233663 Outbreak of acute childhood lead poisoning in Zamfara State, Nigeria, 2010

Wednesday, November 10, 2010 : 9:30 AM - 9:50 AM

Carrie Dooyema, MSN, MPH , Epidemic Intelligence Service Program, Centers for Disease Control and Prevention (CDC), Atlanta, GA
Yi-Chun Lo, MD , Epidemic Intelligence Service Program, Centers for Disease Control and Prevention (CDC), Atlanta, GA
Antonio Neri, MD, MPH , Healthy Homes and Lead Poisoning Prevention Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA
James Durant, MSPH, CIH , Division of Toxicology and Environmental Medicine, Agency for Toxic Substances and Disease Registry, Atlanta, GA
Oladayo Biya, MBBS , Nigerian Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
Saheed Gidado, MBBS , Nigerian Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
Tolough Geoffrey, MBBS , Nigerian Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
Suleiman Haladu, DVM, MSC , Nigerian Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
Patrick Nguku, MBChB , Nigerian Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
Lora Davis, DVM, MPH , National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Abuja, Nigeria
Background: In May, 2010 the Nigerian Ministry of Health assembled a team of national and international organizations including Centers for Disease Control and Prevention, World Health Organization, and Medecins Sans Frontieres, to investigate reports of child death due to lead poisoning in multiple villages in northwestern Nigeria. Methods: A cross-sectional house-to-house questionnaire was administered in every family compound in one affected village and to those in the central area of a second affected village. Blood from available children aged 2 48 months and soil samples collected within family compounds were analyzed for lead. Results: We surveyed 119 family compounds. In total 118 of 463 (26%) children aged <5 years had died since May 2009. Blood samples collected from 60% (205/345) of living children revealed lead poisoning (≥10 g/dL), and 97% of children had levels above the threshold (≥45 g/dL) for initiating chelation therapy. Two-thirds of households processed gold ore inside their family compounds. Breaking, drying, separating and washing ore were each associated with child death (p < 0.05). Overall, children living in family compounds that processed ore were 3 times more likely to die than children living in compounds that did not process ore (OR 3.02; CI 1.2, 7.4). Discussion: This outbreak was caused by gold ore processing activities putting children in family compounds that process ore at high risk for lead poisoning. Ongoing control measures include chelation therapy, public health education, and controlling mining activities. Lead contaminated family compounds have undergone environmental remediation to reduce further child mortality.

Learning Areas:
Basic medical science applied in public health
Environmental health sciences
Epidemiology

Learning Objectives:
Learning Objectives: Describe the epidemiologic methods used in this investigation Identify risk factors associated with lead poisoning in this outbreak investigation List 2 public health measures implemented to control this outbreak

Keywords: Lead, Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an Epidemic Intelligence Officer (EIS) assigned to the CDCs Healthy Homes and Lead Poisoning Prevention Branch. I was the lead EIS officer in this field investigation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.