Public Health Implications of Cholera- a Water Sanitation and Hygiene (WASH) Related Infectious Disease in the Era of Climate Change: The Nigeria Experience

Abstract

Water, sanitation and hygiene (WASH) play key roles in management of infectious diseases like cholera and other waterborne diseases; given that millions of people globally have no access to safe water. This cross-sectional study, conducted in 7 communities of Ogoni region (Khana, Gokana, Tai and Eleme LGAs), Orashi region (Abua/Odual, Ahoada West, Ahoada East and Ogba-Egbema-Ndoni LGAs) and Obolo region (Andoni LGA) all in Rivers State, Nigeria, enrolled 274 inhabitants comprising 164 females and 110 males. These included persons passing watery stools accompanied with vomiting, abdominal cramps and those with such prehistory. Questionnaires were used to obtain socio-demographic data. A total of 274 faecal samples were collected and transported in Cary-Blair stool culture transport medium to Rivers State University Teaching Hospital laboratory; and inoculated on Thiosulphate sulphate citrate bile salt-sucrose agar. Gram staining and biochemical tests were performed using standard procedures. Among the 274 subjects, 40 were infected giving a prevalence rate of 14.6%, including 26(15.9%) females and 14(12.7%) males though this was statistically insignificant, (U=8738.000, p=0.474). On educational levels, those who attended secondary schools had the highest prevalence rate (26.3%), compared with others and it was statistically significant, (p=0.00). WASH perceived predisposing factor showed the prevalence rate among those without access to safe water was 33(21.6%) against those with access to safe water 7(5.8%) and was statistically significant, (p=0.00). Subjects engaged in routine environmental sanitation and hygiene practices had lower prevalence 7(7.6%) than their counterparts, 33(18.1%), p=0.02. Respondents who think climate change had a positive impact on cholera transmission had prevalence of 34(23.3%) against those who disagreed, 6(4.7%), which was statistically significant. The study deduced that unavailability of safe drinking water, climate change, and unhygienic practices were major predisposing factors to cholera infection. Provision of safe water is advocated as greater percentage of the communities lacked access to safe drinking water. Routine environmental sanitation exercise should be revisited and enforced.