CHOLERA PANDEMIC IN 2024: ASSESSING PUBLIC AWARENESS OF ITS RISK FACTORS AND PREVENTIVE MEASURES IN LAGOS STATE

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

Cholera is a rapid-onset gastrointestinal infection resulting from the consumption of contaminated food or water containing the bacterium Vibrio cholerae. Cholera continues to pose a worldwide risk to public health and serves as a marker of inequality and insufficient social progress. According to researchers, the annual incidence of cholera ranges from 1.3 to 4.0 million cases, resulting in 21,000 to 143,000 fatalities globally. Cholera is a highly grave illness that can result in intense acute watery diarrhoea accompanied by severe dehydration. The incubation period for symptoms to manifest after ingesting infected food or drink ranges from 12 hours to 5 days. Cholera has the potential to impact individuals of all ages, including children and adults, and can result in death within a matter of hours if not treated.

The majority of individuals infected with Vibrio cholerae do not exhibit any symptoms, despite the presence of the bacteria in their faeces for a period of 1-10 days following infection. This implies that the bacteria are released into the surroundings, which has the potential to contaminate other individuals.Cholera is frequently foreseeable and avoidable. The ultimate elimination of the problem can be achieved by ensuring and maintaining access to clean water and sanitation facilities, together with promoting appropriate hygiene practices for the entire community.

In industrialized countries, the implementation of modern sewage and water treatment systems has effectively eradicated cholera. However, cholera continues to be present in Southeast Asia, Haiti, and Africa (Seun, 2023). The likelihood of a cholera pandemic is greatest when poverty, conflict, or natural calamities compel individuals to reside in densely populated environments lacking proper sanitary facilities. According to the World Health Organisation (WHO), a minimum of 24 countries across the globe still document instances of cholera. Based on past transmission patterns and seasonality, several locations are currently experiencing low or inter-epidemic transmission phases. This suggests that the number of cases may rise in the upcoming months. Nevertheless, Nigeria is still susceptible to cholera because of its inherent and periodic occurrence. The disease typically manifests during the rainy season and is more widespread in regions with inadequate sanitation, such as Lagos state, Nigeria.

Lagos, the economic hub of Nigeria, is currently experiencing a cholera epidemic that is rapidly spreading through communities and resulting in fatalities. As of far, there have been approximately five fatalities and more than 60 individuals have been admitted to hospitals (Punch, 2024). Cholera outbreaks have been recurring in Lagos state over time. The Lagos state administration has made extensive efforts to mitigate the recurrence of this disease, although outbreaks persist. According to Funke (2024), the outbreak is happening again because there has been insufficient awareness to educate the people of Lagos about the dangers of cholera in Lagos state. Thus, elevating the overall consciousness and knowledge of the general population regarding the causes and prevention of cholera. Pascal (2018) describes the level of awareness and knowledge as the extent to which a person is cognizant of various aspects of life, including their environment, information, events, things, individuals they interact with, and themselves. This study aims to evaluate the extent of awareness and understanding of the risks associated with cholera in Lagos state, following unsuccessful attempts by the Lagos state government to address the cholera outbreak.

1.2 Statement of the Problem

Cholera prevention in a community at high risk can be accomplished by implementing a comprehensive package that includes health and hygiene education. This education plays a crucial role in encouraging individuals to adopt behaviours that promote good health. The World Health Organisation (2012), as mentioned by Julius (2022), emphasises the significance of this component. The continuous existence and reappearance of cholera in Lagos State is a noteworthy public health issue. A study of the ongoing cholera epidemic in the State has uncovered a notable surge in cholera cases in specific Local Government Areas (LGAs).

A recent study proposed a correlation between the amount of rainfall occurring on a weekly basis and the occurrence of probable cases of cholera (Camacho et al. 2018). A separate study conducted by Dureab et al. in 2019 found that the key risk factors for cholera were the use of water from a shared source, failure to wash fruits, vegetables, and khat, and the absence of chlorine or soap usage inside the home. 

The evidence suggested a strong correlation between the occurrence of cholera and the practice of open defecation (Cowman et al. 2017). While a small proportion of households acknowledged engaging in open defecation, over 23% of households were seen to have indications of open defecation near their homes. The statistics from this survey indicate that the majority of respondents have access to latrines, although open defecation is still being practiced in these communities. According to a study conducted in India, it was shown that people continue to engage in open defecation even in locations where there are already a large number of latrines available (Barnard et al., 2013). Qualitative research is essential for comprehending the social and cultural elements linked to the practice of open defecation in Yemen, in order to bolster the current endeavours to decrease it.

In addition, Dan-Nwafor et al (2022) discovered in their study on cholera conducted in a district in North central Nigeria that the residents exhibited a deficiency in their understanding and awareness of cholera prevention and management. Daniel et al. (2024) also noted that there is a lack of information regarding the preventable disease cholera in Nigeria, particularly in the Lagos state. This is concerning given the significant public health impact of cholera, as many outbreaks are either not properly recorded or not examined. Elimian et al (2024) also highlighted the lack of evidence about the understanding, awareness, and management of cholera in Lagos state and Nigeria as a whole. Therefore, the necessity for doing this investigation arises. 

1.3 Objectives of the study 

The primary objective of this study is to critically assess the extent of public awareness of risk factor and preventive measures of cholera in Lagos state. Specific objectives of this study are to:

Ascertain the prevalence of cholera outbreak in Lagos state

Determine the extent of public awareness on risk factor and preventive measures cholera in Lagos state.

Identify the causes of cholera in Lagos state

Analyze the effects of cholera in Lagos state.

Identify the strategies adopted by government to create awareness and knowledge on risk factor and preventive measures of cholera in Lagos 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 is the extent of public awareness on risk factor and preventive measures cholera in Lagos state?

What are the causes of cholera in Lagos state?

What are the effects of cholera in Lagos state?

What strategies are adopted by government to create awareness and knowledge on risk factor and preventive measures of cholera in Lagos state?

1.5 Research Hypotheses

The following research hypothesis will be validated in this study:

Ho: The extent of public awareness on risk factor and preventive measures cholera in Lagos state is low

Ha: The extent of public awareness on risk factor and preventive measures cholera in Lagos state is high.

1.6 Scope of the study

Broadly, this study focuses to critically assessing the level of awareness and knowledge on hazards associated with cholera in Lagos state. Specifically, this study focuses on ascertaining the prevalence of cholera outbreak in Nigeria, the extent of public awareness on risk factor and preventive measures cholera in Nigeria, the effects of cholera in Nigeria, the effects of cholera in Nigeria and the strategies adopted by government to create awareness and knowledge on risk factor and preventive measures of cholera in Nigeria.

This study will be carried out in Lagos.

1.7 Significance of the study

This study will serve as a baseline for researchers and students and also guide government, health practitioners on creating awareness and knowledge on risk factors and preventive measures with cholera. 

By filling knowledge gaps and promoting proactive health behaviors, this research aims to contribute towards mitigating the impact of cholera outbreaks and advancing global efforts in infectious disease prevention and control.

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 endeavor, 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 cholera pandemic in 2024: assessing public awareness of its risk factors and preventive measures 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.

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