Abstract
This research work was designed to examine and analyze the
incidence of cholera among children in Benin City. Four (4) research questions
were formulated and questionnaires were administered to three hundred and
eighty four (384) respondents in order to gather data for the research. Results
showed that poor environmental sanitation leads to cholera outbreak, washing of
hands before eating help to prevent cholera outbreak, drinking and batting with
contaminated water leads to cholera infection and also, poorly kept toilet
causes cholera outbreak etc. recommendations included that; government should
swing into action by providing various measures in other to prevent cholera
disease in the country, our water should be treated properly by adding chlorine
before drinking and batting with it.
TABLE OF CONTENTS
Abstract
CHAPTER ONE: INTRODUCTION
1.1 Background to the study
1.2 Statement of problem
1.3 Purpose of the study
1.4 Research questions
1.5 Significance of the study
1.6 Scope/delimitation of the study
1.8 Definition of terms
CHAPTER TWO: LITERATURE
REVIEW
2.1 Cholera Overview
2.2 Infection and clinical aspects of cholera
2.3 Hygiene Practices
CHAPTER THREE: METHODOLOGY
3.1 Design of Study
3.2 Study Area
3.3 Study Variables
3.4 Sampling
3.5 Data Collecting Techniques/Methods
3.6 Data Processing and Analysis
CHAPTER FOUR: DATA ANALYSIS
AND INTERPRETATION
4.1 Results
4.2 Discussion of Findings
CHAPTER FIVE: CONCLUSION AND
RECOMMENDATION
5.1 Conclusion
5.2 Recommendations
REFERENCES
RESEARCH QUESTIONNAIRE
CHAPTER ONE
INTRODUCTION
1.1 Background to the study
Cholera is an infection of the small intestine that is
caused by the bacterium Vibrio cholerae 01 and 0139 (Riyan 2004 & WHO
2010). The main symptoms are profuse watery diarrhea and vomiting. Transmission
is primarily through consuming contaminated drinking water or food. The
severity of the diarrhea and vomiting can lead to rapid dehydration and electrolyte
imbalance. Every year there is an estimated 3-5 million cholera cases and
100,000-120,000 deaths due cholera. The short incubation period of two to five
days, enhance the potentially explosive pattern of out breaks (Faruque 2008 and
WHO 2010). Cholera transmission is closely linked to inadequate environmental
management. Typical at-risk areas include peri-urban slums, where basic
infrastructure is not available, as well as camps for internally displaced
people or refugees, where minimum requirements of clean water and sanitation
are not met. The consequences of a
disaster – such as disruption of water and sanitation systems, or the
displacement of populations to inadequate and overcrowded camps – can increase
the risk of cholera transmission should the bacteria be present or introduced.
Epidemics have never arisen from dead bodies. Cholera remains a global threat
to public health and a key indicator of lack of social development. Recently,
the reemergence of cholera has been noted in parallel with the ever-increasing
size of vulnerable populations living in unsanitary conditions (Emch 2008 and
WHO, 2010).
Two serogroups of v. cholera - 01 and 0139 - causes out
breaks (Alexander 2008). v. cholera 01
causes the majority of outbreak, while 0139
-first indentified in Bangladash in 1992 –is confined to South-East
Asia. Non-01 and non-0139 v. cholera can cause mild diarrhea but dot not
generate epidemics. The bacteria are transmitted via contaminated drinking
water or food. Pathogenic v. cholera can
survive refrigeration and freezing in food supplies. (Reildl et al 2002) The
dosage of bacteria required to cause an infection in healthily volunteers via
oral administration of living vibrios is greater than 1000 organisms (Hartely 2006 ). After consuming an antacid, however, cholera
development in most volunteers after consumption of only 100 cholera
vibrios experiments also show that
vibrios consumed with food are more likely to cause infection than those
from water alone (Finkelstein 1996). Cases tend to be clustered by location as
well as season, with most infections occurring in children ages 1-5 years (WHO
2010).
Cholera is severe water-born infectious disease caused by
the bacterium vibrio cholerae. In 2005, 131,943 cases including 2,272 deaths
have notified from 52 countries. The year was marked by a particular
significant series of outbreaks in West Africa, which affected 14 countries and
accounted for 58% of all cholera cases world-wide (WHO 2006). In the same year
Nigeria had 4,477 cases and 174 deaths. There was reported case of cholera in
2008 in Nigeria in which 429 death out of 6,330 cases. More so, 2,304 cases in
Niger State in which 114 were reported death in 2008 (NBS 2009). Recent years
have seen a strong trend of cholera outbreak in developing countries, including
among others, those in India (2007), Iraq (2008), Congo (2008), Zimbabwe
(2008-2009), Haiti (2010), Kenya (2010). Koko in Edo State (1989). In Nigeria,
according to UN figure, 1,555 people have died since January and 38,173 cases
have been reported. The figure is more than four times the death toll the
government reported in August (Guardian. 2010)
Cholera is a disease characterized by profuse diarrhea
accompanied with a severe dehydration and loss of electrolyte (Colwell and Huq,
1994), caused by toxigenic Vibrio cholerae, a serologically diverse,
environmental, and gram-negative rod bacterium (Li et al., 2002). In the
absence of appropriate treatment, there is a high mortality rate. Cholera is a
major public health concern because of its high transmissibility, death-to-case
ratio and ability to occur in epidemic and pandemic forms (Kaper et al., 1995).
Cholera is responsible for an estimated death of 120,000 globally every year
(WHO, 2001), and still continues to be a scourge worldwide covering all
continents. In developing countries with endemic areas, cholera is still very
significant with incidence of more than five million cases per year (Tauxe et
al., 1994; Lan and Reeves, 2002). The explosive epidemic nature and the severity
of the disease and the potential threat to food and water supplies have
prompted the listing of V. cholerae as an organism of biological defense
research (Zhang et al., 2003). In an epidemic, the great majority of cases can
be recognized by clinical diagnosis easily and a bacteriological diagnosis is
often not required.
Cholera is endemic in Nigeria (Falade and Lawoyin, 1999)
and epidemiological features (Utsalo et al., 1991, 1992; Eko et al., 1994;
Hutin et al., 2003) have been reported from various parts of the country with
investigations on possible sources of outbreaks. Outbreaks of cholera had been
reported from various State in Nigeria such as Ogun, Edo, Pleatue State etc, of
Nigeria. Investigations on outbreak of cholera in Nigeria have focused on the
epidemiological features, the probable source of contamination and the risk
factors without spatial linkage of health data. However, advances in
Geographical Information Systems (GIS) technology provides this opportunity and
have become an indispensible tool for processing, analyzing and visualizing
spatial data within the domains of environmental health, disease ecology and
public health (Kistemann et al., 2002).
The use of GIS is not new in waterborne disease outbreaks
and cholera studies. It has been applied in investigating waterborne disease
outbreak (NWW, 1999), microbial risk assessment of drinking water reservoirs
(Kistemann et al., 2001a), drinking water supply structure (Kistemann et al.,
2001b), and spatial patterns of diarrhoea illness with regards to water supply
structures (Dangendorf et al., 2002). In cholera studies, GIS technology has
been applied in studying the correlation between socio-economic and demographic
indices and cholera incidence (Ackers et al., 1998), environmental risk factors
(Ali et al., 2002a), spatial epidemiology (Ali et al., 2002b), health risk
prediction (Fleming et al., 2007) and spatial and demographic patterns of
cholera (Osei and Duker, 2008). This study seeks to assess the causes and
effect of cholera outbreak in Benin City, Edo State.
1.2 Statement of problem
The threat of cholera rampaging through Nigeria has long
been of concern to many. The crowded settings coupled with minimal water,
sanitation, hygiene and health services, present a fearsome breeding ground for
cholera to quickly escalate beyond control. In an attempt to avoid this
worse-case scenario, a massive response needs to be mounted by the Government
to enlighten the general public about the causes of this deadly disease and
also ways to avoid the outbreak. Hygiene promoters should be employed to work
every day, sharing information on how to avoid contracting the illness and the
signs and symptoms of the disease.
1.3 Purpose of the study
The purpose of this study is to determine the causes and
effect of cholera during rainy season in Benin City.
The specific objectives of the study are:
1. To identify the cause of cholera in Benin City.
2. To ascertain if cholera outbreak is usually rampant during
the rainy season among children in Benin City.
3. To identify the problems associated with the prevention of
cholera in Benin City
4. To determine the ways of preventing cholera outbreak in
Benin City.
1.4 Research questions
The following research questions were asked and answered
in the study:
1. Does poor environmental sanitation lead cholera outbreak?
2. Is cholera outbreak rampant during the rainy season?
3. Does the use of pipe borne water for drinking and cooking
help reduce cholera outbreak?
4. What ways can be used to prevent cholera outbreak in Benin
City?
1.5 Significance of the study
The research work is important in several ways both to the
health personnel and the individual within the society. Firstly, this study
will expose to us some of the causes of cholera outbreak in Benin City and also
proffer ways of preventing cholera outbreak within our community.
This study will also be of importance to the health
personnel and our local community health workers in the sense that it will
expose to them the various preventive measures to put in place to avoid cholera
outbreak in our community and Benin City at large.
This study is also be relevant to the government by
providing the number of cholera outbreak within the Nigeria economy and also
presenting the figures of victims who dies as a result of this disease, by this
the government will swing into action by providing various measures in other to
prevent further outbreak of the disease.
1.6 Scope/delimitation of the study
The study is set out to determine the causes and effect of
cholera outbreak during rainy season in Benin City, Edo State. Therefore, the
study is restricted to only community health workers, and other health related
personnel in Benin City, Edo State. Respondents include students, teachers,
civil servants, youths, and drivers.
1.8 Definition of terms
Cholera: is an acute diarrhoeal infection caused by ingestion of
food or water contaminated with the bacterium, Vibrio cholera
Infection: is the invasion
of body tissues by disease-causing microorganisms, their multiplication and the
reaction of body tissues to these microorganisms and the toxins that they
produce.
Transmission: The act or process of transferring a disease from a
person to another.
Threat: An expression of an intention to inflict pain, injury,
evil, or punishment. An indication of
impending danger or harm. One that is
regarded as a possible danger; a menace.
Contamination: Is the term describing the state of a person or material
on coming in contact with the disease pathogen.
Disease: Can be seen as a depart from the normal healthy state of
the body soul and mind of a human being, which manifests itself in an abnormal
development of the physical, physiological and mental state of the human being
concerned.
Epidemiology: The study of disease that affect large numbers of
people. Traditionally, epidemiologist has been concerned primarily with
infectious diseases such as typhoid and influenza, that arise and spread
rapidly among the population as epidemics.
Environment: This is the physical, chemical, and biological condition of the region
in which one lives.
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