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KNOWLEDGE, PERCEPTION AND ATTITUDE TO CHOLERA OUTBREAK AMONG RESIDENTS IN IBADAN NORTH-WEST LOCAL GOVERNMENT AREA, NIGERIA
BACKGROUND
CHAPTER 1 INTRODUCTION
In developing countries, cholera often occurs as rapidly progressive, large-scale outbreaks (Swerdlow, e tal., 1997). These large-scale outbreaks cause a high burden of disease and rapidly overwhelm curative health care services, particularly during complex humanitarian emergencies or in settings where public health systems have broken down (Swerdlow & Isaacson, 1994). 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 (Quadri, 2005). These create many health problems; food and water supplies can become contaminated by parasites and bacteria when essential systems like those for water and sewage disposal are destroyed. Developing countries are disproportionately affected because of their lack of resources, infrastructure and disaster preparedness systems (Sur, 2000). In newly affected areas, outbreaks may occur during any season and affect all ages equally.
Cholera is a diarrhoea disease caused by infection of the intestine with the bacterium vibrio cholera, either type 01 or 0139. The bacteria is a short, curved rod shaped germ which produces a powerful endotoxin. Infection is mainly through ingestion of contaminated food or water (Kelly, 2001).The organism normally lives in aquatic
environments. 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. According to Anderson (1975), cholera is a very serious infection involving the lower part of the small bowel. Approximately 102 – 103 cells are required to cause severe diarrhea and dehydration (Sack et al., 1998). Both children and adults can be infected. Cholera is usually transmitted through faecally contaminated water and food and remains ever- present risk in many countries. The disease no longer poses a threat to countries with minimum standards of hygiene, but it remains a challenge to countries where access to safe drinking water and adequate sanitation cannot be guaranteed. Typical settings for cholera are peri-urban slums where basic urban infrastructure is lacking.
A disease outbreak happens when a disease occurs in greater numbers than expected in a community or region, or during a season. According to CDC, an “outbreak” is the occurrence of more cases of disease than normally expected within a specific place or group of people over a period of time. An outbreak may occur in one community or even extend to several communities. African countries have continued to experience outbreaks of disease such as cholera, dysentery, measles, meningitis, plague, viral hemorrhagic fever and yellow fever; these continue to pose serious public health threats in Member states of the WHO African region. A disease outbreak causes severe threats to population health and causes large economic losses (WHO, 2000).