By Kevin Okunzuwa
On January 20, 2023, the Federal Ministry of Health and other relevant health stakeholders declared a diphtheria outbreak in Nigeria, and by the end of October, no fewer than 13,204 persons are said to have died from the disease nationwide in Nigeria, affecting 114 Local Government Areas (LGAs) across 19 states, including the Federal Capital Territory.
Experts say diphtheria is a serious bacterial infection caused by the bacterium called corynebacterium species affecting the nose, throat and sometimes, the skin of an individual.
Those most at risk of contracting diphtheria are children and adults who had not received any or a single dose of the pentavalent vaccine (a diphtheria toxoid-containing vaccine).
Also likely to be affected are people who live in a crowded environment, in areas with poor sanitation and healthcare workers exposed to suspected or confirmed cases of diphtheria.
The disease spreads easily among people through direct contact with infected people, droplets from coughing or sneezing and contact with contaminated clothing and objects.
The symptoms of diphtheria include fever, runny nose, sore throat, cough, red eyes (conjunctivitis) and neck swelling.
In severe cases CDC said that a thick grey or white patch appeared on the tonsils and/or at the back of the throat associated with difficulty in breathing.
According to Nigeria Centre for Disease Control and Prevention (NCDC) records, of the 8,406 confirmed cases, 6,202, representing 73.7 per cent, were between ages one and 14.
The statistics also showed that 7,188 of the cases were recorded in Kano State in the northwest, accounting for 86 per cent of the total 8,406 confirmed cases.
Yobe state, it said, followed on the log of infections with 775 cases, while Katsina and Borno states recorded 232 and 118 cases.
Statistics have also showed that Jigawa state recorded 23 infections, followed by Bauchi, 20; Kaduna, 17; Lagos, eight; FCT, six.
It further revealed the Gombe as having, five; while Osun and Sokoto states had recorded three cases each.
While Niger had recorded two cases, six states namely, Cross River, Enugu, Imo, Nasarawa, Zamfara, and Kebbi had recorded one case each.
Although the affected states are doing their best to combat the spread, it appears their efforts are not good enough, particularly in prevention education and dispelling conspiracy theories.
The NCDC, Dr. Ifedayo Adetifa, says to combat the disease states affected by diphtheria need to commence extensive education campaigns to tackle vaccine hesitancy.
Adetifa said in Nigeria vaccine hesitancy had been a significant obstacle in achieving widespread immunisation coverage.
“This hesitancy is fuelled by various factors, including lack of awareness, cultural and religious beliefs, fear of side effects, and mistrust in the healthcare system.
“However, efforts are underway to debunk myths and misconceptions surrounding vaccines and address these issues head-on through the national infodemic management team,” he said.
Adetifa said that campaigns by affected states should be aimed at providing accurate information about vaccines, their benefits, and the rigorous testing and safety protocols they undergo.
“By disseminating this knowledge, individuals can make informed decisions based on scientific evidence rather than misinformation.
“And, crucially engaging healthcare professionals play a vital role in addressing vaccine hesitancy”, he said.
According to him, health professionals should be empowered with up-to-date knowledge and communication skills to effectively address concerns and provide evidence-based information to the public.
He said by leveraging their expertise, they could play pivotal role in dispelling myths and misconceptions surrounding vaccines.
According to him, community engagement is another key strategy in tackling vaccine hesitancy.
He said community leaders, religious leaders, and influencers should be involved in vaccine education efforts to help debunk myths within their communities.
“Their influence and trust can help bridge the gap between skepticism and acceptance, ensuring that accurate information reaches even the most hesitant individuals,” he said.
Adetifa had said that digital platforms were paramount in today’s digital age.
“These platforms should be leveraged to share accurate information, debunk myths, and address concerns promptly.
“By reaching a wide audience through these channels, the message of vaccine safety and efficacy will be amplified and reach those who need it the most,” he said.
He said that transparency and accountability were also crucial in addressing vaccine hesitancy.
“Ensuring transparency in vaccine distribution to every community of your states, safety monitoring, and adverse event reporting builds trust in the healthcare system.
“By being open and accountable, concerns about the healthcare system can be addressed, and individuals can feel confident in their decision to receive vaccines,” he said.
Adetifa explained that states would be able to address the vaccine hesitancy through a combination of vaccine education campaigns, engagement with healthcare professionals and community leaders.
“We still have above a million children who haven’t had a single vaccination, making it the second-largest group of its kind globally.”
He had said it was imperative that everyone should unite and promptly work to significantly diminish this figure.
“Every Nigerian child is entitled to safeguarding against avoidable illnesses. There’s no room for negotiation on this matter.
“Every parent wants to do what is best for their children. We know about the importance of car seats, baby gates, and other ways to keep them safe.
“But did you know that one of the best ways to protect our children is to make sure they have all of their vaccinations?” he asked rhetorically.
He had called on state governors to ensure routine immunizations were strengthened through community engagement and ensure health systems avoid similar outbreaks in the future.
“I know parents will be wondering why their children should get a diphtheria shot. It protects them against diphtheria, which can be very serious and even deadly, as well as tetanus, and whooping cough (pertussis).
“It prevents your child from developing a thick coating in the back of the nose or throat from diphtheria that can make it hard to breathe or swallow.
“It keeps your child from missing school or child care, and you from missing work,” he said.
The director general said that diphtheria shots were safe and effective at preventing diphtheria.
“Vaccines, like any medicine, can have side effects. These are usually mild and go away on their own,” he said.
The NCDC boss said that preventing diphtheria depended almost completely on giving the diphtheria/tetanus/pertussis vaccine to children (DTaP) and non-immunized adolescents and adults.
The Executive Director of the NPHCDA, Dr Faisal Shuiab, recently urged participants at a media training to dispel rumours, misinformation and conspiracy theories hampering the smooth uptake of diphtheria vaccines in some parts of the country.
Shuiab, who said that vaccination, was the most effective tool of prevention of diseases, also emphasized on the role of the media in promoting vaccination uptake.
UNICEF Social Behavioural Change Officer, Margaret Soyemi, underscored the role of the media in promoting health seeking behaviour of the people as Nigeria Government responded to the outbreak.
She said emphasis should be placed on the high burden states such as Kano, Kaduna. Bauchi, Jigawa, Katsina, Borno and Yobe.
Soyemi therefore urged the media to go beyond the headlines into in-depth reportage of human angle stories on diphtheria outbreak.
Regrettably, she said, there was a wide gap in knowledge about diphtheria in Nigeria that needed to be filled appropriately.
“As such, we recommend swift public health actions to be taken by the Nigerian government for quick health interventions for diphtheria to mitigate the current outbreak and future spread of the infection in Nigeria.”
“Like other African nations, Nigeria underreports cases. In 2011, there were 98 instances in the north-eastern region, with 21 per cent of those cases resulting in subsequent mortality,” she said.
According to her personnel, the public should be educated on the importance of immunisation, while medical personnel should be appropriately trained to recognize and treat diphtheria.
“Nigeria must work closely with other countries and international organisations to share information and resources and support efforts to eradicate diphtheria on a global scale.
“The implementation of such measures is essential for preventing and controlling epidemics and outbreaks of diphtheria in the country,” she said.
NANFeatures
