• Official on deadly season: Stop visiting patients with diarrhoea and vomiting in hospital until they get better

By Bashir Bello

Katsina State is going through a hard time after cholera hit the state.   Sunday Vanguard gathered that all the 34 local government areas of the state are affected, about 53 dead while several others were hospitalized and discharged.

The local government areas worst hit are Batsari with 561 cases, Funtua (468), Jibia (406), Danmusa (146), Katsina (145), Rimi (132), Batagarawa (117), Faskari (115), Bakori (111) and Mani (102).

Penultimate Saturday, a fresh outbreak in Charanchi local government area of the state claimed 15 lives.

The death toll later rose to 18 or thereabouts a day or two days after when three other victims hospitalized at the Charanchi Comprehensive Clinic were confirmed dead.

A credible source in Rimi local government area, who strongly pleaded to speak on the condition of anonymity, said 13 people had so far been lost to the outbreak in the area.

Statistics of past outbreaks in Katsina shows that, as of June 30, 2018, death toll from an outbreak stood at 11 – Funtua (5 deaths) and Kusada (6 deaths) from 132 cases recorded in six local government areas of the state.

The six local government areas which recorded the outbreak at that time are Funtua (40 cases), Kusada (83), Kaita (3 cases), Ingawa (4 cases), Kankia (1) and Katsina (1 case).

Additional 5 people died in Jibia local government area.

The victims include male and female as well as young and old persons.

Meanwhile, Sunday Vanguard learnt that cholera has become an annual occurrence in the state.

Causative factors

The outbreak usually occurs between May and September every year. This is the period when the country records high rainfall and this is presumed to be the major cause.

Sometimes, the rainfall leads to an overflow of sewage systems and subsequent breakdown in overall hygiene standards.

In other cases, residents tend to trap water directly from rainfall for consumption or even visit ponds to fetch water for domestic use.

Poor access to potable water and crowded living conditions are highlighted as other factors.

According to researchers, cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium, vibrio cholera.

•Ibrahim Officer

Govt response to outbreak

The state Commissioner for Health, Hajia Mariatu Bala Usman, after the outbreak that reportedly killed 11 in Funtua and Kusada local government areas in June 2018 simply put the number of cases at 17 and confirmed 12 deaths from diarrhoea and vomiting.

The Commissioner, at that time, said the state government had, before then, put in place proactive measures from the N70 million released this year for Communicable Diseases Control such as CSM, diarrhoea and vomiting among others.

“We do have a cholera outbreak in Katsina. We have a surveillance system across the 34 LGAs. The disease surveillance and notification officers work directly with the Primary Health Care Development Agency responsible for the managing of outbreaks like this. They have been on alert since the first case was reported in Kusada”, she said.

“Currently, we have cases of diarrhoea and vomiting in about seven LGAs namely Funtua, Kaita, Jibia, Kankia, Ingawa, Kusada and Katsina. 180 persons are affected by the diarrhoea and vomiting outbreak and we have recorded 12 deaths.

“Government has procured emergency drugs for all the 34 LGAs in the state and released the drugs to the PHC at the LGAs for onward distribution to affected areas. We are proposing to procure chlorine for the 34 LGAs to safeguard their water because we realised that the causes are the drinking of contaminated water and consumption of contaminated foods or vegetables.

“Our religion encourages that we visit a sick patient in hospital and it attracts reward but we are advising the people to desist from visiting patients with diarrhoea and vomiting until they get better.

“Adequate steps have been taken to curtail the spread including public enlightenment, live phone-in radio and television programs, on-the-spot assessment by the State Epidemiologist and his team, provision of drugs and commodities for the treatment of patients free of charge. Intensive radio and television jingles are scheduled to commence this week InshaAllah”.

Meanwhile, at the point of conveying interventions to persons affected by the recent outbreak in Charanchi local government area, the Permanent Secretary, Ministry of Health, Katsina State, Kabir Mustapha, said the outbreak is an annual thing and that which, he simply put, occurs year-in-year-out.

“If you have been following cases of gastroenteritis in the state, we recorded the first case in Funtua local government area in May 2018. But it is not surprising; with the coming of the rains, we expected it to happen. This is a year-in-year-out thing”, Mustapha said.

“Despite the fact that we are on the radio and television educating the people on basic simple hygiene and even how to prevent the contamination of the water source through open defecation, people mostly don’t heed the advice. And many find it easy to fetch water from open sources where there is connection irrespective of whether the water is pure or not.

“People also prefer to fetch water from the downpour particularly during the rainy season rather than going to the boreholes that are there, not minding the risk inherent in it. They feel they can’t wait to join the queue or so. This is one of the causes of cholera.

“Water is the main source but food can be contaminated too through that same water”.

In the same vein, the Executive Secretary, Katsina State Primary Health Care Development Agency, Dr. Muhawwiya Aliyu, said that with the NIMET forecast of floods and possibly occurrence of gastroenteritis, the state administration had put in place adequate measures to stop cholera.

“Since we received information from NIMET that there is going to be flooding this year, we forecast that there could be gastroenteritis. Since that time, we had prepositioned drugs at both state and local government levels. And the moment we started receiving the cases, we started responding,” Aliyu said.

“The causes of these are contaminated water and person-to-person

“The people are so used to fetching water from the river. Even, if not from there, you know flood can go and contaminate the good water source in the deep well.

“And then poor personal hygiene. The way the people of the community poorly handle the patients before coming to the hospital, there can be person- to-person transmission of the disease”.

Cholera kits, according to him, had been packed for onward distribution to about 3,600 households in the affected Charanchi local government area.

Aliyu disclosed that the water treatment guard in the kits was for the people to treat contaminated water, soaps to always wash their hands and the bleach to ensure personal hygiene.

Health workers, supported by Medicine San Frotiers, MSF, Doctors Without Borders, also carried out sensitization campaign on cholera outbreak in Bindawa local government area of the state.

The campaign was carried out among the clients/patients/patients’ relatives and at their personal houses with general community members.

Residents’ comments

A resident of Batsari local government area, the LGA worst hit by the latest outbreak, Muhammad Surajo, commended the swift intervention of the state government which, he said, helped to avert the spread of cholera.

“We actually had cases of cholera outbreak in Batsari local government but it has been contained. The state government intervened swiftly and that had helped in stopping the spread of the outbreak”, Surajo said.

“Here we have people who were affected by the outbreak but have been treated and discharged”.

Also speaking to Sunday Vanguard, a resident of Jibia local government area, Ibrahim Officer, said the outbreak was not a new thing to them in the area as cholera breaks out every time.

“In recent times, we have been recording cases of cholera outbreak every time. It is common here. Even last Sunday, we had cases. Only that I don’t have at my disposal the number of casualties”, Officer said.

“I am aware of a group which came to the area to embark on sensitization programme for like three months, a kind of house-to-house sensitization or intervention”.

Another resident but in Rimi local government area, who didn’t want his name published, spoke on the incident that claimed the lives of 13 persons in the LGA, saying the majority of the victims were from Rimi town while others were from the villages.

A member representing Funtua Constituency, Hon. Ahmad Abubakar, had to table the matter of the cholera outbreak before the state House of Assembly for swift intervention by government to save lives.

At that time, Abubakar said over 50 persons had been hospitalized while highlighting affected LGAs to include Maska, Goya, Dikke and some parts of Funtua.

The plenary, presided over by the Deputy Speaker, Hon. Shehu Dalhatu, referred the matter to its committee on health to investigate.

Disclaimer

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