Hepatitis E virus (HEV) infection in developing countries is associated with poor hygiene, lack of clean drinking water, and inadequate sanitation. In this study, we report the first case investigation and describe the present situation of HEV outbreak within displaced persons camps in the Diffa region, Republic of Niger. The investigation showed the outbreak to be closely linked to unclean water supply, low hygiene, and sanitation facility standards. Between January and September 2017, a total of 1,917 HEV suspect cases were recorded from which 736 (38.4%) have been confirmed positive for HEV by reverse transcription polymerase chain reaction and enzyme linked immunosorbent assay. Overall, 38 (1.9%) deaths were recorded, including 17 (44.7%) pregnant women. The ongoing outbreak highlights poor drinking water quality and sanitation conditions in displaced persons camps in the Diffa region. Disease containment and patient care activities, particularly for pregnant women, may have resulted in decreased transmission of infection and deaths.

This study aims to evaluate the factors influencing the adherence to the 2nd and 3rd doses of Amodiaquine (AQ) during seasonal malaria chemoprevention (SMC) in Burkina Faso, Mali, and Niger. Overall, 3132 people were interviewed during surveys between 2019 and 2020 in 15 health districts. In Burkina Faso, Mali, and Niger, the proportions of non-adherence were 4.15%, 5.60%, and 13.30%, respectively, for the 2nd dose and 3.98%, 5.60% and 14.39% for the 3rd dose. The main cause of non-adherence to the 2nd and 3rd doses was other illnesses in 28.5% and 29.78%, respectively, in Burkina Faso, 5.35% and 5.35% in Mali and 1.6% and 0.75% in Niger. It was followed by vomiting in 12.24% and 10.63% for Burkina and 2.45% and 3.78% in Niger. The last cause was refusal in 6.12% and 4.25% in Burkina, 33.9% and 15.25% in Mali and 0.8% and 1.51% in Niger. Non-adherence of doses related to parents was primarily due to their absence in 28.5% and 27.65% in Burkina, 16.07% and 16.07% in Mali and 7.37% and 6.06% in Niger. Traveling was the second cause related to parents in 12.24% and 12.76% in Burkina, 19.64% and 19.64% in Mali and 0.81% and 0.75% in Niger. Non-adherence related to community distributors was mainly due to missing the doses in 4.08% and 4.25% in Burkina, 23.21% and 23.21% in Mali, 77.04% and 76.51% in Niger. Our study reported very small proportions of non-adherence to 2nd and 3rd doses of SMC and identified the main causes of non-adherence. These findings will provide helpful information for policymakers and public health authorities to improve adherence to SMC

Background: Niger has experienced multiple cholera outbreaks since the occurrence of cholera in West Africa in 1970-1971. Understanding the origins of these geographic variations at different scales in the region and in health districts is an essential step in the rational and operational fight against this disease. Methods: We conducted a retrospective review of all suspected cholera cases in Niger from 2003 to 2015. Data from 2010 to 2015 were reviewed to determine the number and percentage of stool specimens tested, with distribution by serotype. We also determined the time between sampling and sending to a laboratory. Results: From 2003 through 2015 a total of 16 328 cases of cholera, including 578 deaths, were reported to the National Surveillance Database (overall case fatality rate 3.5%). The number of cases was greater among males (63.29%). Patients >15 y of age accounted for 69.80% of cases. All regions recorded cholera cases throughout the period 2003 to 2015, except in 2009, when no outbreak was reported. All epidemics recorded were due to the subtype serogroup O1 serotype Ogawa and all strains confirmed the presence of the ctxB, rstR, tcpA, zot, ace and ctxA genes encoding the toxin of this serotype. Conclusions: The global burden of cholera remains high in Niger. To successfully prevent and control outbreaks, adapted guidelines and strategies should be reviewed to provide more focused information and assign clear roles and responsibilities.

This study aims to evaluate the factors influencing the adherence to the 2nd and 3rd doses during each cycle of seasonal malaria chemoprevention (SMC) in Burkina Faso, Mali, and Niger. Overall, 3,132 people were interviewed during surveys between 2019 and 2020 in 15 health districts. The median age was 30 years. In Burkina , Mali, and Niger, the proportions of non-adherence were 4.15% , 5.60%, and 13.30%, respectively (95% CI (-3.27% -0.37 %, p = 0.114 ) for the 2nd dose and 3.98%, 5.60% and 14.39% for the 3rd dose. The main cause of non-adherence to the 2nd and 3rd doses was other illnesses in 28.5% and 29.78% respectively in Burkina, 5.35% and 5.35% in Mali and 1.6% and 0.75% in Niger. It was followed by vomiting in 12.24% and 10.63% for Burkina and 2.45% and 3.78% in Niger. The last causes were refusal in 6.12% and 4.25% in Burkina , 33.9% and 15.25% in Mali and 0.8% and 1.51% in Niger. Non-adherence of doses related to parents was primary due to their absence in 28.5% and 27.65% in Burkina , 16.07% and 16.07% in Mali and 7.37 % and 6.06% in Niger. Travelling was the second cause in 12.24 % and 12.76% in Burkina , 19.64% and 19.64% in Mali and 0.81% and 0.75% in Niger. Non-adherence related to community distributors was mainly due to missing of the doses in 4.08% and 4.25% in Burkina , 23.21% and 23.21% in Mali, 77.04% and 76.51% in Niger. Our study reported very small proportions of non-adherence to 2nd and 3rd doses of SMC and identified the main causes of non-adherence.

La paralysie flasque aigüe (PFA) causée par la poliomyélite aigüe antérieure (PAA) persiste sur un mode endémique dans certains pays d’Asie et d’Afrique notamment au Niger. Des indicateurs de performance définis par l’OMS permettent d’évaluer le système de surveillance des PFA dans les pays atteints. L'objectif de cette étude est d'en mesurer les résultats au Niger de 1998 à 2021. Il s'agit d'une étude transversale portant sur l'ensemble des données secondaires de la surveillance des cas de PFA notifiés au niveau de la Direction de la surveillance et de la riposte aux épidémies au Niger, sur une période de 24 ans allant de 1998 à 2021. L’échantillon était constitué de 9 659 patients sans distinction d’âge ou de sexe. Le sex-ratio était de 1,23 et 92,01 % des patients avaient moins de 5 ans. La région de Maradi était la première des huit régions du Niger en termes de déclaration des cas (32,27 %). Elle accueille une grande partie de la population du Nigeria, pays voisin également endémique de PFA. Plus de la moitié des patients (66,59 %) avaient reçu 1 à 10 doses de vaccin antipoliomyélitique oral. De 1998 à 2021, 8 419 selles provenant de 9 494 cas (88,70 %) étaient exploitables à l'arrivée au laboratoire. Les cas de poliovirus confirmés et compatibles étaient respectivement de 0,80 % et 2,35 %. Sur les 276 patients ayant présenté une paralysie, 71,73 % souffraient d'une paralysie des deux membres, et dans 94,35 % des cas, la paralysie avait progressé en trois jours. Cette étude a permis d'analyser les performances du système de surveillance active de la PFA. Au Niger, cette surveillance est acceptable au regard des indicateurs de performance, mais il reste encore beaucoup d'efforts à fournir aussi bien au niveau de la population qu'au niveau du personnel de santé.

Background: Bacterial meningitis is a major public health problem, especially in low-income countries. We analyzed national surveillance data and isolates from Niger to describe the epidemiology of bacterial meningitis from 2005 to 2020. Methods: We conducted a retrospective study of nationwide case-based surveillance data of all reported meningitis cases in Niger from 2005 to 2020. Modified case definition was used to classify the cases. Results: A total of 47,953 suspected meningitis cases and 3,276 deaths (CFR=6.83%) were reported, corresponding to an incidence of 189.01 cases per 100,000 population. The male represented 55.41% ( sex-ratio male : female = 1.30) and 40.52% were 5 -14 y. A total of 29,998 cases were reported through RNL, of which 10,979 (36.60%) were confirmed, of which 6,149 (56.01%), were confirmed by culture. The predominant organism identified was N. meningitidis serogroup A (33.91%). All regions reported meningitis cases and a consistent and substantial reduction was seen in confirmed NmA cases, with no cases occurring in the country after the completion of mass campaigns. Nevertheless, other pathogen species and Nm variants, including NmX, NmC, and Streptococcus pneumoniae, have become more prevalent. Conclusion: Increased surveillance of multiple serogroups throughout is necessary, as well as consideration of vaccination with combination vaccines rather than just using a single strain as is currently the case with NmA.