-preventable deaths among children under age five worldwide.Pneumonia still kills 1.4 million people daily in the world and it is the second commonest cause of death of children aged 5 and below in Nigeria.
Currently, Nigeria has the highest burden of infant and child deaths from pneumococcal disorders in Africa and is second only to India in the entire world.Most cases of pneumococcal diseases are vaccine preventable but the challenge has been to ensure the most vulnerable children have easy, affordable access to the life-saving interventions.
In 2012 this remained a daunting task, particularly in Nigeria, where only half of children with pneumonia have access to an appropriate healthcare provider, and fewer than one in five of them ultimately receive the correct antibiotics.
A silent and hidden emergency, more than half of all childhood deaths in Nigeria are associated with malnutrition – one of the biggest obstacles to attainment of the Millennium Development Goals (MDGS), related to health, hunger, and poverty. Vitamin and mineral deficiencies including folate (vitamin B9), iodine, iron, vitamin A, zinc, and other B vitamins important for healthy and productive populations remain significant as each year, more than one million children under five die from vitamin A and zinc defects, blindness and low IQ are long-term disabilities, in the face of sub-optimal breastfeeding and increasing complementary feeding. HIV & AIDS Still one of the biggest health challenges, the HIV and AIDS epidemic in Nigeria remains a public health problem of enormous magnitude.
Only a fraction of those that require ARV drugs have access. Also voluntary testing to determine HIV status remains challenging, complicated by persistent stigma and discrimination.
With the current National prevalence of 4.1 percent, the number of people infected is estimated at about 3.1 million.
This means that Nigeria still has the second largest number of People Living with HIV/AIDS in Sub-Saharan Africa and the highest in the West African sub-region.
Currently, about 1.5 million people including 250,000 children are in need of AIDS treatment.
The map of polio cases improved tremendously in 2012. Cases really exist only in the Nigeria, Pakistan and Afghanistan, which have not yet interrupted transmission.
In Nigeria in particular, there has been benefit from the strong political leadership and commitment of a number of governors in the Northern part of the country.
New polio cases are in about 50 handful of local government areas that are the weak links in the chain, where immunization coverage rates are low and children are vulnerable. Tracking to get vaccinators to immunize every child has increased the progress. But there is need to keep that up.