ACAPS Briefing Note: Niger - Hepatitis E in Diffa Region (4 May 2017)


Crisis overview

Between 9 January and 25 April, a total of 164 cases of hepatitis E, including 25 deaths (CFR: 15.2%) have been reported in Diffa region, where there is a population of 673,146.

The outbreak was declared by the Nigerien authorities in mid-April. All the deaths occurred among pregnant mothers. Over 76% of reported cases were among females.

As of 28 April, five of the six health districts in Diffa region had been affected, with Diffa and N’Guigmi districts accounting for 96% of all cases reported.

Anticipated scope and scale

There is a risk that the outbreak will intensify. New cases are expected to continue to emerge in new health districts in the region. Diffa region is prone to rapid propagation of the disease due to the prevalent underlying factors, such as limited access to safe water, inadequate sanitation, and poor hygiene practices. The region is inhabited by vulnerable populations, such as refugees, IDPs, and returnees who are at risk of contracting the disease due to their living conditions.

The forthcoming rainy season, from June to September, is likely to increase the spread of the disease to neighbouring regions, and will further exacerbate WASH needs among affected populations.

Priorities for humanitarian intervention

  • Health: Hepatitis E is a new disease in Niger and there is no diagnostic capacity in the country. There is an urgent need to mobilise adequate health capacities to respond to the outbreak.

  • WASH: Adequate water supply and sanitation conditions are urgently need in Diffa region.The current outbreak has been linked to unclean water supply and lack of adequate hygiene and sanitation facilities.

Humanitarian constraints

Humanitarian access in Diffa region is limited due to Boko Haram (BH) activity, and the military counter-insurgency in the region. A curfew and restrictions on movement have been imposed on Diffa region after a state of emergency was declared in October 2015.

Since May 2016, access beyond Diffa town in Diffa region is possible, but requires a military escort.