[Malaria infection during pregnancy in Niamey, Niger]. / Infection palustre de la femme enceinte à Niamey au Niger.

INTRODUCTION: malaria during pregnancy is a major public health problem in Africa. It can have serious consequences for mother, fetus and newborn. It is associated with high maternal and infant mortality rate. The purpose of our study was to determine the prevalence of plasmodium infection in pregnant women, describe their clinical signs and potential complications, analyze associated factors, and propose preventive measures. METHODS: we conducted a cross-sectional study at the Issaka Gazobi Maternity Ward (MIG), Niamey, from 1 June to 30 November 2017. Diagnosis was based on microscopic examination. RESULTS: two hundred and forty-nine (249) women were included in this study. The prevalence of plasmodium infection was 36.5% (IC95%; [30.6; 42.9]). Mean parasite density was 177 P/µl (SD: 121; [40; 800]). All infections were due to P. falciparum. Seventy-three point six percent (67/91) of infected women were asymptomatic. Only 26.4% (24/91) of them had uncomplicated malaria; 9.6% (6/91) had miscarriage; 38.4% of newborns were low birthweight; 26.51% (66/249) developed congenital malaria. Mortality rate was 1.1% (1/ 91). Intermittent preventive treatment (IPT) significantly protected patients against gestational malaria (p=0.01). CONCLUSION: in Niger, P. falciparum infection very commonly affects pregnant women. It is most often asymptomatic but it can lead to uncomplicated or even severe malaria. Main consequences include abortion, low birth weight, intrauterine growth retardation, congenital malaria and maternal death. IPT and the use of long-lasting insecticide-treated mosquito nets (LLINs) can prevent infection.

Risk factors associated with Streptococcus pneumonia carriage in children under five years old with acute respiratory infection in Niger.

INTRODUCTION: Streptococcus pneumonia is a leading cause of bacterial pneumonia, meningitis and sepsis in children, and pneumococcal carriage is an important source of horizontal spread of these pathogens within the community. METHODS: A questionnaire was addressed to parents for the collection of sociodemographic and medical information. Nasopharyngeal swabbing was processed using a molecular method. We used logistic regression models to examine independent associations between pneumococcal carriage and potential risk factors. All associations with a p-value of < 0.25 in the bivariate regression analyses were subsequently entered in the multivariate regression model. RESULTS: A total of 637 children aged 1 to 59 months admitted for acute respiratory infection were included. The rate of respiratory virus carriage was 76%, whereas that of bacteria was 47% and that of bacteria-virus co-colonization was 42%. A bivariate analysis showed that carriage was not related to gender, father's or mother's education level, father's occupation, type of housing or lighting, or passive exposure to cigarette smoking in the house. It was also not linked to complete vaccination with PCV-13 or PPSV-23 and antibiotic treatment prior to hospitalization. A multivariate analysis showed that carriage was related to age greater than 3 months, maternal occupation, house flooring type, and co-colonization of another bacterium and virus. CONCLUSION: These results can be helpful to understand the dynamics of pneumococcal nasopharyngeal colonization; they confirm the interest of vaccinating infants before the age of 3 months with appropriate vaccine to prevent spread nasopharyngeal colonization and pneumococcal diseases in children.

Measurement of pneumococcal IgG antibody, carriage and infection with Streptococcus pneumoniae in children under five years of age with acute respiratory infection in Niger.

Pneumonia is the major cause of mortality in children under five years. A total of 751 children aged 1-59 months admitted for acute respiratory infection were included in this study. Pneumococcal serum IgG antibody was determined by ELISA. Carriage of Streptococcus pneumoniae was determined by molecular analyses of nasopharyngeal swabbings, and the rapid urinary diagnostic test Binax NOW®Sp was used for detection of pneumococcal antigen in urine. A total of 224 (29.8%) children had vaccination record books, and among them, 186 (83%) were vaccinated with the 23-Valent Pneumococcal Polysaccharide Vaccine (PPSV-23), 7 (3%) were vaccinated with the 13-Valent Pneumococcal Conjugate Vaccine (PCV-13), and 31 (14%) had not been vaccinated. IgG levels against pneumococcal polysaccharide were ≥1.3µg/mL in most of the children (99.4%). The carriage rate of S. pneumoniae was 39%, and the Binax NOW®Sp test was positive in 26% of children. There was no significant variation between the means of IgG concentrations against pneumococcal polysaccharides as related to vaccination status, age and nasopharyngeal carriage of S. pneumoniae. However, there was a weak positive correlation between age and level of IgG (r=0.08; p=0.021), and there was a significant variation (p=0.038) of the IgG level according to presence of S. pneumoniae antigen in urine. The presence of S. pneumoniae antigen in urine is significantly (p≤0.01) higher in children with nasopharyngeal carriage of S. pneumoniae (40%) than non-carriers (20%). This study shows that S. pneumoniae has high circulation in children under the age of five years either through infection or carriage.