Implementation and contribution of temperature screening and handwashing practice at points of entry for COVID-19 pandemic response in a humanitarian crisis setting

Introduction over the last decade, insecurity in the Lake Chad Basin has triggered an unprecedented humanitarian crisis in the Niger´s Diffa Region with a significant population movement. In this humanitarian setting, we reviewed the implementation process and the contribution of temperature screening and handwashing practice at points of entry as part of non-pharmaceutical interventions against COVID-19. Methods in Diffa, border officers were trained on the fundamentals of infection prevention and control in relation to COVID-19 readiness and response and a 14-day district response team was constituted. To examine the significance of the implementation process of temperature screening and handwashing practices at points of entry, we conducted a secondary analysis of data submitted by the six health districts of the Diffa Region between March and July 2020. Results travellers screened for fever ranged from 10,499 (in March 2020) to 62,441 (in April 2020) with the health districts of Diffa (mean: standard error of the mean: 25,999: 9,220) and of Bosso (mean: standard error of the mean: 30.4: 19.1) accounting for the most and the least of activities during the entire period, respectively. Overall, 125/169,475 travellers presented fever and were effectively quarantined. Only the Ngourti Health District reported travellers who declined handwashing (54/169,475);this was during the first three months of the first wave of the COVID-19 pandemic. Conclusion we have documented a successful implementation of measures related to temperature screening with some unsubstantial denial of handwashing. Given the importance of border traffic due to insecurity in the Diffa Region, maintaining temperature screening and handwashing in this humanitarian setting is necessary but requires coordinated actions of all stakeholders involved in the region.

Implementation and contribution of temperature screening and handwashing practice at points of entry for COVID-19 pandemic response in a humanitarian crisis setting.

Introduction: over the last decade, insecurity in the Lake Chad Basin has triggered an unprecedented humanitarian crisis in the Niger´s Diffa Region with a significant population movement. In this humanitarian setting, we reviewed the implementation process and the contribution of temperature screening and handwashing practice at points of entry as part of non-pharmaceutical interventions against COVID-19. Methods: in Diffa, border officers were trained on the fundamentals of infection prevention and control in relation to COVID-19 readiness and response and a 14-day district response team was constituted. To examine the significance of the implementation process of temperature screening and handwashing practices at points of entry, we conducted a secondary analysis of data submitted by the six health districts of the Diffa Region between March and July 2020. Results: travellers screened for fever ranged from 10,499 (in March 2020) to 62,441 (in April 2020) with the health districts of Diffa (mean: standard error of the mean: 25,999: 9,220) and of Bosso (mean: standard error of the mean: 30.4: 19.1) accounting for the most and the least of activities during the entire period, respectively. Overall, 125/169,475 travellers presented fever and were effectively quarantined. Only the Ngourti Health District reported travellers who declined handwashing (54/169,475); this was during the first three months of the first wave of the COVID-19 pandemic. Conclusion: we have documented a successful implementation of measures related to temperature screening with some unsubstantial denial of handwashing. Given the importance of border traffic due to insecurity in the Diffa Region, maintaining temperature screening and handwashing in this humanitarian setting is necessary but requires coordinated actions of all stakeholders involved in the region.

Clinical features and predictors of mortality among hospitalized patients with COVID-19 in Niger.

INTRODUCTION: COVID-19 has spread across the African continent, including Niger. Yet very little is known about the phenotype of people who tested positive for COVID-19. In this humanitarian crises region, we aimed at characterizing variation in clinical features among hospitalized patients with COVID-19-like syndrome and to determine predictors associated with COVID-19 mortality among those with confirmed COVID-19. METHODS: The study was a retrospective nationwide cohort of hospitalized patients isolated for COVID-19 infection, using the health data of the National Health Information System from 19 March 2020 (onset of the pandemic) to 17 November 2020. All hospitalized patients with COVID-19-like syndrome at admission were included. A Cox-proportional regression model was built to identify predictors of in-hospital death among patients with confirmed COVID-19. RESULTS: Sixty-five percent (472/729) of patients hospitalized with COVID-19 like syndrome tested positive for SARS-CoV-2 among which, 70 (15%) died. Among the patients with confirmed COVID-19 infection, age was significantly associated with increased odds of reporting cough (adjusted odds ratio [aOR] 1.02; 95% confidence interval [CI] 1.01-1.03) and fever/chills (aOR 1.02; 95% CI 1.02-1.04). Comorbidity was associated with increased odds of presenting with cough (aOR 1.59; 95% CI 1.03-2.45) and shortness of breath (aOR 2.03; 95% CI 1.27-3.26) at admission. In addition, comorbidity (adjusted hazards ratio [aHR] 2.04; 95% CI 2.38-6.35), shortness of breath at baseline (aHR 2.04; 95% CI 2.38-6.35) and being 60 years or older (aHR 5.34; 95% CI 3.25-8.75) increased the risk of COVID-19 mortality two to five folds. CONCLUSION: Comorbidity, shortness of breath on admission, and being aged 60 years or older are associated with a higher risk of death among patients hospitalized with COVID-19 in a humanitarian crisis setting. While robust prospective data are needed to guide evidence, our data might aid intensive care resource allocation in Niger.

Community-based surveillance contribution to the response of COVID-19 in Niger.

INTRODUCTION: the COVID-19 pandemic has spread across all countries in Africa, with much of the model forecasting disastrous results owing to weak health services and political uncertainty. In Niger, an adaptive solution to the COVID-19 pandemic has been implemented by community-based surveillance system (CBS) to complement passive case-finding in health systems. METHODS: the CBS program was designed to use the current CBS polio network spanning 37 health districts in six regions. Between April and November 2020, 150 community health workers (CHWs) were equipped to improve integrated disease surveillance and response (IDSR) preparedness and response to the COVID-19 pandemic. We retrospectively analysed the health data of the National Health Information System to describe the effect of CBS in COVID-19 surveillance. RESULTS: overall, trained CHWs were able to raise awareness among 2,681,642 persons regarding COVID-19 preventions and controls strategies. They reported 143 (84%) valid alerts resulting in two positive COVID-19 cases missing in the community. In addition, CHWs added to the contact tracing of 37 individuals and informed about the deaths in the community. CONCLUSION: community-based surveillance improved COVID-19 response in Niger. Logistic assistance and ongoing training are the foundations for increasing and sustaining the sensitivity of CBS systems in response to the COVID-19 pandemic to deter hotspots across countries.

[The impact of the COVID-19 pandemic on health service utilisation in the City of Niamey: a study conducted in 17 health care facilities from January to June 2020]. / Impact de la pandémie de la COVID-19 sur l'utilisation des services de santé dans la ville de Niamey: une analyse dans 17 formations sanitaires de janvier à juin 2020.

COVID-19 pandemic has posed huge challenges for the health system in Africa; however they haven´t been well quantified. The purpose of this study was to assess the impact of COVID-19 pandemic on curative and preventive activities in health care facilities at 17 integrated health centers in Niamey by comparing the first half of 2020 and the first half of 2019. The differences were more pronounced in the second quarter of 2020, with a 34% reduction (95% CI: -47% to -21%) for curative care, 61% (95% CI: -74% to -48%) for pentavalent vaccines 1 and 3 and 36% (95% CI: -49% to -23%) for VAR 1. A nearly zero gain of 1% (95% IC: -2% to 4%) was reported for prenatal care attendance, thus reversing the gains of the first quarter. The COVID-19 pandemic has had negative effects on service deliveries to the most vulnerable groups, such as women and children. New strategies, such as community engagement, are essential.