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How to prevent, treat cholera with nature

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Bitter leaf.

Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. Cholera remains a global threat to public health and an indicator of inequity and lack of social development.

Researchers have estimated that every year, there are roughly 1.3 to 4.0 million cases, and 21,000 to 143 000 deaths worldwide due to cholera.

According to latest figures from the Nigeria Centre for Disease Control (NCDC), “23 states and Federal Capital Territory (FCT) have reported suspected cholera cases in 2021. These are Benue, Delta, Zamfara, Gombe, Bayelsa, Kogi, Sokoto, Bauchi, Kano, Kaduna, Plateau, Kebbi, Cross River, Nasarawa, Niger, Jigawa, Yobe, Kwara, Adamawa, Enugu, Katsina, Borno, Taraba and FCT.

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“In the reporting week, ten states reported 774 suspected cases-Zamfara (218), Jigawa (136), Kebbi (100), Niger (99), Katsina (97), Yobe (60), Sokoto (43), Kano (15), Kogi (four) and Adamawa (two). Of this, there were 16 confirmed cases from Yobe (14), Niger (one) and Kebbi (one).

“There were 30 deaths from Niger (10), Katsina (eight), Jigawa (six), Kebbi (two), Kogi (two), Sokoto (one) and Zamfara (one) States with case fatality ratio (CFR) of 3.9 per cent No new state reported cases in epi-week 31.

“A total of 770 suspected cases were reported this week representing a 34 per cent decrease compared to 1,162 suspected cases recorded in week 30.”
What are the symptoms of cholera?

According to fact sheet on cholera from the World Health Organisation (WHO) and Medical News Today, most infections are not severe, with 75 per cent of infected people not showing any symptoms.

Within six hours to five days of exposure, symptoms of cholera range from being mild or asymptomatic to severe disease, characterised by huge volumes of explosive watery diarrhea (sometimes called “rice water stools” because of the similarity of appearance to water that has been used to wash rice), vomiting, and leg cramps. Due to rapid loss of fluids up to 20 liters daily, severe dehydration and shock can occur in these individuals.

Signs of dehydration include loss of skin plasticity, sunken eyes, fast heartbeat, low blood pressure, and rapid weight loss. Shock occurs as a result of collapse of the circulatory system.
What are the causes of cholera?

Cholera is a diarrheal illness caused by the bacteria Vibrio cholerae. This species is not endemic to humans, and its presence in the human digestive system is not part of the natural life cycle of the bacteria. Normally found in estuary ecology, the Vibrio cholerae bacteria life cycle naturally shifts between various reservoir species such as small snails and crustaceans, free-floating planktonic forms and static forms resident in the silt and muck of the estuary.

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Vibrio cholera bacteria enter the human ecosystem through a variety of routes. The most common entry is through contaminated food or water. When humans eat seafood–in particular shellfish native to estuary environments such as oysters or crabs–and fail to cook them completely or even eat them raw, they can ingest the large amounts of bacteria necessary to cause a case of cholera.

Poorly cleaned vegetables irrigated by contaminated water sources are another common source. In situations where sanitation is severely challenged, such as in refugee camps or communities with highly limited water resources, a single affected victim can contaminate all water for an entire population.

People with blood type O more susceptible to severe cholera – researchers from Massachusetts General Hospital, Harvard University and the Broad Institute of Massachusetts Institute for Technology (MIT) reported in Science Translational Medicine that people with blood type O are more likely to develop severe cholera.

What are the treatment options for cholera?
Because death from cholera is a consequence of dehydration, the disease is treated using oral rehydration therapy (ORT), which consists of large volumes of water mixed with a blend of sugar and salts.

Prepackaged mixtures are commercially available, but wide distribution in developing countries is limited by cost. Therefore, homemade ORT recipes using common household ingredients and materials have been developed. Severe cases of cholera require intravenous fluid replacement.

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Antibiotics can shorten illness, but ORT is still necessary even when antibiotics are used. Do not use anti-diarrheal medicines, since they prevent flushing of the bacteria out of the body.

In many areas of the world, antibiotic resistance is increasing. In Bangladesh, for example, most cases are resistant to tetracycline, trimethoprim-sulphamethoxazole, and erythromycin.
Corn pap, bitter leaf and guava validated as ‘cure’ cholera, diarrhoea

Guava leaves

Guava and guava leaves | Photo – Twitter

A recent study published in the journal African Health Sciences has validated the efficacy of corn pap (Ogi-tutu in Yoruba and Akamu in Ibo), Vernonia amygdalina (bitter leaf) and Psidium guajava (guava) in treating cholera and diarrhoeal diseases.

The study is titled “Intestinal ameliorative effects of traditional Ogi-tutu, Vernonia amygdalina and Psidium guajava in mice infected with Vibrio cholera.”

The Nigerian researchers investigated the ameliorative effects of Ogi-tutu, Vernonia amygdalina and Psidium guajava on intestinal histopathology of experimental mice infected with Vibro cholerae.

The researchers wrote: “Several traditional treatments of diarrhea and specifically, cholera are in practice in South-Western Nigeria. These traditional claims require experimental investigation to ascertain their effectiveness. Preliminary investigation of vibriocidal activities of Ogi-tutu, V. amygdalina and P. guajava showed in vitro vibriocidal activities. These agreed with findings on antibacterial activities documented in the literature.

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“However, investigation on histopathological effects gave varied ameliorative effects. Ogi-tutu (500 mg/ml) was less effective in treating V. cholerae infection as evidenced by the moderate diffuse degenerative and inflammatory changes observed at histopathology. Ogi-tutu contains lactic acid bacteria (LAB), which have been shown to possess or have antimicrobial potentials, and it is significant in the management of human clinical infections.

“Vernonia amygdalina showed very high preventive and effective treatment measures in both the immediate and delayed groups of mice demonstrating excellent ameliorative effect and very mild degenerative changes in vivo. Similar antidiarrheal activity was demonstrated in castor oil induced diarrhea. The varied biological activity of V. amygdalina is said to be likely due to the combination of its active compounds such as saponins and alkaloids, terpenes, steroids, coumarines, flavonoids, phenolic acids, lignans, xanthones and anthraquinones edotides, tannins and sesquiterpene lactone.

“Psidium guajava displayed very high activity as both prevention and treatment of V. cholerae infections when compared with positive and negative control groups. The ameliorative effects of this plant were attested to by the very mild degenerative and inflammatory changes observed in this study. Antidiarrheal activity of the leaves has been proven and also, of the fruit in castor oil induced diarrhea. The decoction of the leaves is capable of neutralizing Vibrio cholerae.

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