In Nigeria, cholera caused twice as many deaths in one year as COVID-19 did in two years

In 2021, Nigeria experienced the worst cholera epidemic to affect the country in recent history. According to the Nigeria Centre for Disease Control (NCDC), the country reported an annual total of 111,062 suspected cholera cases and 3,604 deaths (case fatality rate: 3.2%) (1,2). The epidemic also spread into neighboring countries in West Africa; although, Nigeria represented 85% of cases and 93% of deaths in entire the region that year (2).

The epidemic was widespread throughout Nigeria; however, the north of the country was the most affected with 53% of cases concentrated in Bauchi (19,558 cases), Jigawa (15,141 cases) Kano (12,116 cases), and Zamfara (11,931 cases) (1). Children between the ages of 5 to 14 years were the most affected age group (1).

The key drivers of the epidemic included poor sanitation and consumption of contaminated water (3). The rainy season and subsequent flooding further worsened the situation (3). Furthermore, many people in some heavily affected areas were displaced due to conflict and are thus particularly vulnerable (4).

In response to the epidemic, the NCDC activated a comprehensive cholera Emergency Operations Centre (3). However, the unstable security situation in some affected areas hindered humanitarian and health workers from providing needed assistance (3).

The overall case fatality rate of 3.2% indicates an issue with case management, healthcare access or both. Indeed, cholera caused twice as many deaths in one year in the country as the COVID-19 pandemic did in two years (2). Nevertheless, cholera remained largely underfunded in 2021 (2). With the goal of eliminating cholera by 2030, it is critical to increase funding to bolster efforts to prevent and control cholera outbreaks, especially focused in cholera hotspots.