title: High concentration of blood lead levels among young children in Bagega community, Zamfara - Nigeria and the potential risk factor.
abstract: BACKGROUND
  In May 2010, lead poisoning (LP) was confirmed among children <5years (U5) in two communities in Zamfara state, northwest Nigeria. Following reports of increased childhood deaths in Bagega, another community in Zamfara, we conducted a survey to investigate the outbreak and recommend appropriate control measures.
  
  
  METHODS
  We conducted a cross-sectional survey in Bagega community from 23rd August to 6th September, 2010. We administered structured questionnaires to parents of U5 to collect information on household participation in ore processing activities. We collected and analysed venous blood samples from 185 U5 with LeadCare II machine. Soil samples were analysed with X-ray fluorescence spectrometer for lead contamination. We defined blood lead levels (BLL) of >10ug/dL as elevated BLL, and BLL ≥45ug/dL as the criterion for chelation therapy. We defined soil lead levels (SLL) of ≥400 parts per million (ppm) as elevated SLL.
  
  
  RESULTS
  The median age of U5 was 36 months (Inter-quartile range: 17-48 months). The median BLL was 71µg/dL (range: 8-332µg/dL). Of the 185 U5, 184 (99.5%) had elevated BLL, 169 (91.4%) met criterion for CT. The median SLL in tested households (n = 37) of U5 was 1,237ppm (range: 53-45,270ppm). Households breaking ore rocks within the compound were associated with convulsion related-children's death (OR: 5.80, 95% CI: 1.08 - 27.85).
  
  
  CONCLUSIONS
  There was an LP outbreak in U5 in Bagega community possibly due to heavy contamination of the environment as a result of increased ore processing activities. Community-driven remediation activities are ongoing. We recommended support for sustained environmental remediation, health education, intensified surveillance, and case management.
authors.affiliation: Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
authors.forename: Olufemi Olamide
authors.initials: OO
authors.lastname: Ajumobi
authors.affiliation: Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Tsofo
authors.affiliation: Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
authors.forename: Matthias
authors.initials: M
authors.lastname: Yango
authors.affiliation: Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
authors.forename: Mabel Kamweli
authors.initials: MK
authors.lastname: Aworh
authors.affiliation: Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
authors.forename: Ifeoma Nkiruka
authors.initials: IN
authors.lastname: Anagbogu
authors.affiliation: Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
authors.forename: Abdulazeez
authors.initials: A
authors.lastname: Mohammed
authors.affiliation: Ministry of Health, Gusau, Zamfara state, Nigeria.
authors.forename: Nasir
authors.initials: N
authors.lastname: Umar-Tsafe
authors.affiliation: Ministry of Environment, Gusau, Zamfara state, Nigeria.
authors.forename: Suleiman
authors.initials: S
authors.lastname: Mohammed
authors.affiliation: Ministry of Health, Gusau, Zamfara state, Nigeria.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Abdullahi
authors.affiliation: Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
authors.forename: Lora
authors.initials: L
authors.lastname: Davis
authors.affiliation: Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria.
authors.forename: Suleiman
authors.initials: S
authors.lastname: Idris
authors.affiliation: Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Poggensee
authors.affiliation: Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.
authors.forename: Patrick
authors.initials: P
authors.lastname: Nguku
authors.affiliation: African Field Epidemiology Network, Kampala, Uganda.
authors.forename: Sheba
authors.initials: S
authors.lastname: Gitta
authors.affiliation: Global Public Health Solutions, Atlanta, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Nsubuga
mesh_terms: D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D004391:Dust; D004781:Environmental Exposure; D005191:Family Characteristics; D006046:Gold; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007854:Lead / Q000097:blood*; D007855:Lead Poisoning / Q000097:blood / Q000453:epidemiology* / Q000401:mortality; D008403:Mass Screening; D008906:Mining / Q000331:legislation & jurisprudence; D009549:Nigeria / Q000453:epidemiology; D011159:Population Surveillance; D012307:Risk Factors; D012640:Seizures / Q000139:chemically induced / Q000453:epidemiology; D012987:Soil / Q000737:chemistry
chemical_list: D004391:Dust; D012987:Soil; D007854:Lead; D006046:Gold
keywords: Lead poisoning; Nigeria; child mortality; outbreak