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Death in the Village of Gold, Zamfara Province
Review Process
The village of Gold is a case study experiencing a life-threatening condition to its population after numerous deaths are reported amongst children in three villages of Zamfara Province, Nigeria. The case involves a Disease Detective who has a role in identifying the cause of deaths after getting the information from Doctors Without Borders (DWB). For the sake of the children and the severity of the situation, the Disease Detective could not make an early assumption, but rather take a trip to Nigeria. This was essential because the children were dying faster than normal; thus, a need for intervention was necessary. However, after arriving in Nigeria, the Disease Detective realized that the terrain was challenging as quick transportation to the village of Gold was hampered. Furthermore, the GPS was unavailable based on the fact that the village was remote. In this regard, the Disease Detective had to communicate and travel with the locals, thus ensuring the language barrier was linked as they traverse the villages to the outbreak site. Therefore, an understanding of the disease identification and the epidemiological process is vital in providing intervention as a preventive measure.
The most significant move the Disease Detective did was to seek permission from the village elders to draw samples for laboratory tests. In addition, it was important to travel with a local religious leader as this was vital in ensuring that the Disease Detective gained the trust of the locals. Moreover, traveling with the elders was to ascertain that they do not break any village rules and norms during the process. After analysis of the blood samples, more severe problems emanated. The samples indicated that the children were suffering from lead poisoning. Additionally, the Disease Detective realized that medicines were limited and could not cater to all sick children in the village. In this scenario, the Disease Detective was clinically right to administer the limited medicine to the children that were severely sick. Notably, this was a better move as leaving them untreated would lead to more deaths.
Disease Identification
Lead poisoning is a severe illness that results from an accumulation of lead metal in the blood as a result of exposure to Lead paints and clouds of dust causing severe sickness in both children and adults. According to the Center for Disease Control and Prevention [CDC] (n.d.), even small lead build-up in the blood can result in severe sickness, though fatal in high lead levels. Signs of lead poisoning include such symptoms as developmental delays, abdominal pain, seizures, and irritability. Based on the case above, the children were manifesting the symptoms listed above; seizures, coma, blindness, or death. Having identified the disease, it was important to start treatments even with limited medicines. In this case, chelation therapy was administered for clinical management and control of lead poisoning.
Chelation therapy is a form of treatment that encompasses the oral administration of Succimer. In Africa, and Nigeria, the use of Succimer was reported to be effective in the treatment of lead poisoning as it could bind to such heavy metals as lead, iron, mercury, and zinc among others (CDC, n.d.). In this case, the young children with the most fatal form of lead poisoning receive chelation therapy for several weeks and require more than a single dose for successful clearing of lead in their blood.
Causes and Risk Factors of Lead Poisoning
Upon administration of the medicine and after four weeks, the Disease Detective had to determine the cause of the disease condition. The Disease Detective realized that the main cause of the illness was the mining activities taking part in two villages as their children were sicker compared to the village with less mining. Regardless, they determine the best cause of action is to remove the top layer of the lead-contaminated soil. Based on the Epi-Curve, the Detective continues to provide education about lead poisoning as well as monitor the cases since the commencement of the outbreak. After the completion n of the intervention, the cases were still high though deaths in young children had gradually reduced. The Detective established that during the removal of the top layer of soil covered with lead, the parents often got home smeared with dust containing lead, thus resulting in more infection to the at most risk population, children under 5 years. Stopping the mining process was not a decision to make as the villages depended on gold for survival and as a source of income.
Epidemiological Process
In public health and nursing, epidemiology is a branch of science that is concerned with the investigation of occurrences of an illness, and the resolution of an outbreak. Through epidemiology, the rates of disease can be established through the formulation of rates, counting the number of disease occurrences, and dividing by the total population of the region affected by the disease insurgence (Roberts et al., 2020). The process helps to ascertain the type of the outbreak whether it is typical or atypical for an infected region. In the case study, the Detective used epidemiological study and Epi-curve in articulating the cases to be high in two villages than in the other.
The initial procedure for the epidemiological process is to prepare for fieldwork. Though the time frame for the above case was limited, it was important for the Detective to travel immediately to Nigeria because so many children were dying. At the site of the outbreak, the Detective could not determine the cause of the disease from symptoms alone but performed laboratory tests from blood samples. The test revealed that the children were suffering from Lead poisoning, a nervous disease, which results from Lead build-up in the blood because of exposure to Lead-related dust or paints. Moreover, during the identification, the Detective was guided by the presence of a control group, the one village that had fewer cases and did lesser mining activities. The Detective also concluded that the villagers were using was unsafe, and hence, there is a need for safer methods, noting mining gold was their only source of income.
In conclusion, lead poisoning is a devastating public health issue in Nigeria. Based on the case illustrated, Disease Detective plays a critical role in identifying the causes of such life-threatening conditions. From the analysis, the Detective provides future remedies and control by ensuring environmental safety and delivering educational processes as a preventive measure. Importantly, the Disease Detective employed the use of village elders and the locals to enhance communication because the language barrier was a key factor in reducing the identification of the diseases. Though the Detective only concluded that lead poisoning was from the soil emanating from mining dust, testing samples of drinking water is also essential to ensure all causes of lead poisoning are identified for quick preventive measures. As an intervention, the Disease Detective should consider involving government agencies in sourcing funds to promote other in-come generating sources or provide safe mining devices to the villagers that minimize lead poisoning.
References
Center for Disease Control and Prevention [CDC]. (n.d.). Solve the outbreak. Web.
Roberts, D. J., Crabbe, H., Owodunni, T., Gordon-Brown, H., Close, R., Reshat, S., Sampson, B., Ruggles, R., Dabrera, G., Busby, A., & Leonardi, G. (2020). Case epidemiology from the first three years of a pilot laboratory-based surveillance system for elevated blood-lead concentrations among children in England, 2014-17: Implications for public health action. Journal of Public Health, 42(3), 542-549. Web.
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