THE SPREAD OF DIPHTHERIA

Health authorities should embark on mass vaccination against the disease

Following a recent outbreak of diphtheria in Kano State which killed scores of children in Rano Local Government Area, we warned health authorities in the country to work to ensure the spread of the disease. It is now evident that warning was not heeded given the fatalities in other states like Katsina, Kaduna, Borno, Bauchi, Plateau, Sokoto and Zamfara. According to Zamfara’s State Director of Public Health, Dr Yusuf Haske, no fewer than 44 deaths have been recorded in the state with 367 clinically suspected cases and 320 patients successfully treated. While it remains a shame that Nigerians are burdened with these preventable diseases, especially at this period, we hope that the Nigeria Centre for Disease Control and Prevention (NCDC) will work with health authorities in the states where there is already diphtheria outbreak.

Until about 15 years ago, this serious and highly contagious bacterial infection was known to be endemic only in the Caribbean and Spanish countries. Diphtheria affects the throat and nose and can lead to difficulty in breathing, heart rhythm problems, lungs, kidney issues, and ultimately death. Like many other African countries that do not take pre-emptive measures against looming diseases, Nigeria’s poor vaccination for Diphtheria, Pertussis and Tetanus (DPT) has become the finger-bed for the incessant outbreaks of the disease in the country since 2011.

In 2022, the NCDC issued a national diphtheria surveillance guidelines with specific measures on how to prevent, detect and respond to the disease. A few months later, hundreds of people were killed following an outbreak of disease in the country which suggested that no lessons were learnt. The challenge is obvious. A renowned epidemiologist and Professor of Virology, Oyewale Tomori once revealed that only about 60 per cent of Nigerians have been vaccinated against diphtheria, going by official figures. He added that the statistics cannot be relied upon. Conservatively, according to Tomori, the number of unvaccinated people in the country could be as high as 87 million. Unfortunately, most of those susceptible to the disease are children below five years. These are victims whose immunity cannot withstand the associated illnesses for diphtheria.

As experts have warned, the chief factors for the diphtheria scourge are low vaccine coverage, insufficient storage and transportation, as well as inadequate disease and laboratory surveillance. Poor response system, and citizens’ low awareness on vaccination against diphtheria are other factors putting the entire country at risk. The greater danger is that health authorities in many of the 36 states are not doing enough to tackle the problem.

To deal with the challenge posed by diphtheria, government at all levels must take urgent coordinated steps, including mass vaccination of Nigerians. Infected persons should be hospitalised as against the current situation in which most persons are given medications while they remain in their homes. Health facilities, especially primary health centres, should be equipped enough to manage cases where secondary and tertiary health facilities are not available.

In the immediate, health authorities in the affected states seem to be handling the issue on their own. That is not a helpful approach for a contagious disease like diphtheria. It requires the collaboration of the federal government and other critical stakeholders. For long-term planning, there must be collaboration between education and health authorities to ensure that vaccination against DPT becomes requirement for primary and school admissions or for continuous learning. They should also borrow a leaf from many countries free from diphtheria that require people already vaccinated against the disease to take booster shots after being vaccinated for a considerable number of years.

As late in the day as it may seem, government at all levels should isolate infected persons and commence mass vaccination.