FEATURE: Outbreak of killer disease, diphtheria. What you should know

In recent time, diphtheria disease has become a matter of concern among the Nigerian populace. Its fast rising popularity has generated frenzy due to the threat of its potential to become widespread, following the published data by Nigeria Center for Disease Control (NCDC) of 798 cases reported across every geo-political region of the country.

There have also been a lot of controversies over the upsurge of the vaccine preventable disease, despite huge investments and international donations that have gone into immunisation exercises. This has raised many questions challenging the quality of vaccines, cold chain and its administration.

Comments From the Streets and Marketplace

In order to assess the awareness of the populace with respect to diphtheria disease and knowledge of immunisation, this reporter, took to the streets of Gusau, Zamfara State and it was gathered that most of those interviewed were not aware of the disease and its outbreak.

A respondent who simply gave his name as Bello, said: “Diphtheria! we have not heard of anything like that here, it might be possible in Southern region but not here” he enthused.

A number of women were also interviewed on the immunisation schedule and how well they keep to it. Surprisingly, a few of the interviewees were consistent in the schedule from first day of the month till mid month for every childbirth, while others gave excuses for not meeting up.

At Sabo Tsoho (old market), an elderly man identified as Abubakar was asked about how much he supported his wives especially during the time of immunisation, he was dumfounded for awhile before citing financial constraints as an excuse.

“Although, I have no cultural objections toward immunisation exercise, it is just that we were not always meeting up with schedule due to our distant location to the hospital and we could not afford transport fare sometimes” he commented.

‘We Do Call Them on Phone for Reminder’

While engaging a nurse named Jaafar Yakubu at the Federal Medical Center, Gusau, it was gathered that the challenges commonly encountered is negligence.

His words: “They don’t have any excuse even when we didn’t see them, we do give them phone call for reminder. Although they mostly give excuse that they couldn’t remember because their cards were lost.

“There have also been consistency in the administration of vaccines to the children even pregnant women. The support we are getting from appropriate quarters and the hospital management right from the provision of quality vaccines, storage and personels are incredible.

“And notably, when any impotent vaccines are noticed, we do return them because It is not advisable to inject such vaccines to the children as that could be life-threatening” he said.

Diphtheria and its Growing Strength

Diphtheria is an infection caused by bacteria producing toxins called Corynebacterium Diphtheria. It is a highly contagious disease that can cause difficulty of breathing and heart problems which can lead to death, especially among children.

It lives in the mouth, nose and occasionally skin of an infected persons. It can be transmitted when infected persons sneeze, skin contact and article contaminated with oozing sores. The disease occurs when the bacteria releases toxin into the person’s body and the symptoms begin to appear within 2-5days.

The NCDC in a press statement released recently, declared the outbreak of the Diphtheria disease following multiple reported cases since December, 2022 with an estimated 798 cases in eight states (Lagos, Yobe, Katsina and Osun among others) including Abuja, with Kano being the leading state for the confirmed cases.

Although, the disease is vaccine preventable, evidence provided by the agency shows that over 82% of the confirmed cases are unvaccinated which could of course be attributed to poor vaccination coverage. It was also posited that Nigeria may experience increase in number if care isn’t taken.

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Barrier to Accessing Immunisation Coverage in Nigeria

Among many scientific breakthroughs, immunisation has proven to be a most cost-effective strategies to prevent diseases and death. According to World Health Organization (WHO), “the two public health interventions that have had the greatest impact on the world’s health are clean water and vaccines”.

The impact of immunisation was also reiterated that every year, it had helped avert 2-3 million deaths from diphtheria, pneumonia, pertussis and tetanus among others diseases.

It was reported by WHO that out of the global 22.7 million children with missed or zero doses of vaccine, 3.1 million (14%) reside in Nigeria. Achieving child immunization coverage in Nigeria is bottlenecked by many factors.

Meanwhile, in 2022 WHO did a comprehensive research on the challenges that impede effective immunisation coverage in Nigeria. It was revealed that the impediment were linked to economic challenges, insurgency and conflict, maternal Illiteracy, fear and misconception, lack of access to vaccination and out of stock of vaccines.

Response From the Stakeholders

In an effort to contain the spread of the diphtheria disease, the NCDC declared its outbreak, it had activated national multi-sectorial diphtheria working committees for coordinating surveillance and response activities in the country.

It also set to empower journalists by facilitation of fellowship tagged Media EIS Fellowship in order to bridge the gap of public health officials and media to contribute to healthy information systems for health literacy.

Notwithstanding, an Honorable representing Kwara Central, Hon Mukhtar Shagaya had also sponsored a motion in plenary charging the Nigeria Center for Disease Control on the need to intensify awareness by sensitizing and educating the populace on prevention, treatment and control of the disease.

Expert’s View

According to a Medical Laboratory Scientist from Department of Medical Microbiology, Federal Medical Center, Gusau, MLS Hameedah she described the upsurge diphtheria cases as a matter that requires maximum attention because of its severity and risk of communication.

She also emphasized on the need for public enlightenment on the importance of immunisations and their connection to some of the vaccine preventable diseases.

“I suggest the populace need more awareness. They don’t really know how important these vaccines are. These vaccines are essential in saving lives and protect the next generation. They also help in preserving the money for curating disease and prevent various forms of disabilities”.

Hameedah admonished that at this critical time, crowded areas should be avoided at all cost and if it is a must, children and elderly people should not near it. She explained that Diphtheria is highly contagious and most of these people may either be unvaccinated or having compromised immunity which could make them vulnerable to the disease.

She however called on relevant stakeholders to not only establish task force committee in states where they were recently detected, but also charged them to replicate same across the federation.

The scientist emphasized that most laboratories do not have the capacity to detect diphtheria which needs specialized testing, adding, that establishing these committees with adequate funding would help in curtailing the spread through activities like laboratory investigation, surveillance, case management and immunisation exercises.

By Ibraheem Olasunkanmi Qoseem

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