Trends in malnutrition among children under 5 in Niger: a retrospective analysis of demographic and nutrition surveys comparing 2008-2014 with 2015-2021.

OBJECTIVES: For decades, Niger, a Sahelian country in Africa, has faced serious food and nutrition crises. Policies and strategies have been implemented by the Government, with the support of its partners, to address this public health problem. The current study was conducted to assess trends in malnutrition among children under 5 years of age. By comparing results from 2008 to 2014 with results from 2015 to 2021, this study aimed to check the efficacy of strategies and policies that were implemented to combat malnutrition. STUDY DESIGN: Retrospective study. METHODS: Data from the annual nutrition survey Standardized Monitoring and Assessment of Relief and Transitions and the Demographic and Health and Multiple Indicator Surveys were used. Meta-analyses were performed on the data as a whole and in each age group by time period. For analysis of age groups, the 95% confidence interval (CI) data were missing, thus an estimate was made from the 'design effect' calculated based on existing CIs. RESULTS: Institutional arrangements had not changed from 2008 to 2014 to 2015-2021, and there were very few changes to existing strategies and policies. The prevalence of Global Acute Malnutrition and Global Chronic Malnutrition (GCM) both remained above critical thresholds for each year in both periods. GCM was above the emergency threshold for both periods, indicating that all regions of the country were affected by malnutrition. The most populated regions (40%) of Maradi and Zinder were the most affected by malnutrition. These two regions also had highest incidence of poverty and the least health service coverage. CONCLUSIONS: Despite the implementation of various policies and strategies, the nutritional status of children under 5 remains an important public health problem.

[Pygomelus: a surgical case report from Nigeria]. / La pygomélie: à propos d'un cas opéré au Niger.

We report a case of pygomelus, a malformation characterized by the presence of supernumerary limb. The patient was a 3-month-old girl born full term in the Zinder area of Niger. The mother had not attended prenatal visits. No drug had been administered during pregnancy and the family was not inbred. The malformation consisted of an almost fully developed third lower limb, attached to the lumbosacral spine, and of a small fleshy mass at the base of the limb resembling a penis. The appendage was removed surgically without complications and the child has been developing normally since the intervention.

Persistence of the cholera epidemic in the Tillabery district (Niger): epidemiological analysis of determining factors.

To analyze the determinants of the persistence of the cholera epidemic in Tillabery to obtain a durable solution. Case-control study 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 are 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.

Purification and characterization of a human pancreas-specific antigen.

A pancreas-specific antigen was identified by immunologic techniques and purified from saline extract of human pancreas. The purified pancreas-specific antigen was shown to be homogeneous by polyacrylamide gel electrophoresis under both denaturing and non-denaturing conditions. It had a molecular weight of 44000 as estimated by gel filtration or sodium dodecyl sulfate-gel electrophoresis, and a sedimentation coefficient of 3.4 S as analyzed by sucrose gradient centrifugation. Pancreas-specific antigen possessed an isoelectric point of 4.9 and migrated to alpha-beta region upon immunoelectrophoresis. By colorimetric assay procedures, pancreas-specific antigen exhibited no enzyme activity, such as amylase, protease, esterase, lipase, acid phosphatase, alkaline phosphatase peroxidase, deoxyribonuclease or ribonuclease. Immunoreactivity of pancreas-specific antigen was sensitive to proteolytic enzymes, perchloric acid and high temperature (70 degrees C, 10 min); but insensitive to neuraminidase or beta-glucosidase. Immunohistochemical staining revealed that pancreas-specific antigen was located in acinar cells of human pancreas. In addition, a higher concentration of pancreas-specific antigen was detected in pancreatic juice than in the saline extract of pancreas. This newly identified pancreas-specific antigen, therefore, may be a useful marker protein in physiological studies of pancreas and pancreatic secretion.

Evaluation of a human pancreas-specific antigen by enzyme-linked immunosorbent assay.

A sensitive sandwich-type enzyme immunosorbent assay has been developed for quantitation of a new human pancreas-specific antigen (PaA). With this method, PaA at a concentration as low as 0.8 ng/ml can be detected. The assay was reproducible as shown by the coefficients of variation for within (4.8%) and between (6.1%) assays. Serum PaA levels from 51 healthy persons ranged from less than 4 to 34 ng/ml. Using 21.5 ng/ml (the upper 97.5 percentile of normal controls) as an upper limit, 42 of 60 pancreatic cancer (70%), 3 of 14 pancreatitis (21%) and 2 of 6 cholelithiasis (33%) had an elevated PaA. Very few patients with other cancers were shown to have an elevated PaA: 3/40 (8%) of lung cancer, 2/43 (5%) of colorectal cancer, 3/40 (8%) of prostate cancer and 1/39 (3%) of breast cancer. The sensitivity and specificity of the serum PaA test for the detection of pancreatic cancer were calculated to be 70% and 95%, respectively. These results indicate that PaA may be useful as an adjunctive tool in immunodiagnosis of pancreatic cancer.

[Medical fault or professional negligence? Case studies in two recovery nutrition centers in Niger]. / Faute médicale ou négligence professionnelle ? Étude de cas dans deux centres de récupération nutritionnelle au Niger.

In developing countries such as Niger, the risk of medical malpractice is ubiquitous in health, jeopardizing patient safety. The aim of this work was to contribute to patients' safety and respect of code of ethics and conduct in the exercise of the medical profession. The reported cases involved two children under 5 years who were admitted to nutrition rehabilitation centers, died as a result of medical malpractice. In Niger, there are no statistics on this phenomenon and a few cases found have always been considered "accident" or "fate." The establishment of an observatory collections of such information should improve their frequency, consequences and propose a prevention plan.