6 research outputs found
Supplemental Material, sj-pdf-1-fnb-10.1177_03795721211039869 - Costs of Implementing an Integrated Package of Maternal and Pediatric Interventions Including SQ-LNS in Rural Niger
No full textSupplemental Material, sj-pdf-1-fnb-10.1177_03795721211039869 for Costs of Implementing an Integrated Package of Maternal and Pediatric Interventions Including SQ-LNS in Rural Niger by Lindsey Hiebert, Kevin Phelan, Moumouni Kinda, Nafissa Dan-Bouzoua, Maurice Kyungu, Thomas Bounameaux, Sani Sayadi, Oumarou Maidadji and Robert Hecht in Food and Nutrition Bulletin</p
The FEAST trial of fluid bolus in African children with severe infection
No full text[No abstract available
Campagne de vaccination contre la rougeole en période de pic épidémique dans une zone à forte prévalence de malnutrition au Niger: cas du district sanitaire de Mirriah (Zinder)
No full textFront Public Health
No full textBACKGROUND: In the treatment of acute malnutrition (AM), non-response is considered a treatment failure for not meeting recovery criteria within a therapeutic window of 12-16 weeks, but this category of children is misunderstood. As current research emphasizes ways to simplify and optimize treatment protocols, non-response emerges as a new issue to enhance program efficiency. METHODS: A prospective cohort study was conducted from 2019 to 2020 at two health centres in Mirriah, Niger among children aged 6-59 months with uncomplicated AM treated under the Optimising treatment for Acute MAlnutrition (OptiMA) protocol. Children who did not meet recovery criteria by 12 weeks (mid-upper arm circumference (MUAC) ≥125 mm without oedema for two consecutive weeks) were classified as non-responders. Non-responders received a home visit six-months post-discharge. Logistic regression was used to analyze factors associated with non-responders compared with children who recovered. RESULTS: Of the 1,112 children enrolled, 909 recovered and 139 were non-responders, of which 127 (80.6%) had significant MUAC gain (mean: +9.6 mm, sd = 5.1) at discharge. Girls (adjusted hazard ratio (aHR) = 2.07, 95% CI 1.33-3.25), children <12 months of age (aHr = 4.23, 95% CI 2.02-9.67), those with a MUAC <115 mm (aHR = 11.1, 95% CI 7.23-17.4) or severe stunting (aHR = 2.5, 1.38-4.83) at admission and a negative or flat MUAC trajectory between admission and week 4 (aHR = 4.66, 95% CI 2.54-9.13) were more likely to be non-responders. The nutritional status of non-responders had generally improved 6 months after discharge, but only 40% had achieved MUAC ≥125 mm. CONCLUSION: Non-responders are not a homogeneous group; while most children ultimately show significant nutritional improvement, rapid hospital referral is crucial for those not gaining MUAC early in treatment. As efforts to expand MUAC-based programming progress, adapting exit criterion and/or providing additional food supplementation with smaller daily ration for children with risk factors discussed here may help improve programme efficiency without adding to the cost of treatment
Treatment outcomes and associated factors for hospitalization of children treated for acute malnutrition under the OptiMA simplified protocol: a prospective observational cohort in rural Niger
No full textIntroductionGlobally, access to treatment for severe and moderate acute malnutrition is very low, in part because different protocols and products are used in separate programs. New approaches, defining acute malnutrition (AM) as mid-upper arm circumference (MUAC) < 125 mm or oedema, are being investigated to compare effectiveness to current programs. Optimizing Malnutrition treatment (OptiMA) is one such strategy that treats AM with one product – ready-to-use therapeutic food, or RUTF – at reduced dosage as the child improves.MethodsThis study aimed to determine whether OptiMA achieved effectiveness benchmarks established in the Nigerien National Nutrition protocol. A prospective cohort study of children in the rural Mirriah district evaluated outcomes among children 6-59 months with uncomplicated AM treated under OptiMA. In a parallel, unconnected program in one of the two trial sites, all non-malnourished children 6-23 months of age were provided small quantity lipid-based nutritional supplements (SQ-LNS). A multivariate logistic regression identified factors associated with hospitalization.ResultsFrom July-December 2019, 1,105 children were included for analysis. Prior to treatment, 39.3% of children received SQ-LNS. Recovery, non-response, and mortality rates were 82.3%, 12.6%, and 0.7%, respectively, and the hospitalization rate was 15.1%. Children who received SQ-LNS before an episode of AM were 43% less likely to be hospitalized (ORa=0.57; 0.39-0.85, p = 0.004).DiscussionOptiMA had acceptable recovery compared to the Nigerien reference but non-response was high. Children who received SQ-LNS before treatment under OptiMA were less likely to be hospitalized, showing potential health benefits of combining simplified treatment protocols with food-based prevention in an area with a high burden of malnutrition such as rural Niger
Evaluation of community-based surveillance for acute flaccid paralysis cases in a security-compromised setting, Tillabéri Health Region, Niger, 2021
No full textIntroduction: Community-based surveillance (CBS) is based on community engagement in disease and public health event surveillance. Enhancing the CBS project has been implemented since 2020 through a Community Relays’ network in a security-compromised setting of Tillabéri Health Region in Niger to ensure progress towards poliomyelitis eradication. The study aimed at describing the CBS system and assessing its usefulness, simplicity, sensitivity, acceptability, timeliness, representativeness and determining its positive predictive value.
Methods: This was a descriptive cross-sectional study that included all alerts and acute flaccid paralysis (AFP) cases reported, as well as the selected surveillance system personnel from January 2017 to December 2021. Data were collected via desk reviews and individual face-to-face interviews to describe the CBS’ organisation and operation and assess its usefulness and attributes using the US Center for Disease Control and Prevention, Atlanta, 2001 guidelines. Usefulness were assessed by the Non Polio Acute Flaccid Paralysis Rate (NPAFP-R) before and during CBS, simplicity: no constraint in cases investigation, sensitivity: NPAFP-R≥3.0 cases/100,000 under 15 children in CBS districts, acceptability: ≥80.0% Community Relays reporting alerts associated with ≥80.0% priority sites adequately visited, ≥80.0% cases notified within 7 days after paralysis onset and ≥80.0% adequate cases, timeliness: ≥80.0% AFP cases notified within 7 days after paralysis onset investigated within 48 hours and received at National lab in good condition within 72 hours, representativeness: expected NPAFP-R with both sex and associated with the expected age groups within AFP cases in the CBS districts, Positive Predictive Value: percentage of Poliomyelitis cases among cases notified. Results are presented in proportions.
Results: Community Relays report to the health system through a free fleet mobile phone network involving all CBS stakeholders from the operational to the central level. The overall NPAFP-R rose from 1.3 to 18.0 cases/100,000 under 15 in CBS districts. AFP cases should be notified within 7 days after paralysis onset, investigated within 48 hours, and specimens should be collected 14 days after paralysis onset. The proportion of AFP cases notified within 7 days was 42.1% (8/19) and 65.1% (69/106) in 2020 and 2021 respectively. The NPAFP-R (Number of AFP cases/100,000 under 15) was 15.0 in Abala, Ayorou: 66.0, Gothèye: 13.0 and Kollo: 16.0. M/F sex ratio: 0.96. Age (years) distribution of cases was <1: 13.1% (15/114), 1-4: 84.3% (96/114), and 5-14: 2.6% (3/114). The overall Positive Predictive Value was 1.4% (2/141).
Conclusion: The enhanced CBS in Tillabéri Region was useful, sensitive, representative, complex, neither reactive nor acceptable. Its timeliness and acceptability could be improved if Community Relays were established and introduced to their respective communities
