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Assesment Of Knowledge, Attitude And Practice Towards Cholera Prevention And Control
[A CASE STUDY OF ILORIN METROPOLIS KWARA STATE, NIGERIA]
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CHAPTER TWO
LITERATURE REVIEW
2.1 EPIDEMIOLOGY OF CHOLERA
The word cholera comes from the Greek ‘khole’ meaning ‘illness from bile [9].’ The first notable reports specifically referencing cholera come from John Snow of London, England, and Filippo Pacini of Florence, Italy. Both reports come from 1854. Pacini was the first to identify V. cholera as the etiologic agent of cholera, though his discovery was not widely known until Robert Koch publicized his own independent research in 1884. John Snow did not discover the cause of cholera, but he did impart knowledge on how to stop a local outbreak [9]. Cholera caused by Vibrio cholera continues to be a global threat to public health and a key indicator of lack of social development. Once common throughout the world, the infection is now largely confined to developing countries in the tropics and subtropics. It is endemic in Africa, parts of Asia, the Middle East, and South and Central America. In endemic areas, outbreaks usually occur when war or civil unrest disrupts public sanitation services. Natural disasters like earthquake, tsunami, volcanic eruptions, landslides and floods also contribute to outbreak by disrupting the normal balance of nature [1]. This creates many health problems, food and water supplies can become contaminated by parasites and bacteria when essential systems like those for water and sewage are destroyed. Developing countries are disproportionately affected because of their lack of resources, infrastructure and disaster preparedness systems [2, 3]. In newly affected areas, outbreaks may occur during any season and affect all ages equally. The organism normally lives in aquatic environments along the coast. People acquire its infection by consuming contaminated water, seafood, or other foods. Once infected, they excrete the bacteria in stool. Thus, the infection can spread rapidly, particularly in areas where human waste is untreated.
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 [4]. 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 [4].
In 2016, 132 121 cholera cases and 2420 deaths were reported to WHO worldwide. Outbreaks continued to affect several countries. Overall, 54% of cases were reported from Africa, 13% from Asia and 32% from Hispaniola. Cholera remains a major public health problem and affects primarily developing world populations with no proper access to adequate water and sanitation resources.
In Nigeria, the infection is endemic and outbreaks are not unusual. In the last quarter of 2009, it was speculated that more than 260 people died of cholera in four Northern states with over 96 people in Maiduguri, Biu, Gwoza, Dikwa and Jere council areas of Bauchi state [4]. Most of the Northern states of Nigeria rely on hand dug wells and contaminated ponds as source of drinking water. Usually, the source of the contamination is other cholera patients when their untreated diarrhoea discharge is allowed to get into water supplies [4].
2.2 CAUSES OF CHOLERA
A bacterium called Vibrio cholerae causes cholera infection. However, the deadly effects of the disease are the result of a potent toxin called CTX that the bacterium produces in the small intestine. CTX binds to the intestinal walls, where it interferes with the normal flow of sodium and chloride. This causes the body to secrete enormous amounts of water, leading to diarrhea and a rapid loss of fluids and salts (electrolytes) [2, 4, 8].
Contaminated water supplies are the main source of cholera infection, although raw shellfish, uncooked fruits and vegetables, and other foods also can harbor V. cholerae. Cholera bacteria have two distinct life cycles — one in the environment and one in humans.
2.2.1 CHOLERA BACTERIA IN THE ENVIRONMENT
Cholera bacteria occur naturally in coastal waters, where they attach to tiny crustaceans called copepods. The cholera bacteria travel with their hosts, spreading worldwide as the crustaceans follow their food source — certain types of algae and plankton that grow explosively when water temperatures rise. Algae growth is further fueled by the urea found in sewage and in agricultural runoff [1, 8, 16]
2.2.2 CHOLERA BACTERIA IN HUMANS
When humans ingest cholera bacteria, they may not become sick themselves, but they still pass the bacteria in their stool. When human feces contaminate food and water supplies, both can serve as ideal breeding grounds for the cholera bacteria. Because more than a million cholera bacteria — approximately the amount you'd find in a glass of contaminated water — are needed to cause illness, cholera usually isn't transmitted through casual person-to-person contact.
The most common sources of cholera infection are standing water and certain types of food, including seafood, raw fruits and vegetables, and grains.
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ABSRACT - [ Total Page(s): 1 ]ABSTRACT IS COMIG SOON ... Continue reading---
APPENDIX A - [ Total Page(s): 1 ] APPENDIX ICONSENT FORMI am MUHAMMAD BALA from the Department of Community Health Science Kwara State University Malete hereby to conduct a study on knowledge, attitudes and practice on cholera prevention and control utilization of Salt Sugar Solution (SSS) among people living in Ilorin metropolis. The study is trying to assess the knowledge, attitude and practice on cholera prevention among people of Ilorin metropolis and also to investigate factors affecting SSS utilization during cholera epi ... Continue reading---
APPENDIX C - [ Total Page(s): 1 ]APPENDIX IIIBUDGET AND EXPENDITUREEstimated Budget: N 53,500 ... Continue reading---
APPENDIX B - [ Total Page(s): 2 ]APPENDIX IIWORK PLAN ON ASSESSMENT OF KNOWLEGDE, ATTITUDE AND PRACTICE ON CHOLERA PREVENTION AND UTILISATION OF SALT SUGAR SOLUTION AMONG PEOPLE LIVING IN ILORIN METROPOLIS, ILORIN KWARA STATE, NIGERIA ... Continue reading---
APPENDIX D - [ Total Page(s): 2 ]APPENDIX IVQUESTIONAIRE ON ASSESSMENT OF KNOWLEGDE, ATTITUDES AND PRACTICES ON CHOLERA PREVENTION AND UTILISATION OF SALT SUGAR SOLUTION AMONG PEOPLE IN ILORIN METROPOLIS, ILORIN KWARA STATE, NIGERIADear Sir/ Ma,This study is being undertaken to assess the knowledge, attitudes and practices on cholera prevention and utilization of Salt Sugar Solution (SSS). The aim is to assess the level of knowledge on malaria prevention and utilization of SSS among people. It is also for the purpose of colle ... Continue reading---
CHAPTER ONE - [ Total Page(s): 3 ]Cholera preparedness workshop held from 31st May – 1st June, 2017 in Abuja to develop Cholera preparedness plan as the season set in. NCDC/partners provided onsite support in Kwara, Zamfara and Kebbi States. NCDC/partners are providing onsite support in Borno State. Cholera Preparedness Checklist sent to all States to assess their level of preparedness with recommendations for prevention of and response to an outbreak. RDT procured by NCDC and WHO currently being prepositioned in affected ... Continue reading---
CHAPTER THREE - [ Total Page(s): 3 ]To compensate for attrition or non-response rate, a response rate of 80% is anticipated the sample size will be calculated using the formula: ns = n 0.8Where, n = calculated sample size ns = sample size to compensate for attrition and non-response 0.8 = Taken that 80% response rate is anticipatedThen,n ... Continue reading---
REFRENCES - [ Total Page(s): 1 ]1. Centers For Disease Control and Prevention. “Cholera – Vibrio cholerae Infection.†July 30, 2013. http://www.cdc.gov/cholera/general/index.html Accessed December 5, 2014 2. Babaniyi OA. Oral Rehydration of Children with Diarrhoea in Nigeria: a 12-year Review of Impact on Morbidity and Mortality from Diarrhoeal Diseases and Diarrhoeal Treatment Practices. J Trop Pediatr. 20111;37(2):57–63. [PubMed]3. Coppo A, Colombo M, Pazzani C. Vibrio cholerae ... Continue reading---
