Introduction
According to World Health Organization [WHO] (2013), cholera is an acute diarrheal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholera the bacterium Vibiro cholera produce an enter –toxin choleragen that promotes the secretion of fluid and electrolyte into the lumen of the small intestine the patient may experience abdominal cramps and Stooling (water painless diarrhea) or rice water appearance with a fishy Odour. Cholera has been nicknamed the “ Blue Death” because a person’s skin may turn bluish bray from extreme loss of body fluids an untreated person with cholera may produce diarrhea a day sever cholera if not treated can result in life threatening dehydration and loss of electrolyte the disease spread clue to deteriorating hygiene and sanitation condition and disruption to water supply more than fourteen (14) million people are cut off from regular access to clean water, good sanitation and wastes collection has ceased in most cities. Cholera epidemic is a global threat to public health and a key indication of lack of social development and its transmission is closely linked to poverty, poor food, poor personal hygiene and sanitation practices thereby resulting to serious epidemic which is prevalent among infants . the incubation period id five (5) hours to five (5) days with symptoms such as vomiting stooling, fever, loss of appetite and abdominal cramp.
Cholera can be spread or transmitted by the ingestion of contaminated food, water which contain the infection agent and fly is the vector which aid the transmission as a result of deposition of germs to mans food. Numerous social factors has also been responsible for endemicity of cholera, these comprises Certain human habits favoring water and soil pollution, low standards of personal hygiene, lack of education and poor quality of life Vibiro transmission is readily possible in communities with poor sanitation (Park, 2005). The implication of the environmental factors is that the magnitude of environmental destruction continues to rise affecting mostly infants in most communities. There is no doubt that environmental factors is responsible for disease transmission and it affects human health resulting in environmental devastation.
Environmental Factors affecting the infant’s mortality rate
- Water supply.
- Sewage disposal system
- Refuse
- Housing conditions
- Vector control
- Food supply and food hygiene
- Atmospheric pollution
Factors influencing epidemic
- Presence of disease agents
- Mobility
- Environmental condition
- Climate and seasonal variations
- Availability of medical services.
Environmental factors in cholera epidemic amongst infants
- Inadequate wholesome water supply
Olojoba (2009) states that inadequate wholesome water supply is a major issues and threat to public health 8% of sickness and death among children in developing countries are attributed to unsafe water supply shortage of wholesome water supply experience around the globe is due to anthropogenic activities resulting to climate change, flooding and incidence of communicable disease each as cholera.
- Improper disposal of feaces
Park (2005) stated that about 95% of people in rural communities use about 95% of people in rural communities use open fields, stream and river for defecation. Most people are ignorant that faeces are a source of pollutant in the environment. Cholera is spread mostly by water and food contaminated with human faeces containing vibiro cholera, thus transmission is through faecal oral route. Many school, churches and markets particularly in rural areas do not have access to safe water supply for latrine accommodation. Thus creating a scenario of indiscriminate disposal of excreta a major public health nuisance that is capable of:
- Favoring the infestation of vermins such as flies a major vector of cholera.
- Contamination of water source
- Emanation of obnoxious odour.
Also small scale farmers who use untreated sewage as manure in their agricultural operation are unaware of the dangers it posses on crops harvested for consumption (Namuwoza, 2013). These factors are responsible for the endemicity of the disease cholera
- Poor disposal of solid waste
Solid waste management has gradually lesson in different communities, refuse heaps are left unattended to the alarming rate at which heaps of refuse clogged the streets not only constitute odor nuisance but also encourage the attraction of flies, that is capable of spreading the agent of the disease (cholera) (Olojoba, 2009) also ascertained that due to indiscriminate dumping of social waste materials into canals and drainage system causing blockage and lead to flooding which can tiger the spread of the disease (cholera). Indiscriminate disposal of solid waste is a major public health concerned in developing countries including Nigeria
- Poor personal hygiene and sanitation practices
Hygiene practices means formulation and application of measures to promote quality of public health . in contrast, poor hygiene practices can lead to poor nutritional status poor hygiene practices exposes people to poor immune system thereby predisposing them to disease such as cholera poor hygiene and sanitation practices ranked high in the causes of child morbidity and mortality in developing countries poor personal hygiene (Habit) and sanitation practices is an endemic problem common to contemporary urban and rural communities African. Poor personal hygiene and sanitation practices can severe as a medium of disease transmission.
- Poor food supply and hygiene
Poor food supply can lead to starvation and death poor food intake coupled with poor hygiene can lead to malnutrition however the presence of micro organisms in human food by itself may not imply direct infection to consume. It has been established that the microbial load must reach some minimum threshold before disease symptoms con show in consumers. Microbiological qualities of foods and water consumed in crowed slums are very similar to these street food consumed in the same area they are purchased from the same source stored in similar premises, prepared by the same people in dusty environments, solid and consumed under similar conditions (Sigh & West, 2014) malnutrition among children below five years in poor hygienic areas is influenced by many different factors in which sanitation is prevalent. The health and live hood condition of slum dwellers are diverse. Suffer from poverty poor access to safe food which predispose them to illness (Njoku, 2012).
Ways of preventing environmental factors in cholera epidemic amongst infants
- Effective environmental sanitation
Environmental sanitation is closely linked to community sanitation which could be defined as the provision and control of some factors in a given human geographical area with a view of promoting health and preventing disease. Improved sanitation in the poor sanitation areas should therefore be central to all initiatives gears toward the improvement of health such activities include: clearing of overgrown weeds clearing of blocked drains, proper waste collection and disposal and supply of wholesome water etc.
- Potable and adequate water supply
Safe and adequate water supply along with adequate sanitation and basic hygiene practices have implication across all the Millennium Development Goals (MDGs) for eradicating poverty and death among infants (WHO, 2010) various of water supply should be protected from possible source of pollution to avoid contamination of water source what over method of storage that would be adopted must ensure that would be adopted must ensure that would be adopted must ensure that protection of contamination of water which must be taken into consideration
- Treatment of water before consumption
Treatment of water at household level such as coagulation and sedimentation, filtration, disinfection through chlorination and boiling should be carried out before consumption of water to remove pathogenic organism, turbidity, taste and also to prevent unpleasant odor in water. Water meant for a large number of houses, town or a community should undergo specific treatment process till the water is certified safe for human consumption the optimal purpose of conventional treatment of water is to provide potable water devoid or free from water borne disease which ensure good health of the community which enable them to perform their individual daily activities
- Personal hygiene practices
Good personal hygiene practices and adequate sanitation is associated with decreased morbidity and improved nutritional status and lower childhood mortality (Muller & Krawinked, 2015). Good personal hygiene practices is essential to promoting good health. People with good personal hygiene are less likely to get disease causing germs and parasites. They tend to live a more healthy live. Such practices include hand washing after using the toilet and urinals coughing and sneezing, after handling refuse and cleaning chemicals, washing of hands before and after eating also ensuring proper and clean handling of food and food areas, cleaning of dirty environment, ensuring proper ventilation in the house, covering ones mouth/ nose when coughing or sneezing etc.
- Health education on the part of food handlers
Sanlier (2009) state that food handles have a major role to play in the prevention of food role tom play in the prevention of food born disease during production and distribution phase. Food handling involves all the aspects of treating and storing food and receipts of raw material to the delivering of the final prepared product. They have to be educated on the aspect of personal hygiene and food hygiene practices such as washing hands before handling food, washing vegetable before cooking and the use of properly cleaned utensils are healthy practices to prevent disease. People with septic hands or should be prevented from handling food unless they undergo treatment. They should also carryout periodic medical examination to certify them fit to handle food items.
- Proper waste management
Proper waste management practices such as source reduction, recycling and composting, prevent or diverts material from the waste stream source reduction involving altering the design manufacturer Or use of product and materials to reduce amount and toxicity of what we thrown away. Recycling involves the reprocessing of discarded materials are sorted collected and processed and then manufacture, sold and brought as new product therefore waste should be proper managed and dispose of so as to prevent managed and dispose if so as to prevent odor nuisance flies infestation, rodent infestation, unsightliness of the environment and also to prevent ground water pollution.
Benefits of the provision of health promotion amenities in the community
According to Obionu (2009) the provision of basic health promotive infrastructure will improve the health status of the community also promote socio-economic growth and human capital development of each members of the community WHO (2014) stated that cholera authorities of different of government whole failed to provide certain basic amenities such as adequate water supply and waste disposal system. The international health body places more emphasis on adequate safe water supply, food hygiene and personal hygiene sanitation practices at grass root level as a key indicator of avoiding the quarter of all preventable communicable disease quarter of all preventable communicable disease such as cholera which is directly associated with environmental factors.
The primary assignment and purpose of every government as stipulated in the section 14 (2) of the 1999 constitution of the government as stipulated in the section 14 (2) of the 1999 constitution of the Federal Republic of Nigeria (FRN) as amended in 2004 is to provide security and welfare for its citizen this is in line with WHO/UNICEF declaration on health as enshrined in primary health care (PHC) termed as social justice National Environmental Sanitation Policy (2005 as cited in Olorunda, 2013) pointed out that the provision of basic amenities such as safe water supply for improved personal hygiene and sanitation practices is highly political process targeting all tiers of government to include it as their top priorities.
Government at all levels can play a major role in combating cholera epidemics by ensuring the provision of basic affordable health amenities such as sanitary latrine accommodation for proper disposal of excrete, adequate sustainable water supply improved solid disposal methods in various communities.
Conclusion/ recommendations
Environmental factors is responsible for cholera epidemic amongst infant, these factors can lead to disease transmission not only cholera but other diseases. The possible ways of preventing these factors is through the following
- Enactment and enforcement of laws
- Proper environmental sanitation
- Provision of adequate potable water supply
- Provision of sanitary conveniences for disposal of sewage
- Increase personal hygiene practices
- Health education of food handlers
- Proper solid waste management
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