Laboratory organisation and management of SARS-CoV-2 infection in Niger, West Africa.

BACKGROUND: As the coronavirus disease 2019 (COVID-19) pandemic unfolds, laboratory services have been identified as key to its containment. This article outlines the laboratory organisation and management and control interventions in Niger. INTERVENTION: The capitol city of Niger, Niamey, adopted a 'National COVID-19 Emergency Preparedness and Response Plan' to strengthen the preparedness of the country for the detection of severe acute respiratory syndrome coronavirus-2. Laboratory training and diagnostic capacity building were supported by existing active clinical and research laboratories for more rapid and practicable responses. The National Reference Laboratory for Respiratory Viruses located at the Centre de Recherche Médicale et Sanitaire was designated as the reference centre for COVID-19 testing. The national plan for COVID-19 testing is being gradually adopted in other regions of the country in response to the rapidly evolving COVID-19 emergency and to ensure a more rapid turn-around time. LESSONS LEARNT: After the decentralisation of COVID-19 testing to other regions of the country, turn-around times were reduced from 48-72 h to 12-24 h. Reducing turn-around times allowed Niger to reduce the length of patients' stays in hospitals and isolation facilities. Shortages in testing capacity must be anticipated and addressed. In an effort to reduce risk of shortages and increase availability of reagents and consumables, Niamey diversified real-time reverse transcriptase-polymerase chain reaction kits for severe acute respiratory syndrome coronavirus-2 detection. RECOMMENDATIONS: Continued investment in training programmes and laboratory strategy is needed in order to strengthen Niger's laboratory capacity against the outbreak.

[Severe forms of malaria in children in a general hospital pediatric department in Yaounde, Cameroon]. / Les formes graves du paludisme de l'enfant dans un service de pédiatrie générale à Yaoundé, Cameroun.

Severe forms of malaria in children are responsible for 1 million deaths yearly in young children in hyperendemic areas. The main objective of this study was to identify and compare common manifestations of different forms of severe malaria and to evaluate the prognosis for hospital treatment in an endemic area. 271 files of children admitted into hospital between March 1991 and September 1996 were analysed. These children were confirmed to have Plasmodium falciparum in their peripheral blood. 78 patients (29%) had the severe form of malaria. 43 patients (53%) were under 5 years of age. The 5 severe types identified were characterized by very high temperatures 28 cases (36%), cerebral malaria 20 cases (26%), prostration and weakness 15 cases (19%), severe anaemia 14 cases (18%) and haemoglobinuria 1 case (1.3%). Cerebral malaria and severe anaemia were more common in children under 5 years old. The average parasitemia was 16,366 +/- 1390 parasites per microlitre. Clearance of parasitemia was obtained on day 3 in almost all cases; 6 patients with very high temperatures presented neither sign of visceral complications nor convulsions. The average period in coma for cases of cerebral malaria was 1.7 days; 12 anaemic patients were transfused. There were no deaths. No abnormality was found on physical examination after an average hospitalisation of 5.3 days. An early diagnosis and adequate treatment of severe forms of malaria in children by qualified personnel will usually result in a favourable prognosis in our area.

Evaluation of community intervention with pit latrines for trachoma control in Ghana, Mali, Niger and Nigeria.

Trachoma is the leading cause of preventable blindness worldwide and is controlled with an integrated strategy of treatment and prevention which includes latrine provision and promotion. We aimed to evaluate the latrine uptake, construction, and usage in villages participating in latrine promotion programmes supported by The Carter Center in Ghana, Mali, Niger and Nigeria where 113 457 new latrines have been reported from 2002 to 2008. In each country a two stage cluster random sampling design was used to select villages and households for evaluation. Household heads were interviewed using a standardised structured questionnaire and latrines were inspected. The sample included 1154 households (Ghana: 326; Mali: 293; Niger: 300; and Nigeria: 235). Overall, 813 (70.5%, 95% confidence interval [CI] 65.7-74.8) had pit latrines, ranging from 30.3% of households in Niger to over 92.0% of households in Ghana and Mali. Of those with latrines 762 (93.7%) were found to be usable and 659 (86.5%) were in use. Overall 659/1154 (57.1%) of households in the targeted communities were using latrines at least 12 months after latrine promotion was initiated. Latrine promotion had been successful increasing access to sanitation in different country contexts and demonstrates the target population are willing to construct, use and maintain household latrines.

Household latrine use, maintenance and acceptability in rural Zinder, Niger.

We conducted a survey in rural Niger to assess use, maintenance and acceptability of household latrines one year after a subsidized promotion project. Standard interviews were conducted with 200 randomly selected project participants and a visual latrine inspection. Before the project, 21.5% (43/200) of households had latrines. After the first year, 100% of these households had at least one latrine. Overall, 2577 household latrines were built in the 50 targeted villages. Latrines were 'always' used by 92.5% of adults and 55% of children in the households. The latrines were adequately maintained: superstructure 93%, covers 74.5%, clean 70%. The main perceived advantages of latrine ownership were proximity/easy access (59.5%) and privacy (22.5%). The project demonstrated that the implementation of a household latrine promotion project is acceptable and feasible in rural Niger. Future promotion projects may develop local sanitation expertise and focus on perceived benefits--proximity and privacy--rather than health.