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The global burden of cholera outbreaks in Niger: an analysis of the national surveillance data, 2003–2015
S. I. Alkassoum | I. Djibo | H. Amadou | A. Bohari | H. Issoufou | J. Aka | S. Mamadou
Date of Publication:
Transactions of The Royal Society of Tropical Medicine and Hygiene
Niger has experienced multiple cholera outbreaks since the occurrence of cholera in West Africa in 1970–1971. 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. 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.
Persistence of the cholera epidemic in the Tillabery district (Niger): epidemiological analysis of determining factors
M. Doudou Halidou | A. Arzika | M. L. Manzo | M. Dramaix Wilmet
Date of Publication:
Feb 01, 2018
Medecine Et Sante Tropicales
The aim of this study was to analyze the determinants of the persistence of the cholera epidemic in Tillabery to obtain a durable solution. A case-control study was conducted in three health centers in June 2013 in Tillabery. Cholera cases were confirmed by laboratory testing or epidemiologically linked with a confirmed index case. Controls were individuals with no history of diarrhea, of the same sex, from the same village and with an age difference that did not exceed five years. A logistic regression model was used to analyze the appearance of cholera according to the determining factors. The analysis showed significant association between the occurrence of cholera and variables related to behavior. The adjusted OR confirm higher risks of cholera for persons in households with more than five inhabitants (crude OR = 1.55 95 % CI (1.06 to 2.28) and adjusted OR 95 % CI 2.68 (1.79 to 4.56)), or in contact with a person with diarrhea (crude OR = 1.86 95% CI (1.26 to 2.75) and adjusted OR = 1.61 95% CI (1.5 to 2.68)), and who report not washing their hands after defecation (crude OR = 3.44 95% CI (2.20 to 5.41) and adjusted OR = 2.76 95% CI (1.73 to 3.79)). This study concludes that the Tillabery cholera victims were primarily those with hazardous hygienic practices. Niger must define operational recommendations to limit the continuance of cholera in certain river areas, particularly in the Tillabery.
Water, Sanitation and Hygiene and Cholera Epidemiology: An Integrated Evaluation in the countries of the Lake Chad Basin
Pierre-Yves Oger | Bertrand Sudre
Date of Publication:
The preparation for and response to cholera epidemics demand a multi-sectoral approach based on knowledge about the epidemiology of the disease over different dimensions of space and time and involving actors in charge of access to water, sanitation and hygiene. Following the explosion of sub-regional epidemics in 2010, the present study aims to propose integrated Health-WASH responses through, on the one hand, by describing the epidemiology of cholera in the Lake Chad Basin and, on the other hand, by proposing interventions based on coordinated actions of prevention, preparation and response to cholera epidemics with the support of all health sector actors as well as those from the domains of water access, sanitation and hygiene.