Usman A, Sarkinfada F, Mufunda J, Nyarango P, Mansur K, Daiyabu T M
WHO Eritrea Country Office Asmara, Eritrea.
Cent Afr J Med. 2005 Mar-Apr;51(3-4):34-8.
The study examined the factors associated with recurrent cholera epidemics in Kano State of Northern Nigeria, the management of the epidemics and health outcomes.
Using epidemiological data from the Public Health Department of the Kano State Ministry of Health, the study examined the frequency and geographical distribution of the epidemics for the period 1995 to 2001; procedures for detection; control measures as well as results of biological and bacteriological testing of water from different sources. Mapping and testing for significance of faecal contamination of water sources were done.
The number of cholera cases in the city was 2 630; 847 and 2 347 in 1995/6, 1997 and 1999 respectively. The State Epidemiological Unit which is responsible for surveillance detected epidemics using set thresholds and activated multi-sectoral emergency responses. Control measures encompassed accurate diagnosis at the reference laboratory, Kaduna; registration of cases; case management and public health measures targeting personal hygiene and water treatment. The cholera epidemics attracted worldwide attention with emergency responses from many agencies including WHO, UNICEF and Medicens Sand Frontiers (MSF). Case fatality rates decreased from 15% in 1995/6 to 5% in 1997 and 2% in 1999. The organism responsible for all the outbreaks was Vibrio cholerae, el-tor of inaba serotype. Water contamination of all sources was the principal cause of the epidemics. There were statistically significant differences in levels of faecal contamination of water sources, wells being most affected, followed by piped water, chi2 = 11.556, (p < 0.02). Bore holes were relatively safer sources of water. Point source epidemics always started from Kano City before fanning out to the rest of the State.
Multi-sectoral Epidemic Preparedness and Response (EPR) approaches have contributed to the reduction in case fatality rates over the years and should be sustained. However, in order to prevent future cholera epidemics, there is need to introduce intervention measures that address the root problems of poor sanitation and unsafe water supplies.
本研究调查了与尼日利亚北部卡诺州霍乱疫情复发相关的因素、疫情管理情况及健康结果。
利用卡诺州卫生部公共卫生部门的流行病学数据，本研究调查了1995年至2001年期间疫情的发生频率和地理分布；检测程序；控制措施以及不同水源水的生物学和细菌学检测结果。对水源粪便污染进行了绘图并检测其显著性。
该市霍乱病例数在1995/6年、1997年和1999年分别为2630例、847例和2347例。负责监测的州流行病学单位使用设定的阈值检测疫情，并启动了多部门应急响应。控制措施包括在卡杜纳参考实验室进行准确诊断；病例登记；病例管理以及针对个人卫生和水处理的公共卫生措施。霍乱疫情引起了全球关注，包括世界卫生组织、联合国儿童基金会和无国界医生组织（MSF）在内的许多机构都做出了应急响应。病死率从1995/6年的15%降至1997年的5%和1999年的2%。所有疫情的病原体均为霍乱弧菌，稻叶型埃尔托生物型。所有水源的水污染是疫情的主要原因。水源粪便污染水平存在统计学显著差异，井水受影响最大，其次是自来水，χ2 = 11.556，（p < 0.02）。钻孔水源相对更安全。点源疫情总是先从卡诺市开始，然后蔓延到该州其他地区。
多年来，多部门疫情防范与应对（EPR）方法有助于降低病死率，应予以持续。然而，为预防未来的霍乱疫情，需要采取干预措施来解决卫生条件差和供水不安全的根本问题。
