Niger: Cholera Outbreak - Jul 2018

As of 23 July, 247 cases of cholera, including four deaths, have been registered in the department of Madarounfa, in the southern Maradi region, according to the Ministry of Public Health. The areas of Dan Issa, Gabi, Harounawa, Madeini, Maraka and N’Yelwa are the most affected. A cholera outbreak was declared on 13 July following sample analysis conducted in Niamey. To contain the outbreak, the Ministry of Public Health has positioned medicines, set up six treatment centers and strengthened epidemiological surveillance. (OCHA, 23 Jul 2018)

According to the authorities, as of 28 July, 520 cholera cases, including eight deaths, have been recorded in the Madaroufa health district, in the southern Maradi region. The number of recorded cases has tripled compared to the previous week when 148 cases had been recorded as of 19 July. (OCHA, 7 Aug 2018)

1,489 cholera cases (including 26 deaths) have been reported in Maradi region since 15 July. After showing signs of improvement in early August, the outbreak intensified after 10 August. More than 930 cases, including at least 19 deaths, have been reported since 11 August. The outbreak was initially contained in Madarounfa department but has now spread to the heavily populated city of Maradi, the capital of Maradi region. Heavy rainfall and floods in the area have affected more than 20,000 people and are exacerbating the risk of contamination. (ACAPS, 24 Aug 2018)

Since the beginning of the outbreak on 5 July 2018, a total of 2638 suspected cholera cases, including 51 deaths (case fatality ratio 1.9%), have been reported...Two new health districts, namely Damagaram Takaya (12 cases, 1 death) and Gaya (44 cases, 2 deaths), have been affected during the reporting week...The cholera outbreak in Niger is rapidly increasing, with large numbers of new cases and deaths occurring, and new districts being affected. The risk factors for further spread of the disease in the communities are huge. The latest WASH assessment carried out by UNICEF and WHO estimates that only 37% of the population in Maradi Region has access to basic sources of potable water, 75% of the population are said to practice open defaecation, with only 10% having access to basic sanitation. Currently, there is ongoing heavy rainfall, causing occasional floods in several places, likely to exacerbate the risk of contamination of water sources. The ongoing outbreak control measures on the ground have not been able to halt the propagation of the disease. All these factors are favourable for further escalation of the outbreak. (WHO, 7 Sep 2018)

Cholera is showing a downward trend since week 37. In week 42 (only partial data available), a total of 6 new cases with no death were notified at the national level. Four regions have been affected and these include Maradi, Tahoua, Dosso and Zinder. Almost 70% of cases have been reported from Madarounfa Health District in Maradi Region. (WHO, 19 Oct 2018)

The cholera outbreak situation in Niger has continued to improve. Nevertheless, there is a need to continue with intense response measures, especially active surveillance, public health education/social mobilization as well as WASH interventions. The risk factors for cholera transmission are still known to be high, namely poor local hygiene and sanitation, along with major population movement and trade between the affected districts and neighbouring Nigeria, also experiencing a cholera outbreak. The upcoming vaccination campaigns may well reverse the trend still further, but while there is a poor WASH situation, the risk will remain. Cross-border activities with Nigeria need to be strengthened and national authorities need to address the underlying transmission factors in order to bring the outbreak to a complete close. (WHO, 2 Nov 2018)

The Government of Niger with the support of [WHO] and partners has successfully concluded an oral cholera vaccination (OCV) campaign to protect more than 152,000 people at high risk of the disease...There has been a downward trend in the number of cases reported since 1 October, and the most recent case was reported on 19 November...There has been a total of 3,824 cases, including 78 deaths, in 14 health districts in this current outbreak...The immunization campaign targeted people in the urban areas of Aguié health district. Public health experts reasoned that even as the number of reported cases fell nationwide, the population in Aguié remained at high risk because of its status as a national transport hub and because of the flow of people back and forth across the Nigerian border. Since the start of 2018, Nigeria has been battling one of its largest cholera outbreaks in recent years. (WHO, 6 Dec 2018)

No new suspected case of cholera has been reported since 19 November 2018. A total of 125 639 persons were vaccinated (vaccination coverage: 82.5%) during the second round of the OCV campaign from 21 to 24 December 2018 in Aguie Gazaoua and Tchadoua Districts. (WHO, 04 Jan 2019)