No announcement yet.

Niger - Cholera outbreak 2021

  • Filter
  • Time
  • Show
Clear All
new posts

  • Niger - Cholera outbreak 2021


    Week 34: 16 - 22 August 2021
    Data as reported by: 17:00; 22 August 2021


    Cholera Niger

    1 404 Cases
    54 Deaths
    3.8% CFR


    On 9 August 2021, the Ministry of Public Health of Niger officially
    declared a cholera outbreak in the country. The first cases were
    reported in week 23 (week ending 13 June 2021) in Birni N’Konni
    district, Tahoua region which shares a border with Nigeria. The
    region also has some districts that share borders with Mali in
    the north but no cases have been reported thus far. During week
    26 (week ending 4 July 2021), districts in the Zinder and Maradi
    regions reported cholera cases and subsequently Dosso region
    reported cases in week 30 (week ending 1 August 2021). The capital
    city of Niamey, which is also the most populated area in the country,
    has also reported at least 58 cases of cholera.

    As of 20 August 2021, a total of 1 404 cases and 54 deaths (CFR
    3.8%) have been reported from 22 (31%) out of 72 health districts in
    Niger. Currently, 17 of the 22 health districts are reporting ongoing
    transmission of the outbreak. Districts reporting the most cases
    thus far are Madarounfa (475 cases) and Maradiville (315 cases)
    both in Maradi region, followed by Magaria (135 cases) in Zinder
    region. Of the 109 samples tested, 60% of them were confirmed
    positive with the isolated serotype identified as Vibrio cholerae O1
    Ogawa. Overall, 735 cases (52%) have been reported among females
    while 643 cases (45%) have been among males. Proportionally, the
    highest death rate has occurred among children below five years of
    age. Death rates have also been higher in Niamey region (Niamey
    Urban Community) (28% death rate) and Tahoua region (25% death
    rate), while the other regions’ death rates all remain lower than 6%.
    The rainy season in Niger is seasonal and usually lasts between June
    and October. All regions reporting cholera cases have also reported
    floods making conditions even worse. According to the Ministry of
    Humanitarian Action and Disaster Management, 69 515 people from
    7 812 households have been affected by the floods throughout the
    country facilitating the spread of cholera.

    In addition, many of the affected districts share borders with other
    countries and outbreaks in the past have been linked to cross-border
    cases. Nigeria’s northern states are currently known to have active
    cholera outbreaks and imported cases from Katsina and Sokoto
    states have been detected in Tahoua and Maradi regions. There
    is much population movement across borders in this area which
    is a major threat to the spread of cholera within the West African
    subregion. The current outbreak in Gaya district of the Dosso region
    in Niger poses a major threat to Benin and other neighbouring
    countries considering that it is a major trade and transportation hub
    in the subregion.


    An incident management coordination committee was formed
    and meets daily

    A One Health committee is being established.
    Response teams at all levels (district, regional, and national)
    have been activated.

    Case investigations are being carried out in the affected regions.
    Laboratory and infection prevention control supplies have been
    prepositioned to all health districts.

    Contacts of cases are being traced and receiving preventative

    Cholera isolation and treatment units were established in
    affected health areas.

    Safe and dignified burials have been conducted for the deceased.

    Affected regions were provided with water treatment supplies
    for household drinking water.

    Water points were rehabilitated in villages in the Zinder region
    with more planned for the future.

    Risk communication and community outreach is being

    Preparations are underway for a reactive vaccination campaign.


    The cholera outbreak has deteriorated rapidly in Niger. Although an
    outbreak has not been reported in more than a year, the country is
    known to be endemic for the disease. The ongoing rainy season has
    contributed to the precarious situation as floods have been reported
    in all the regions where they have been reported cases of cholera.
    Similar seasonal flooding is commonplace at this time of the year
    across the West African subregion and have been reported in
    neighbouring Nigeria, a country also currently experiencing a large
    outbreak of cholera. Furthermore, frequent population movement
    between nearby countries for travel and trade have in the past
    accounted for subregional spread of outbreaks and has the potential
    for much wider regional spread of the current cholera outbreak. A
    case has already been documented in Burkina Faso which was from


    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

  • #2

    Week 38: 13 - 19 September 2021
    Data as reported by: 17:00; 19 September 2021


    Cholera Niger

    4 283 Cases
    144 Death
    3.4% CFR


    The cholera outbreak in Niger, which was declared on the 9 August
    2021, is rapidly worsening.
    As of 14 September 2021, a total of
    4 283 cases of cholera with 144 deaths (case fatality ratio (CFR
    3.4%) have been reported. This CFR is high compared to the
    expected of < 1%. The outbreak is currently affecting 6 out of 8
    (75%) regions of the country. A total of 29 (40%) health districts
    out of 72 have reported at least one case of cholera and 20 (69%) of
    these 29 health districts are currently active.

    Among the total cases, females 55% (2 347) have been more
    affected than the males 45% (1 936). The most affected age group
    is 15 years or older with 2 822 cases (66%) followed by 5-14 years
    with 549 cases (13%). Majority of the deaths, 117 (81%) have been
    recorded among the same age group of 15 years or older. Regarding
    deaths, men are more affected with 77 deaths (53%) against 67
    deaths among women (47%).

    Since the onset of the outbreak, a total of 278 stool samples have
    been collected and tested, of which 156 are positive, a positivity rate
    of 56%. The Vibrio cholerae Ogawa 01 serotype has been isolated.

    The Maradi region is leading in number of cases with 2 381 cases
    (55.6%), and is considered the epicenter of the outbreak, followed
    by Tahoua with 981 cases (23%), Zinder 498 (11.6%), Tillabery 236
    (5.5%), Niamey 107 (2.5%) then Dosso 80 (1.8%). Niamey has
    recorded the highest CFR with 11 deaths out of 107 reported cases
    (CFR 10%), followed by Tahoua 6.0% (58/2 381), Zinder 4.0%
    (20/498), and Tillabery 3.4% (8/236).

    Regarding the dynamics of the outbreak, Dosso region has not
    reported new cases for the last 10 days and is therefore no longer
    considered as a hotspot given that two incubation periods of 5 days
    for cholera has been reached. The 3 regions of Maradi, Tahoua and
    Tillabery have at least one health district that have reported case of
    cholera every day for the past 10 days.

    The rainy season is still ongoing and its resulting floods, which are
    the main factor for the spread of this outbreak, have already affected
    nearly 195 851 people and killed 66 people as of 6 September 2021.
    About 12 475 houses have collapsed, 5 960 hectares of cropland
    buried, and more than 10 000 cattle were lost.

    Imported cases of cholera from Nigeria are still reported in the
    affected regions mainly in Maradi region. In addition to BurkinaFaso
    that reported 2 cases so far imported from Niger, Mali has
    just declared the cholera outbreak in the Gao region linked to the
    ongoing outbreak in Tillabery region of Niger. The strain isolated
    in Mali is the same as the one causing outbreak in Niger (Vibrio
    cholerae Ogawa 01).


    The national incident management coordination committee
    continues to meet on regular basis; weekly meetings of this
    committee with the national One Health committee are also
    taking place.

    High-level joint visit led by the Minister of Public Health, to the
    of the outbreaks affected regions of Maradi and Zinder with WHO
    and others UN agencies has been conducted, the main objective of
    this mission was to assess the quality of the response activities.

    Regular meetings of regional One Health Committees in the
    affected regions are ongoing

    Deployment of five multidisciplinary support teams to the
    affected regions took place

    Case management and investigation in the affected areas as
    well as strengthened surveillance activities are ongoing
    Daily transmission of data from health districts to the regional
    level as well as data analysis at all levels are also ongoing
    Collection tubes and laboratory supplies have been prepositioned in all health districts
    Strengthened water, hygiene and sanitation activities including
    regular treatment of water points, distribution of Aquatab tablets,
    cholera treatment centers and environmental disinfections are
    ongoing in the affected areas.

    With the WHO support, the country has submitted the
    vaccination request at the International Coordination Group on
    7 September 2021.


    The ongoing cholera outbreak in Niger seems to be more severe
    compared to the last major outbreak the country experienced in
    2018, especially in terms of caseload and deaths counts as well as
    its spreading pattern.
    The ongoing rainy season has contributed
    to the dangerous situation as floods have been reported in all the
    regions where cases of cholera have been reported. Among some of
    the hypotheses for the high CFR are late visits to health care facilities,
    advanced age of patients and low quality of case management,

    Children, a priority target of the cholera vaccination campaign.
    however, an in-depth assessment on the high lethality is necessary
    to confirm these hypotheses. Two neighboring countries (Burkina
    Faso and Mali) have already declared cholera outbreaks linked to
    the one in Niger, causing concern of further international spread
    throughout the region. Cases imported from Nigeria also continue
    to be reported. The epidemic is still active in Niamey, the capital
    city of the country and which has the highest population density,
    potentially causing risk to even more disease spread. It is therefore
    paramount to double efforts deployed so far to overcome this


    Multisectoral response to the cholera outbreak in Niger should
    be prioritized because it facilitates the harmonization of actions
    and promotes the effectiveness of the response. An in-depth
    assessment to understand the causes of the high death rates
    should be conducted urgently and appropriate remedies put
    in place. Awareness-raising activities for the population about
    the disease remain essential and should be intensified in the
    areas most affected and at risk. A reactive cholera vaccination
    campaign must be organized as quickly as possible targeting
    those at risk.

    It is also important to think for a sustainable solution since
    cholera is endemic in Niger. It is therefore necessary to
    strengthen the health system, carry out hygiene promotion
    activities, and all structures put in place for prevention and
    response to cholera outbreaks in the areas at risk. Communities
    should be availed with access to safe drinking water and
    adequate sanitation and hygiene facilities. The national action
    plan for long-term cholera control and elimination should be
    developed and must include recommendations of the global
    cholera control group’s roadmap.
    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela