Surveillance

Diagnosis using the PCR technique, supported by a network of healthcare facilities which sends CSF (cerebrospinal fluid) samples from all areas of the country, has been the main means of microbiological surveillance of bacterial meningitis in Niger since 2002. The CERMES has been officially appointed by the Ministry of Health to collect, manage and distribute data gathered from the monitoring programme. The FSP Meningitis programme has enabled improvement of the laboratory facilities at the CERMES, and the healthcare facilities network involved in meningitis surveillance to be maintained and even extended.

The system for gathering samples and clinical epidemiology data works very well. During the 2008 meningitis season (first half), 2,522 CSF samples were sent to the CERMES by 36 of the country’s 42 health districts, while 3,231 suspected cases of meningitis were reported to the national monitoring system. Only 173 samples could be used in culture and these samples yielded 36 strains: 26 N. meningitidis, 8 S. pneumoniae and 2 H. influenzae. The PCR technique was used on 2,504 samples, with 45.7% of these samples testing positive: 89.2% for N. meningitidis, 8.7% for S. pneumoniae and 2.2% for H. influenzae. Serogroup A accounted for 98.3% of identified meningococci.

The close partnership with the Meningococcus WHO Collaborating Centre in Marseilles (Le Pharo) has continued and 17 strains of N. meningitidis from Niger were documented in great detail (including sequencing).

The CERMES has also produced 5,000 rapid diagnostic kits (5,000 A/W135 strips and 5,000 C/Y strips) which were provided free of charge to 165 healthcare facilities across 30 districts.