1.

0 INTRODUCTION

1.1 HISTORY AND BACKGROUND OF CHOLERA

The world from its original reservoir in the Ganges delta in India. Six subsequent pandemics

killed millions of people across all continents. The current (seventh) pandemic started in South

Asia in 1961, reached Africa in 1971 and the Americas in 1991 (Ali et al., 2015).

In Nigeria, since the first appearance of epidemic cholera in 1972, intermittent outbreaks have

been occurring. The later part of 2010 was marked with severe outbreak which started from the

northern part of Nigeria, spreading to the other parts and involving approximately 3,000 cases

and 781 deaths (Adeneye et al., 2016). Cholera has been a deadly diseases, which are majorly

found in the rural areas within a geometric point in communites or country at large. Cholera was

prevalent in the U.S. in the 1800s, before modern water and sewage treatment systems

eliminated its spread by contaminated water. Only about 10 cases of cholera are reported each

year in the U.S. and half of these are acquired abroad. Rarely, contaminated seafood has caused

cholera outbreaks in the U.S. However, cholera outbreaks are still a serious problem in other

parts of the world. The World Health Organization reports that there are 1.3 million to 4 million

cases each year (Ali et al., 2015).

The disease is most common in places with poor sanitation, crowding, war, and famine.

Common locations include parts of Africa, south Asia, and Latin America. Cholera is an

infectious disease that causes severe watery diarrhea, which can lead to dehydration and even

death if untreated. It is caused by eating food or drinking water contaminated with a bacterium

(Ali et al., 2015).

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During the 19th century, cholera spread across the world from it's original reservoir in the gange

Delta in India ,six subsequence pandemic killed millions of people across all continent ,the

current pandemic started in south Asia in 1961and it got to Africa in 1971 and the America in

1991,.Cholera now is spread throughout the global economic (Ali et al., 2015).

Cholera is a diarrhea illness caused by the bacteria, this species is not endemic to human, it is

present in the human digestive system ,is not part of the natural life cycle of the bacteria (Audu

et al., 2000).

Normally found in estuary ecology, the bacteria life cycle naturally shift between various

reservoir species such as small snails and crustaceans, free floating planktonic forms and static

form resident in the silt and muck of the estuary (Oliver and Kaper , 2007).

Bacteria enters the human body through contaminated food or water, Poorly cleaning or

washing of vegetables irrigated by contaminated water source are another common source. In

situation where sanitation is severely challenging such as in refuse camps or communites with

high limited water resource, a single infected victim can contaminate all water for an entire

population. (Weil et al., 2019). People with blood type O more susceptible to severe cholera

(Barua and Paguio, 1977).

Researchers from Massachusetts general hospital, Harvard University and the board institute of,

Massachusetts institute for technology (MIT)reported in science translational medicine that

people with blood type O are more likely to develop severe cholera (Barua and Paguio, 1977).

1.3-4.0 million cases and 21,000 to 14300 deaths worldwide are due to cholera every year.Upto

80% of cases can be successfully treated with oral rehydration salt known as (O.R.S) if detected

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and treated early.The Oral cholera vaccine (O.C.V) is safe, effective and have proven to be

acceptable for the treatment and cholera control (Ali et al., 2015).

2.0 ENDEMIC CHOLERA.

An area where confirmed cholera cases resulting from local transmission, have been detected in

the last three (3) years. An area can be define as any subnational administrative unit including

state, district or smaller localities. Children dehydrate more rapidly than adults and they are also

more susceptible to the effect of dehydration, children are also more prone to hypoglycemia from

cholera, and children who are malnourished are at increased risk of severe illness and death (Ali

et al., 2015).A recent study published in the journal Africa health sciences has validated the

efficiency of corn pap known as (ogi -tutu) in Yoruba and (akamu) in igbo.

Vernonia amygdalina known as bitter leaf, and psidium guavana (guava) these are used locally

in treatment of cholera and diarrhea diseases. The Nigeria researchers investigated the

ameliorative effects of ogi-tutu, vernonia amygdalina and psidium, guavana (Balkrishna et al.,

2017).

OGI-TUTU: contain lactic acid bacteria which possess or have antimicrobial potentials and it is

significant in the management of human clinical infection (Talkington et al., 2011).

Vernonia amygdalina: showed very high preventive and effective treatment measures in both the

immediate and delayed group of mice demonstrating excellent ameliorative effect and mild

degenerative changes in vivo (Okere et al., 2015).

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Psidium guajava: this displayed very high activity as both prevention and treatment of cholera

infection when compared with positive and negative control groups (Birdi et al., 2010).

In previous years kogi state recorded about 15 suspected cases of cholera diseases, two infected

victims lost their lives due to the diseases and lack of proper treatment (Qadri, 2004).

2.1 CAUSES OF CHOLERA DISEASES TO HUMANITY

Cholera is a diarrhea illness caused by the bacteria, this species is not epidemic to humans, it's

presence in the human digestive system, which is not part of the natural life cycle of the bacteria

(Audu et al., 2000). Normally found in estuary ecology, the vibrio cholerae bacteria life cycle

naturally shift between various reservoir species such as small snails and crustaceans, free

floating of plantonic forms and static forms resident in the silt and muck of the estuary (Oliver

and Kaper, 2007). The most common entry is through contaminated water or food been exposed

(Oliver and Kaper, 2007).

(1). When human eat seafood- in particular shellfish native to estuary environment such as

oysters or crabs and fail to cook them completely or even eat them raw, they can ingest the large

amount of bacteria necessary to cause a case of cholera (Sedas, 2007). Influence of

environmental factors on the presence of Vibrio cholerae in the marine environment

(2). Poorly washing of vegetables, irrigated by contaminated water source are another common

source, in situation where sanitation is severely challenging, such as refuge camps or

communites with highly limited water resource, a single affected victim can contaminate all

water for an entire population. People with blood type O are more susceptible to severe cholera

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attack (Audu, et al., 2000). Researchers from Massachusetts general hospital, Harvard University

and the board institution Massachusetts.

2.2 EFFECT OF CHOLERA TO HUMANITY:

The effect of cholera to humans are as follows below:

Watery diarrhea, vomiting and leg cramps.

In these people, rapid loss of body weight fluids leads to dehydration and shock without proper

treatment, death can occur within hours (Audu et al., 2000). The social impact of cholera was

mainly characterised by financial concerns that were manifested by people reporting less of

family income and interference with work related activities.

In all three settings albeit with significantly differing prominences. Most cases of cholera that

cause symptoms, causes mild or moderate diarrhea that often hard to tear apart from diarrhea

caused by other peoblems.

1. Diarrhea: cholera related diarrhea comes on suddenly and can quickly cause dangerous fluid

loss, as much as a quare (1 litre) an hour, diarrhea due to cholera often has a pale, milky

appearance that resemble water in which rice has been rinsed ((Audu et al., 2000)).

2. Nausea and Vomiting: vomiting occurs especially in the early stages of cholerae and can last

for hours.Reference (Oliver and Kaper, 2007).

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3. Dehydration: can develop within hours after cholera symptoms start and range from mild to

severe loss of 10%percent or more of body weight indicates severe dehydration (Oliver and

Kaper, 2007).

The signs and symptoms of cholera dehydration includes irritability ,fatigue ,sunken eye, a dry

mouth, extremely thirst, dry and shrivel skin that is slow to bounce back when pinched into a

fold, little or no urinating ,low blood pressure and an inregular heartbeat. Dehydration can lead to

rapid loss of minerals in your blood that maintains the balance of fluids in your body (Anon,

1979).

This is called an electrolyte imbalance, An electrolyte imbalance can lead to:

(A). Muscle cramps: these result from the rapid loss of salt such as sodium, chloride and

potassium. (Sedas, 2007).

(B). Shock: this is one of the most serious complications of dehydration, it's occur when low

blood volume causes a drop in the blood pressure and a drop in the amount of oxygen in your

body, if untreated, severe hypovolemic shock can cause death in minutes ((Sedas, 2007)).

Most people exposed to the cholera bacterium (vibrio cholera) do not become I'll and do not

know if there have been infected (Sedas, 2007).

But because they shed cholera bacteria in their stool for seven to fourteen days, they can still

infect others through contaminated water (Sedas, 2007).

2.3 SOURCE OF CHOLERA IN OUR ENVIRONMENTS

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 The source of cholera in our environment to humans are the contaminated food and water around

us, which is been taken by people without any further treatment or proper purification of the

contaminated water and food before comsuption, washing of grains with clean and portable

water is highly necessary to reduce the causes of cholera and washing off the bacterias present in

the grains and also full treatment of the water we drink and use. This process need to be done in

order to save human race out of cholera diseases and make it free from the surroundings, for

healthy living promote weath and well-being of humanity in the society. Such water can be

gotten from surface water which is the rivers around us ,and crops we plant around us ,these

contains some bacteria naturally which can lead to cholera diseases to human when consumed,

without appropriate purification or further treatment to kill the bacteria and making it harmless to

the human body system (Anon, 1979).

2.4 MEDICINAL PLANTS USED FOR THIS STUDY AND CONTROL

Collection of Plants Material: The leaves or plants, was collected within the eastern part of kogi

state Nigeria (ogudu omala government area and Dekina local government area).

The healthy leaves are named below:

COMMON NAME OF PLANTS: NATIVE NAME METHODS OF USE

bitter leaf Emi- ilo Squizing the leaf boiling of leaf in water

native lime leaf Alemu - inalē Boiling of leaf in water drinking

before drinking
scent leaf Emi-anyeba Add to food when cooking and also
boiling to drink
mango leaf and shell Emi`-mango and olah Oli Boiling process of both the leaf and shell
mango
guava leaf Emi - gova boiling process in water

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This leaves are used as local herbs to cure cholera infection and there are prepared locally by

boiling them in hot water to extract it nutrients for curing the infections. After boiling it can be

use directly by drinking the boiled herb, this also lead to fast effect to eliminate the infections

present in the body. With the help of local treatment the rise of cholera infection in the

communities or nation will reduced down or lead to total cure of the infection. Proper sanitation

is also one of the key point to reduce the spread of cholera infection and also proper treatment of

stagnant water or any polluted water within the community treating turbid water to make it

wholesome for consumers improve human health and also decreases the risk of been infected by

cholera disease through the contaminate water around the society at large.

3.0 Conclusion

An outbreak of cholera was investigated in Gomani Settlement Kwali Local Government Area of

FCT. We established that drinking water from Zamani river was the major source of the

outbreak. Poor personal hygiene and overcrowding were also identified as risk factors. On the

interim health education on proper hand hygiene and chlorination of water were initiated based

on our recommendation and this controlled the outbreak.Implementation of targeted

interventions such as rehabilitation of existing boreholes, construction of standard pit latrines and

the establishment of proper waste disposal systems are long-term sustainability measures to

prevent future outbreaks.

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