The Federal Teaching Hospital (FTH) Katsina says its children’s ward is overwhelmed by an influx of suspected and confirmed diphtheria cases, while the number of infections and deaths from the disease in Katsina State remains unclear.

The hospital said on Saturday that patients were being referred from health facilities across the state, resulting in severe overcrowding and pressure on available bed spaces.

It did not disclose the number of children currently on admission, the number of laboratory-confirmed cases or deaths recorded so far.

PREMIUM TIMES reported on Saturday that the federal government had activated an emergency multi-agency task force involving the Federal Ministry of Health and Social Welfare, the Nigeria Centre for Disease Control and Prevention (NCDC), the National Primary Health Care Development Agency (NPHCDA), the affected state governments and development partners.

The task force was directed to strengthen outbreak investigation and surveillance, intensify immunisation and expand access to treatment.

The federal government said the NPHCDA had deployed 500,000 vaccine doses to Katsina and Kano states for intensified immunisation in affected and at-risk communities.

It did not specify how many of the doses were allocated to Katsina.

Pressure on referral hospital

FTH Katsina, which serves as a major referral facility for Katsina and some neighbouring states, said the increasing number of patients had placed its paediatric services under considerable pressure.

“The hospital is making every possible arrangement to accommodate and manage the increasing number of patients, even in the absence of sufficient bed spaces,” the hospital said in its statement.

It said healthcare workers were continuing to attend to critically ill children despite the pressure on the ward.

The hospital also called for stronger collaboration among health institutions, government agencies and other stakeholders involved in the response.

The federal government has since directed the emergency task force to mobilise additional support to FTH Katsina, including diphtheria antitoxin, intravenous antibiotics, additional clinical personnel and personal protective equipment.

It also directed the establishment of treatment annexes across Katsina’s three senatorial zones, covering Katsina, Daura and Funtua, to reduce pressure on the referral hospital and bring treatment closer to affected communities.

Details of the locations, bed capacities and operational status of the proposed treatment centres have not yet been made public.

Questions over scale of outbreak

Despite the pressure reported at FTH Katsina and the activation of the federal emergency response, there is no official statements on the current Katsina-specific breakdown of suspected cases, confirmed infections, deaths or the LGAs most affected.

The vaccination status of the affected children is also yet to be disclosed.

These figures could help establish the extent to which gaps in routine immunisation are contributing to the outbreak.

The Federal Ministry of Health said part of the emergency intervention would focus on closing “population immunity gaps” by vaccinating unvaccinated children.

Questions also remain about when the current increase in cases was first detected, what measures were taken before referrals began to overwhelm FTH Katsina, and what diphtheria treatment capacity existed at secondary health facilities across the state before the latest federal intervention.

PREMIUM TIMES understands that the Katsina State Primary Healthcare Development Agency is expected to brief journalists on the outbreak and the government’s response on Sunday.

The federal government has underscored the importance of early cancer detection, saying the stage at which the disease is diagnosed determines the treatment approach and chances of cure.

Uchechukwu Nwokwu, National Coordinator, National Cancer Control Plan (NCCP), Federal Ministry of Health and Social Welfare, said this in an interview with the News Agency of Nigeria (NAN) on Sunday in Abuja.

Mr Nwokwu also explained how cancer progresses through four stages, adding that it is not a single disease but a group of diseases that could affect different organs and behave differently depending on the type of cancer and the cells from which it originated.

According to him, cancer begins when abnormal cells develop within a particular organ or body system, with the extent of spread determining its stage.

He said Stage One cancer referred to a disease that remained within the area where it originated and had not spread beyond that location.

“When the cancer may arise from a small cell inside the organ of a particular system of the body, and as long as it is within the area it originated, it is an early stage, stage one,” he said.

Mr Nwokwu said Stage Two occurs when the cancer has moved beyond its original area but remains confined within the affected organ.

He explained that Stage Three is when the disease has grown beyond the affected organ but remains within the same body system or surrounding region.

“For example, if a breast cancer is growing beyond the breast and affects the chest wall, which is hosting the breast, that’s Stage Three,” he said.

The coordinator said Stage Four is the most advanced stage, occurring when the cancer has spread from the original organ to other systems or distant parts of the body.

He said such a spread is known as metastasis.

“So when it leaves the whole of where it’s growing, it’s a different system, we call it metastasis. That’s stage four,” he said.

Mr Nwokwu explained that breast cancer, for instance, could spread to the brain, bones, liver or lungs, with tests showing that a tumour in those locations originated from the breast.

He said Stage Four cancer is particularly difficult to manage because treatment is no longer focused solely on the original organ.

“So that means you can see breast cancer affecting some in the brain. You can see a tumour in the brain that’s actually from the breast,” he said.

Mr Nwokwu said the stage at which cancer is detected has significant implications for treatment and the possibility of achieving a cure.

He explained that some stage one cancers could potentially be cured through surgery alone because the disease remained confined to its site of origin.

“If you have somebody who has a breast cancer in stage one, like I said, it’s still within where it started from,” he said.

“You might just cut off that place and do a surgery that can just take a small part of the normal tissue where it has not affected, and with that surgery alone, the person is completely cured of that cancer.”

According to him, surgery can also be effective for some stage two cancers because the disease remains confined to the organ.

He said stage two and stage three cancers could, however, require combinations of treatment, including surgery, chemotherapy and radiotherapy.

Mr Nwokwu explained that doctors could also use what is known as neoadjuvant or adjuvant therapy alongside surgery, depending on the patient’s condition.

He said targeted therapy is another treatment option for cancers driven by particular hormones or biological mechanisms.

The coordinator cited prostate cancer as an example, explaining that some patients could undergo removal of the testes to reduce testosterone, a hormone that could stimulate the growth of prostate cancer.

He, however, noted that some advanced prostate cancers could become resistant to this approach, a condition known as castration-resistant prostate cancer, requiring other medicines to control disease progression.

Mr Nwokwu said treatment of stage four cancer is more complex because the disease could involve several parts of the body.

He explained that chemotherapy could be useful in some circumstances because it is a systemic treatment that can reach cancer cells throughout the body.

He, however, said that radiotherapy had to be applied more selectively depending on where the cancer had spread and the patient’s overall condition.

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Mr Nwokwu emphasised that the differences in treatment across the stages reinforced the importance of detecting cancer early, before it spreads beyond the organ where it originated.

He said early diagnosis allowed doctors to determine the stage of the disease and select the most appropriate combination of treatment modalities.

The coordinator also emphasised that cancer treatment should be individualised because cancers affecting the same organ could behave differently depending on their biological characteristics.

He urged Nigerians to seek medical attention promptly when they notice unusual symptoms and to follow appropriate screening and diagnostic recommendations to improve the chances of detecting cancer at an early stage.
(NAN)