AN ASSESSMENT THE GROWING PREVALENCE OF CHOLERA OUTBREAK IN 2024 IN LAGOS STATE

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

Poor sanitation is a significant driver of water-borne infections worldwide and plays a role in the spread of communicable diseases like cholera (Gambo, 2022). In underdeveloped countries, the problem is exacerbated, especially in slum environments, by factors such as inadequate cleanliness, substandard housing, congested living circumstances, and insufficient measures for safe food preparation and handling (Mehrabi, Fallah & Atace, 2019). Cholera is a gastrointestinal sickness caused by the bacterium Vibrio cholerae. It can affect people of all ages and occurs in areas where there is a lack of proper water, sanitation, food safety, and hygiene standards (Cohen, 2018). The symptoms are marked by a rapid and severe onset of watery diarrhoea accompanied by signs of significant dehydration (Gbemi, 2020). Cholera has the ability to cause death in individuals with weakened immune systems and those who are malnourished in a very short period of time, typically within one hour (Barusa, 2022).

The cholera's brief incubation period, ranging from 2 hours to 5 days, greatly accelerates the rapid spread of the disease. Consuming contaminated food, such as vegetables and fruit washed with sewage-affected water, or drinking water that has been polluted by the faeces of infected individuals, increases the susceptibility of individuals or communities to the risk of cholera. Cholera continues to pose a global concern and challenge to countries with low hygiene standards, limited access to clean water, and inadequate sanitation (Igboukwu et al., 2020). Cholera outbreaks exhibit varying degrees of severity and can persist for a period of several months to over a year (Mehrabi, Fallah & Atace, 2019). This disease is prevalent in nations across Asia, South America, and Africa. To reduce the risk of cholera, it is important to filter drinking water, prevent bacteria contamination in food, and implement sewage treatment and monitoring, as is done in developed areas (Richard et al., 2023).

From January to August 2023, Nigeria saw more than 3,000 suspected instances of Cholera, resulting in the deaths of 3 individuals and the hospitalisation of 42 others in Lagos state (Aliu, 2023). The incidence was caused by factors such as inadequate housing, hunger, and overcrowding, among others (Martin, 2022). This study aims to assess the factors that contribute to the occurrence of cholera outbreaks in Lagos state. Lagos State is located in the southwestern region of Nigeria. Among the 36 states, this particular state ranks second in terms of population and is the lowest in terms of land area. Lagos is characterised by significant urban disparities and social devaluation, where the practice of open defecation is prevalent and toilets hold no social significance (Akin, 2022). Sewage is disposed of without discrimination, and there is a lack of understanding regarding the risk of cholera. If these issues are not resolved, not only will cholera persist, but also the majority of contagious diseases prevalent in slums. Therefore, the necessity for this investigation arises. 

1.2 Statement of the Problem

The ongoing presence and resurgence of cholera in Lagos State is a significant public health concern. An investigation of the occurrence of cholera in the State has revealed that certain Local Government Areas (LGAs) are now seeing a significant increase in cholera cases. Several environmental elements have been recognized as contributing to the persistent recurrence of Cholera in Lagos state. 

The environmental conditions taken into account comprised precipitation and temperature. The environmental factors contributing to the spread of cholera encompass sanitation, trash dumps, topography, flooding, supplies of potable water, and sewage disposal systems. The environment in most portions of Mushin LGA is typically damaged, unclean, and nearly blighted. The escalating annual precipitation is a significant catalyst for the resurgence of cholera (Abiola, 2023). The fluctuating intensity of precipitation throughout the year leads to significant instances of flooding in several regions of the State, particularly in densely populated areas that have experienced excessive land expansion. Furthermore, as a result of excessive population density in those regions, there is a significant need for land, leading to a fierce competition for space. Open spaces and drainage areas are always utilized for their intended purposes. This frequently leads to inundation and its related repercussions. Increased and persistent rainfall leads to the contamination of drinking water supplies by floods, resulting in the re-emergence of cholera (Yekini, 2023). 

Furthermore, temperature is a significant environmental element contributing to the resurgence of cholera. As the years pass, the heat of the Earth is becoming more intense due to the escalating effects of climate change and global warming (Chioma, 2023). Cholera is more prevalent in warmer temperatures than to lower temperatures. The area has a mean minimum temperature of 24.1o C and a mean maximum temperature of 31.6o C. These high temperatures, together with variables like overcrowding and filthy conditions, increase the vulnerability of populations to cholera outbreaks. This study aims to assess the growing prevalence of cholera outbreak in 2024 in Lagos state.

1.3 Objectives of the study 

The primary objective of this study is to critically assess the growing prevalence of cholera outbreak in 2024 in Lagos state. Specific objectives of this study are to:

Ascertain the prevalence of cholera outbreak in Lagos state

Identify the causes of cholera in Lagos state

To analyze the effects of cholera in Lagos state.

To identify the strategies adopted by the Lagos State government to tackle cholera outbreak in the state.

1.4 Research Questions

The following research questions will be answered in this study:

What is the extent of cholera outbreak in Lagos state?

What are the causes of cholera in Lagos state?

What are the effects of cholera in Lagos state?

What are the strategies adopted by the Lagos State government to tackle cholera outbreak in the state?

1.5 Research Hypotheses

The following research hypothesis will be validated in this study:

Ho: The extent of cholera outbreak in Lagos state is low

Ha: The extent of cholera outbreak in Lagos state is high.

1.6 Scope of the study

Broadly, this study focuses to critically assess the growing prevalence of cholera outbreak in 2024 in Lagos state. Specifically, this study focuses on ascertaining the prevalence of cholera outbreak in Lagos state, the causes of cholera in Lagos state. the effects of cholera in Lagos state, and the strategies adopted by the government to tackle cholera outbreak in the state.

This study will be carried out in Lagos state.

1.7 Significance of the study

This study will serve as a baseline for researchers and students and also guide government, health practitioners to evaluate elements contributing to the outbreak of cholera. 

This study's findings will provide invaluable insights into the factors contributing to the increased incidence of cholera, including environmental, social, and economic determinants.

Moreover, this study will contribute to the existing body of knowledge by offering a comprehensive assessment of current cholera trends

Finally, this study will also serve as a reference material to students and researchers for further studies and future research.

1.8 Limitations of the study

Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. The significant constraint was the scanty literature on the subject owing that there are no much data on the topic of elements contributing to the occurrence of cholera outbreak in Lagos state. Thus, much time and organization was required in sourcing for the relevant materials, literature, or information and in the process of data collection. Also the study is limited in sample size and geography covering only Lagos state. Therefore, findings of this study cannot be used for generalization thus creating a gap for further studies. 

Also encountered was time constraint as the researcher had to carry out this research in addition to attending lectures and other educational activities required of him.

1.9 Definition of terms

Cholera: Cholera is an infectious disease that causes severe watery diarrhea, which can lead to dehydration and even death if untreated. It is caused by eating food or drinking water contaminated with a bacterium called Vibrio cholerae.

Diarrhoea: This is a condition in which feces are discharged from the bowels frequently and in a liquid form. a range of symptoms including diarrhea and vomiting.

Communicable disease: Communicable diseases are illnesses caused by viruses or bacteria that people spread to one another through contact with contaminated surfaces, bodily fluids, blood products, insect bites, or through the air. There are many examples of communicable diseases.