The Nigeria Centre for Disease Control and Prevention has raised concerns over what it described as the politicisation of cholera in some parts of the country.
In a situation report obtained by Saturday PUNCH, the agency listed “politicisation of cholera” among the challenges encountered in efforts to contain the disease.
This came as the NCDC disclosed that it had deployed emergency response teams to cholera-affected states as part of measures to curb the ongoing outbreak.
The report detailed ongoing surveillance, laboratory, case management, water sanitation and risk communication interventions being implemented nationwide.
Highlighting the challenges, the NCDC identified politicisation, delayed diagnosis, shortages of critical supplies and weaknesses in surveillance, among other factors, as issues shaping the trajectory of the outbreak.
Although the report did not provide details of specific incidents, public health experts have repeatedly warned that political interference and misinformation can undermine disease surveillance, weaken public trust and delay coordinated outbreak response efforts.
According to the report, active case search operations are ongoing across affected states, while technical support is being provided to state response teams.
“Active case search ongoing in all affected states; remote and on-site support to state teams; SORMAS data validation and harmonisation; active case search team deployed to Kano,” the NCDC stated.
The agency said surveillance officers were also conducting data validation and harmonisation through the Surveillance Outbreak Response Management and Analysis System to improve outbreak tracking and response coordination.
Laboratory testing is being supported through the National Reference Laboratory in Abuja and the Central Public Health Laboratory in Lagos, while healthcare workers have received training on sample management, rapid diagnostic testing and culture procedures.
The report noted that authorities were also following up on the shipment of samples from Maiduguri to the National Reference Laboratory to strengthen case confirmation efforts.
To improve treatment outcomes, the NCDC said healthcare workers across several states had undergone training in cholera case management, infection prevention and control.
It added that infection prevention handbooks had been distributed to health facilities, standard operating procedures developed and needs assessments conducted to strengthen response capacity.
The report further disclosed that specialised training had been conducted for Cholera Treatment Unit teams in Niger State.
On water, sanitation and hygiene interventions, the agency said boreholes had been constructed and rehabilitated in Benue, Edo, Adamawa and Nasarawa states.
According to the report, 112 water points were chlorinated in Adamawa State, while hygiene promotion campaigns reached more than 12,000 people in affected communities.
The agency also stated that community-level interventions were ongoing to reduce exposure to contaminated water sources.
The NCDC said response commodities were being distributed to states battling the outbreak.
“Essential response commodities distributed to all affected states on an ongoing basis,” the report stated.
The agency added that epidemiological trends were being monitored to determine areas that may require vaccination campaigns.
“Epidemiological trends being monitored to guide ICG request for Oral Cholera Vaccine campaigns in high-risk areas.”
Public awareness efforts have also been intensified, with cholera jingles airing in English and local languages, while information, education and communication materials continue to be distributed nationwide.
However, despite the ongoing response, the NCDC warned that several challenges continue to shape the trajectory of the outbreak.
Chief among them is inadequate access to safe drinking water.
“Inadequate access to safe water in affected communities, particularly in urban wards in Maiduguri and Jere, remains the primary driver of ongoing transmission. Without improvements to water supply and quality, case counts may continue to rise,” the agency warned.
The report also blamed delayed diagnosis and reporting for sustaining transmission in affected communities.
“Delayed diagnosis and reporting contributes greatly to this current burden as the diagnosis of acute watery diarrhoea was made for weeks in place of cholera,” the report stated.
According to the agency, delays in seeking medical attention have also contributed to severe illness and avoidable deaths.
“Late/delayed health-seeking behaviour across affected communities means patients are arriving at Cholera Treatment Centres in severe condition, increasing the risk of preventable deaths. Intensified community messaging is a priority.”
The report further highlighted shortages of critical treatment supplies.
“Shortfalls in medical supplies, including Ringer’s Lactate and IV fluids at treatment centres, are being addressed through emergency national resupply. States have been directed to write formally to the Director-General, NCDC, to accelerate this process.”
The agency also expressed concern about weaknesses in surveillance and laboratory systems.
“Surveillance gaps remain at Local Government Area level, with insufficient active case search teams relative to the scale of hotspot areas. Data reporting discrepancies between field teams and SORMAS continue to affect situational awareness.”
On laboratory operations, the report noted, “Laboratory capacity constraints, including limited universal sample containers and low culture positivity rates, are affecting the ability to confirm suspected cases and track laboratory trends accurately.”
The NCDC further warned that insecurity was limiting access to healthcare and emergency response activities in some communities.
“Access constraints in insecure and hard-to-reach Local Government Areas are limiting both treatment availability and response activities, particularly for night-time referrals.”
The report also identified funding shortages as a major obstacle to outbreak control.
“Funding constraints at state level are limiting the scale and sustainability of response interventions, particularly in a state managing concurrent humanitarian emergencies.”
Nigeria continues to experience recurrent cholera outbreaks driven largely by poor access to safe water, inadequate sanitation facilities and weak hygiene practices.
The disease, caused by the bacterium Vibrio cholerae, is spread through contaminated food and water and can lead to severe dehydration and death within hours if left untreated.
Health experts maintain that while emergency response measures are critical during outbreaks, long-term investments in potable water supply, sanitation infrastructure and public health systems remain essential to ending Nigeria’s recurring cholera burden.
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