Niger: Racing to respond to a large-scale cholera epidemic

NEW YORK/NIAMEY, SEPTEMBER 22, 2021—As Doctors Without Borders/Médecins Sans Frontières (MSF) continues its response to the cholera epidemic that was declared in Niger on August 9, the international medical humanitarian organization is calling on other aid actors to quickly start or scale up their interventions, especially with regard to providing clean water and proper sanitation. So far, 4,283 people across six of the country’s eight regions have fallen ill and 144 have died from this deadly waterborne disease, according to September 14 data from the Nigerien Ministry of Public Health.

Since mid-July, MSF has been responding to the epidemic across four regions of Niger by supporting the Nigerien health authorities with epidemiological surveillance, the medical care of more than 1,770 patients, disinfection of water points and houses, and community education and awareness-raising activities. MSF also stands ready to help the Ministry of Public Health with a future vaccination campaign in the most-affected areas to quickly break the disease’s chain of transmission, prevent the emergence of new cases, and reduce mortality.

“We are currently facing a large-scale epidemic,” said Souleymane Ba, emergency coordinator in Zinder, a region in southern Niger. “The risks of the disease spreading are increased as a result of a lack of drinking water and poor sanitation.”

In addition to increased epidemiological surveillance in the regions where it works, MSF started its emergency response mid-July in the southern region of Zinder, after the first cholera cases were reported in Magaria hospital. The quick spread of cholera clusters throughout the country motivated MSF to scale up its support in Tahoua, Niamey, and Maradi regions. Maradi—known as a hotspot for cholera along the border of Niger and Nigeria—is currently the worst-affected region, with 2,381 reported cases.

In these four regions, MSF has set up 15 cholera treatment centers (CTCs) and units and cared for more than 1,770 patients, installed oral rehydration points in villages, and supported several local health authorities with logistics and medical supplies. CTCs are designed to provide rapid medical care to large numbers of patients while also isolating them to prevent further spread of the disease.

“The aim of our intervention is to reduce the number of cases and deaths linked to this epidemic,” Ba said. “We are cutting the transmission chain through early detection of people who may have contracted cholera, the isolation and medical care of patients, and awareness-raising among communities regarding surveillance and preventive measures, such as washing hands and food.”

Cholera is a highly contagious disease found in settings without clean water and proper sanitation and causes profuse diarrhea and vomiting. It first appeared in Niger in 1971 and is endemic in several regions of the country as well as in neighboring countries. The last epidemic was in 2018.

This year, the rapid deployment of material and personnel in response to the epidemic is particularly challenging because of the high number of districts affected across the country. This, along with seasonal peaks of malnutrition and malaria, are putting Niger’s medical system under a great deal of pressure in terms of health staff and medical care capacity.

“In the region of Zinder, the number of patients with cholera has started to decrease thanks to a quick intervention, including both medical and community components, which allowed us to contain the number of epidemic clusters,” Ba said. “This is the reason why more resources from all the health authority partners must be put in place, in particular to cut the transmission chain within the villages and neighborhood affected by the disease.”

MSF has worked in Niger since 1985. MSF teams currently provide free health care in Agadez, Diffa, Tillabéri, Zinder, and Maradi regions.