WHO, Zamfara train health workers as cholera, diphtheria cases persist

The Zamfara State Government, in collaboration with the World Health Organisation (WHO), has trained frontline health workers to improve the early detection, treatment and reporting of cholera, diphtheria, acute flaccid paralysis (AFP) and other vaccine-preventable diseases.

The exercise, held at Darma Hotel in Gusau, is aimed at strengthening the state’s capacity to identify suspected cases early and prevent outbreaks from escalating through timely notification, appropriate treatment and effective infection-control measures.

The intervention comes against the backdrop of Zamfara’s recent experience with cholera outbreaks and Nigeria’s continuing burden of epidemic-prone and vaccine-preventable diseases.

WHO reported in September 2025 that cholera cases had been recorded in all 14 local government areas of Zamfara, with Gusau, Bungudu, Zurmi, Anka, Talata Mafara and Shinkafi accounting for more than 85 per cent of reported cases at the time.

The scale of the outbreak prompted a reactive oral cholera vaccination campaign across the six high-burden local government areas. WHO said 964,765 people aged one to 45 were vaccinated across 20 wards, following the release of 1,194,742 doses from the global cholera vaccine stockpile.

More than 1,800 frontline workers were also trained during the response, while the state activated its emergency operations structure and strengthened treatment, surveillance and community response.

The latest training therefore places particular emphasis on ensuring that health workers can recognise and respond to cases before they develop into wider outbreaks.

According to a statement by the Public Relations Officer of the Zamfara State Ministry of Health, Sulaiman Isah, the training covered the epidemiology of cholera, diphtheria, AFP and other vaccine-preventable diseases in the state.

Participants were taken through standard case definitions for cholera and diphtheria, as well as procedures for assessing, classifying and managing suspected cases.

The health workers were also trained on treatment protocols, referral systems and appropriate triage, with emphasis on ensuring that patients requiring specialised care are identified and referred without delay.

Focus on early detection

A major component of the programme was the role of clinicians in disease surveillance.

The participants were reminded of the importance of recognising warning signs, notifying suspected cases promptly and working with surveillance and emergency-response teams during outbreaks.

This is particularly important for diseases such as cholera, where severe dehydration can develop rapidly, and diphtheria, which can cause serious complications and death if not diagnosed and treated promptly.

Nigeria’s disease surveillance data show the scale of the challenge facing health authorities. The Nigeria Centre for Disease Control and Prevention’s 2025 annual report recorded 24,349 suspected cholera cases and 20,031 suspected diphtheria cases nationally, making the two diseases among the largest contributors to the country’s burden of epidemic-prone and vaccine-preventable diseases.

The report also identified the North-West, including Zamfara, as a consistent multi-disease hotspot in 2025.

The data underline why strengthening the capacity of health workers at the point where patients first enter the health system is critical to outbreak control.

Infection prevention takes centre stage

The training also addressed infection prevention and control (IPC) in healthcare facilities.

Participants were sensitised on practical measures to limit the spread of infectious diseases among patients, health workers and communities, including the need for appropriate infection-control procedures when managing suspected cases.

For cholera, clinical treatment alone cannot prevent transmission. WHO has stressed that outbreak control requires a combination of surveillance, case management, vaccination and water, sanitation and hygiene interventions.

Zamfara’s previous response illustrates the need for such a multi-pronged approach. During the 2025 outbreak, WHO supported the state with surveillance, case management, treatment centres, oral rehydration points, medicines and diagnostic supplies.

Diphtheria and vaccine-preventable diseases

The inclusion of diphtheria and other vaccine-preventable diseases in the training reflects a broader concern over gaps in immunisation, disease surveillance and access to timely care.

NCDC’s 2025 annual surveillance report recorded measles, cholera and diphtheria as the three diseases contributing the largest shares of the suspected burden among its priority diseases. Children under 15 were identified as the most affected population group.

Zamfara has previously faced challenges in delivering immunisation and other health services, with WHO identifying shortages of skilled health workers and insecurity across the state as factors affecting access to healthcare and vaccination services.

The latest intervention consequently goes beyond treating individual patients. It is intended to strengthen the surveillance chain through which suspected cases are detected, reported, investigated and managed.

For clinicians, this means recognising symptoms at the facility level. For surveillance officers, it means receiving and acting on notifications quickly. For emergency-response teams, it means having accurate information to determine where resources and interventions are most urgently required.

The training also covers AFP surveillance, which remains important to Nigeria’s efforts to sustain progress towards polio eradication. Health workers are expected to identify cases of sudden weakness or paralysis, particularly in children, and ensure that they are promptly reported and investigated.

With Zamfara having recently experienced a major cholera response and continuing to operate within a wider regional disease burden, health authorities are seeking to ensure that lessons from previous outbreaks translate into stronger preparedness.

The partnership between the state Ministry of Health and WHO is therefore focused not only on responding when outbreaks occur, but on improving the ability of frontline workers to detect threats early, contain transmission and connect suspected cases to appropriate care.

For a state where cholera has previously spread across all 14 LGAs, the effectiveness of that first line of defence could determine how quickly the next outbreak is detected and how far it spreads.