Factors responsible for the 2015 Cholera outbreak and spread in Ebonyi state, Nigeria

Abstract

Background: Cholera outbreaks are frequent across Nigeria irrespective of season. Cholera outbreak began on the 17th January 2015 in a community in Ebonyi State. We carried out an investigation to confirm the diagnosis, identify the source of infection, determine the factors associated with its spread and carried out some interventions.
Methods: Descriptive cross-sectional study was carried out in the affected communities during which active case search, environmental survey and key informant interviews were done. Stool samples were taken from cases for laboratory diagnosis. A cholera case was defined as any person that presented with diarrhoea and or vomiting with laboratory confirmation or with epidemiological linkage to the affected areas.
Results: A total of 551 cases were recorded in 38 communities with a case fatality rate of 8.6%. Vibrio Cholera was isolated from 5 stool samples. Those who were 20 years or less and females were more commonly affected. Males and attendance at burial in another community within the two weeks preceding onset of outbreak was significantly associated with death (p<0.001). Inadequate safe water supplies, poor sanitation and hygiene practices were observed.
Conclusion: The outbreak was caused by Vibrio Cholera. Socio-cultural practices surrounding burial such as overcrowding, ceremonial killing of animals and communal eating together may have contributed to its widespread. A system thinking approach such as behavior change communication and community dialogue are needed for Cholera control.