Niger - Diphtheria outbreak 2023

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The SURGE team deployed in a high insecurity area to investigate a rumor about an unknown disease in the district of Banibangou (Tillabéri region).

May 16, 2023



From April 15 to 19, 2023, the SURGE team was deployed in the Banibangou health district, in the border area between Niger and Mali in the Tillabéri region. "We heard about a rare disease which is characterized by chest pain, intense pain in the head and acute drying of the throat", specifies a member of the fact-finding mission. Since March, the rumors spread, the national media relayed the information on this atypical disease. The Ministry of the Interior contacted the Ministry of Public Health to elucidate this rumour. The Epidemic Surveillance and Response Department immediately brought together the multidisciplinary technical teams to analyze the situation and take the appropriate measures.

From the analysis of the data, it follows that the signs presented by the patients “were in favor of the suspected cases of Diphtheria. In Niger, diphtheria surveillance is based on compulsory notification of cases. From January 30 to April 9, 2023, 281 cases were notified, including 19 deaths,” says the head of this mission in the person of Mr. Abdoul Karim Mohamed, epidemiologist from the SURGE team.

As planned by the SURGE initiative, eight (8) multisectoral and multidisciplinary experts were deployed in less than 72 hours to investigate and analyze the situation in collaboration with two (2) executives from the Tillabéri DRSP and two (2) of the health district of Banibangou.

“This deployment took place in an area of high insecurity on the border between Niger and Mali, where 90 soldiers had to be mobilized to secure the village so that the team could work in peace,” reports Dr Mamadou KOUROUMA , coordinator of the SURGE project in Niger.

Once in the health district of Banibangou, the mission examined the various data collection and patient management tools at the Banibangou Integrated Health Center. The team was mainly interested in the symptoms of cough, sore throat, mouth disease and fever. An active search for suspected cases was carried out in the villages of Inekar, 15 km from the Malian border and Hamatey.

Patients suspected of being cases of Diphtheria no longer presented any symptoms, they were all cured after antibiotic therapy based on Erythromycin or Amoxicillin. Thus, CSIs have been asked to increase vigilance during this epidemic season.

The spontaneous arrival of the SURGE team in these localities reassured the population about the presence of a national team capable of intervening anywhere and at any time, even in a situation of insecurity, to provide them with the necessary care.

https://www.afro.who.int/fr/countries/niger/news/lequipe-surge-deployee-dans-une-zone-haute-insecurite-pour-investiguer-une-rumeur-sur-une-maladie?country=840&name=Niger

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Translation Google

Health: UNICEF working to stem the diphtheria epidemic in Niger

Tuesday, October 31, 2023 2:44 p.m. Views: 111

In response to the diphtheria epidemic in Niger, UNICEF, in partnership with the Ministry of Health, launched a joint initiative to combat the spread of the disease. As of October 27, 2023, the outbreak has spread to 30 of the country's 72 districts, resulting in 1,716 confirmed cases and 75 deaths. The Zinder region, severely affected, reported 88% of all cases. It is the most densely populated in the country and is characterized in particular by its numerous exchanges with neighboring Nigeria, itself in the grip of the epidemic declared in January 2023.

Zeyna commission0

Diphtheria is a highly contagious, vaccine-preventable disease that can be fatal in 5 to 10% of cases, with a higher mortality rate in young children. Since 2022, the Zinder region has faced outbreaks of diphtheria epidemics, particularly in the health districts of Tanout, Tesker, Gouré and Takiéta.

UNICEF is stepping up its efforts to provide essential assistance. In partnership with the World Health Organization and with logistical support from ECHO, UNICEF actively supports the ministry's efforts to coordinate the response and purchase medicines and vaccines necessary for the treatment of cases and to the vaccine response. These efforts will treat 5,000 people and vaccinate 490,320 children aged 1 to 14.

“ In the Zinder region, we are all working to curb the epidemic with, in addition to care and vaccination, measures to prevent the spread of the epidemic,” underlined Aboubacry Tall , Representative at UNICEF Niger. “ By combining our resources and expertise, we are determined to provide immediate assistance to those affected and strengthen the healthcare infrastructure in Niger. »

Children, the first victims of the epidemic

It was in October 2022 that a diphtheria epidemic was officially declared by the Ministry of Public Health in Gouré, in the Zinder region. With the support of partners, notably Unicef, the authorities then announced the launch of a vaccination campaign in the region for the benefit of children between 1 and 15 years old, especially since this is the first time in 20 years that A diphtheria outbreak has been recorded in a Nigerian town.

The Zinder region is one of the most populated in Niger and has the lowest vaccination rates in the country, particularly among children, despite the progress made in recent years thanks to the support of partners such as Unicef and WFP. or MSF to the government's efforts.

Also, the risks of spreading the disease have increased due to its proximity to Nigeria, where the most serious diphtheria epidemic ever recorded has occurred in recent years. In a press release published on September 27, UNICEF Nigeria sounded the alarm about the urgent need for widespread vaccination. To date, the epidemic has recorded more than 11,500 suspected cases, more than 7,000 confirmed cases and has claimed the lives of 453 people, mainly children, in this large populous country neighboring Niger. According to the data, most cases concern children aged 4 to 15 who have never received a single dose of this routine vaccine ; a finding highlighting the national emergency in terms of vaccination.

Also in Nigeria, UNICEF is providing urgent support to the Nigerian government in its efforts to combat the epidemic. A key part of this support includes the purchase of vaccines to support the government's response.

To date, at the request of the government, UNICEF has deployed 9.3 million doses of diphtheria vaccines to affected states, including Kano, Bauchi, Borno, Yobe, Katsina, Kaduna and Jigawa, mostly States which border Niger or with which the movement of populations between the two countries is dynamic and quite fluid in view of the historical and socio-cultural relations between the two peoples along the border.

Vaccinate without delay

“The devastating impact of this diphtheria epidemic is a cruel reminder of the importance of vaccination. Nigeria has 2.2 million children who have not received even a single dose of vaccine, placing it second in the world. We must collectively take urgent action to significantly reduce this number. Every child deserves to be protected from preventable diseases. This is not negotiable , ” declared Dr Rownak Khan, acting UNICEF representative .

UNICEF Nigeria is calling on its partners, stakeholders and the international community to mobilize to ensure that every child in Nigeria receives life-saving vaccines . The UN children's agency stresses the importance of strengthening routine immunization, community engagement and health systems to prevent such outbreaks from recurring in the future.

An appeal and recommendations which also apply to Niger where despite the efforts of the authorities and partners such as the vaccination campaign and other support from Unicef and other partners, the situation is under control and not as alarming as in neighboring Nigeria, but with real risks of the epidemic spreading.

actuniger

https://actuniger.com/sante-education/19651-sante-lunicef-a-pied-doeuvre-pour-enrayer-lepidemie-de-diphterie-au-niger.html

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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 42: 16 October - 22 October 2023
Data as reported by: 17:00; 22 October 2023
...

Niger

Diphtheria

1 690 Cases
75 Deaths
4.4% CFR

EVENT DESCRIPTION

The first case of diphtheria in Niger was reported on
17 July 2023. Initially reported in 17 health districts
spanning seven out of eight regions, the outbreak has
now spread to three additional health districts, namely
Agadez, Takieta and Tchirozerine, with an upward trend
over time.

During epidemiological week 42 (ending 22 October
2023), a total of 98 new suspected diphtheria cases,
including two deaths (CFR 2.0%), were reported making
a 64.3% increase in cases, compared to the 35 cases
reported in epidemiological week 41.

From 17 July to 23 October 2023, a cumulative total
of 1 690 suspected cases were reported in 20 health
districts, resulting in 75 deaths (CFR 4.4%). More than
80% (n=1 371) of cases were reported from three
health districts, including Matameye (58%, n=973),
Magaria (15%, n=260), and Tanout (8%, n=138). Of the
75 recorded deaths, 22.7% (n=17) were reported from
Matameye, followed by Zinder (21.3%, n=16), Tanout
(12.0%, n=9), Magaria (9.3%, n=7), Aderbissinat (8%,
n=6), and Gouree (6.6%, n=5).

Only 12.7% (n=204) of samples were collected and
subjected to laboratory testing, with 49.0% (n=100)
testing positive for diphtheria. Most cases (69.0%) were
aged 1-14 years old, with females accounting for 59.0%
of the total cases

PUBLIC HEALTH ACTIONS

Regular integrated coordination meetings at national
and international levels are currently in progress.
A response plan to guide the response has been
developed and a surge team was deployed to
support field activities within Matameye and Abala
districts.

Surveillance and laboratory activities, including
epidemiological case investigations, strengthening
community surveillance, and deploying a laboratory
team to support antimicrobial susceptibility testing
are ongoing

Infection control measures continue to be primarily
implemented within healthcare facilities located in the
affected health districts.

Healthcare personnel have been trained on the
disease, routine vaccination, and laboratory sample
collection techniques, and infected cases are isolated
and provided with appropriate care.

Immunization activities have been successfully carried
out in Matameye health district (Amsoudou and
Kantchee health areas), with a vaccination coverage
of 96.0% for the first round and 82.0% for the second
round. Immunization initiatives are ongoing in the
remaining affected districts.

Risk communication and community engagement
efforts are in progress, including educating the
population about vaccination and preventive
measures.

SITUATION INTERPRETATION

Niger is one of three West African countries (Niger,
Nigeria, Guinea), currently grappling with a diphtheria
outbreak. Three months after the initial report of the first
diphtheria case, the outbreak continues to show an
upward trend and has spread to new districts. Suboptimal
vaccination coverage remains a major contributing factor
to the increase in cases. The Government of Niger, along
with its partners, should urgently implement measures
to reach unvaccinated children (those with zero doses)
in the remaining affected settings and initiate catch-up
interventions to improve overall coverage.

https://www.afro.who.int/countries/niger/publication/outbreaks-and-emergencies-bulletin-week-42-16-october-22-october-2023

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Source: https://reliefweb.int/report/niger/u...-november-2023

UNICEF Niger Diphtheria Flash Update No. 1: 10 November 2023

Format Situation Report
Source UNICEF
Posted 11 Nov 2023
Originally published 10 Nov 2023


Highlights

On 20 October 2023, the Government of Niger, through the Ministry of Public Health, Population and Social Affairs, declared a diphtheria outbreak.

The first case was registered on 17 July 2023. As of 02 November, all eight regions of the country have notified at least 1 case of diphtheria. A total of 1,838 suspected cases of diphtheria, including 91 deaths (lethality: 5%), have been reported.

The regions of Zinder (1,578 cases) and Agadez (132 cases) are the most impacted, contributing to 86% and 7% of the total caseload, respectively.

47% of positive cases are among children aged 5 to 14 years, 22% of positive cases are aged 12 to 59 months, 2.5% of positive cases are less than 1 year old and about 28.5% are aged 15 and above.

Since the onset of the outbreak, UNICEF has initiated its response in support of and partnership with the Ministry of Public Health and other partners involved in the response. To date, 50,000 children aged 0 to 14 years have already been vaccinated.

UNICEF ’s Response...

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Translation Google

Diphtheria epidemic: The response vaccination campaign in the epicenter of the epidemic in Mataméye takes place from November 20 to 24, 2023

November 23, 2023

November 23, 2023. Response vaccination against the diphtheria epidemic in the Matamèye district, Zinder region began on November 20, 2023. “The vaccines necessary to fight this scourge have arrived, and vaccination begins today. I urge you to be vaccinated massively so that we can stop this disease which is circulating among us,” declared the prefect of the department of Matamèye in front of the traditional and administrative authorities and all the audience during his launching speech.

Since July 17, 2023, the Matamèye district in the Zinder region has become the largest focus of the epidemic. To curb the spread of the disease and protect the local population, 294,218 children aged 6 weeks to 14 years are targeted for this first round of response vaccination. “This vaccination campaign steps up the response measures that health authorities have been taking on the ground since the first days of the epidemic, in addition to strengthening routine vaccination, surveillance and case management. Diphtheria is preventable through vaccination, and we intend to continue to support the country with other partners to extinguish the epicenter here in Matamèye and in other epidemic districts ,” said Dr Diaw Mor, WHO Niger Emergency Coordinator.

WHO, Unicef, MSF and other local partners are supporting the region in the response to this epidemic, including the implementation of the vaccination campaign for which they have mobilized more than a million doses. of Pentavalent and Diphtheria Tetanus vaccine for the two rounds of vaccination.

Financial and technical support from WHO through WHO emergency contingency funds and internally through other programs made it possible to deploy 488 vaccinators, 488 mobilizers, 72 supervisors for implementation and monitoring. of this campaign. This support enabled the implementation and supervision of independent monitoring to ensure that all targets are achieved.

As of November 19, 2023, a total of 2936 cases have been reported and 216 deaths recorded for seven affected regions.

https://www.afro.who.int/fr/countries/niger/news/epidemie-de-diphterie-la-campagne-de-vaccination-de-riposte-dans-lepicentre-de-lepidemie-matameye?country=840&name=Niger

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WHO supports Niger to control diphtheria epidemic

November 24, 2023

Niamey – Mariam, mother of 5 children living in Kantché, a rural commune in the Zinder region in southern Niger, remembers the difficult period she experienced earlier this year, when two of her five children were hospitalized in same time. “First it was my nine-year-old son who came home with a bad cough, complaining of a sore throat. He was coughing all night and it was getting worse. He ended up being hospitalized at the Kantché health center, and that's where his eleven-year-old sister also fell ill and eventually both of them were lying there, fighting this deadly illness. It was very difficult for me. »

The illness Mariam is referring to is diphtheria, a highly dangerous and contagious infection caused by bacteria that manifests as a sore throat with a false membrane at the back of the throat. It can lead to cardiac or nervous complications up to paralysis and death. Diphtheria is preventable by vaccination and its mortality rate is highest in young children.

Since July 17, Niger has experienced an epidemic of this disease which broke out in the Zinder region and now affects seven of the country's eight regions. As of November 19, 2023, a total of 2936 cases have been reported and 216 deaths recorded for all affected regions.

In addition to Niger, two other West African countries, Nigeria and Guinea, are also experiencing an unusual increase in diphtheria cases in recent months. At the start of each outbreak, investigation and rapid response missions were funded by the World Health Organization (WHO) to countries, using rapid response teams trained for initial response to emergencies. WHO supported Niger in the development of an epidemic response plan and a management protocol for patients with diphtheria in addition to continuing training in the field, to compensate for the insufficiency qualified health personnel in disease surveillance and treatment. Medicines and anti-diphtheria serum have also been made available to the country for case management.

Recent outbreaks of diphtheria in the sub-region indicate the urgency of strengthening vaccination coverage through national vaccination programs. WHO supports countries in strengthening routine surveillance and immunization, implementing responsive mass immunization campaigns and ensuring adequate case management, to prevent further spread of the disease. epidemic.

In Niger, although the vaccination coverage rate for the 3rd dose of pentavalent (which contains the diphtheria vaccine) is increasing slightly, it is below the 90% required in global, regional and national vaccination strategies. A vaccination campaign was conducted in the Matameye district, the focus of the epidemic in the Zinder region, from November 20 to 24, targeting 294,218 children aged 0 to 14 for the first round. The Zinder region is the most affected area, reporting 48.7% of cases nationally.

Resource mobilization made it possible to release 450,000 US dollars from the WHO Emergency Fund (CFE) and 170,000 dollars internally through other programs to deploy nearly 1,000 responders. front-line workers including vaccinators, social mobilizers and supervisors for the implementation and monitoring of the campaign. This support enabled the implementation and supervision of independent monitoring to ensure that all targets are achieved.

“The vaccination response contributes on the one hand to covering 72% of cases presenting the disease and on the other hand to reducing recorded deaths by 94%. The campaign also allowed us to strengthen routine vaccination in the areas concerned by reaching so-called “zero doses” children or those who are not up to date with their vaccinations. The epidemiological surveillance system has also been strengthened by the detection, notification and management of cases,” explains Dr Diaw Mor, Emergency Coordinator at the WHO Office in Niger.

Diphtheria surveillance is based on compulsory reporting of cases, as explained by Dr Sani Ousseini Lawali, chief medical officer of the Matameye district: “Health centers have been asked to strengthen vigilance during this epidemic season and it is “essential to start treatment immediately in suspected cases of diphtheria without waiting for confirmation of laboratory tests which can take time.”

For Mariam's children, the strategy paid off. She is delighted to have returned home with her children who are now cured. “I prayed a lot that we would return home safe and sound. Thanks to God and the good work of the doctors, my children are well now. I am very happy. »

In the country, administrative, customary and religious authorities participate in efforts to raise awareness and mobilize the population in favor of vaccination, particularly through community relays. “120 relays were chosen to be our representatives within their communities. They were trained on the detection and referral of cases to health centers, with the involvement of religious and customary authorities and community radio stations which continue to broadcast messages on the symptoms of diphtheria and prevention measures in local languages,” says Dr Sani. In each integrated health center, four community dialogue sessions and four home visits per week are planned, thanks to funding from GAVI.

In Kantché, Mariam is also committed to becoming a vaccination champion. “With the experience I had in the hospital, especially the case of children who were not vaccinated, I saw for myself how important and even essential vaccination is. »

Added to diphtheria, Niger is experiencing a sharp increase in epidemics of meningitis, measles, cholera, hepatitis E and whooping cough. Mariam thus joins the ranks of actors committed to ensuring that all children are protected from these preventable diseases with a simple vaccine.

https://www.afro.who.int/fr/countries/niger/news/loms-appuie-le-niger-pour-maitriser-lepidemie-de-diphterie?country=840&name=Niger