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Background: Serotype 1 was the most prevalent pneumococcal meningitis serotype encountered in Niger over the period 2003-2011 (pre-vaccination era), accounting for 45.3% of infections., Methods: Multiple locus VNTR analysis (MLVA) was used to create a genotypic snapshot of a representative subset of the pneumococcal population of serotype 1., Results: MLVA using 16 markers revealed a homogeneous genetic background of pneumococci serotype 1 from Niger, which clustered with few serotype 1 pneumococci from some African countries, while other African countries displayed different clonal complexes. DNA from Niger and from other African countries were different from pneumococci serotype 1 from European countries., Conclusions: MLVA-typing revealed a low genetic diversity among pneumococci serotype 1 from meningitis cases in Niger in the pre-vaccination era., (© The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

To understand 2009 pandemic influenza A virus subtype H1N1 (A[H1N1]pdm09) circulation in West Africa, we collected influenza surveillance data from ministries of health and influenza laboratories in 10 countries, including Cameroon, from 4 May 2009 through 3 April 2010. A total of 10,203 respiratory specimens were tested, of which 25% were positive for influenza virus. Until the end of December 2009, only 14% of all detected strains were A(H1N1)pdm09, but the frequency increased to 89% from January through 3 April 2010. Five West African countries did not report their first A(H1N1)pdm09 case until 6 months after the emergence of the pandemic in North America, in April 2009. The time from first detection of A(H1N1)pdm09 in a country to the time of A(H1N1)pdm09 predominance varied from 0 to 37 weeks. Seven countries did not report A(H1N1)pdm09 predominance until 2010. Introduction and transmission of A(H1N1)pdm09 were delayed in this region.

Epidemiological patterns of malaria are influenced by different kinds of climate. In Sahelian countries, the link between climatic factors and malaria is still insufficiently quantified. The aim of this work was to conduct a time-series study of rainfall to estimate the increased risk of malaria morbidity. Daily suspected malaria episodes among subjects of all ages were collected retrospectively in three health care facilities between 1 January 2000 and 31 December 2003 at Magaria, Niger. These daily numbers were analysed with time-series methods, using generalized additive models with a negative binomial family. The impact of rainfall 40 days before occurrence of suspected malaria episodes was studied using a distributed lag model. More than 13 000 suspected malaria episodes were registered corresponding to an annual cumulative incidence rate of 7.4%. The overall excess risk of suspected malaria episodes for an increase of 1mm of rainfall after 40 days of exposure was estimated at 7.2%. This study allowed to specify the excess risk of rainfall on the occurrence of suspected malaria episodes in an intermediate rainfall area located in the Sahelian region in Niger. It was a first step to a health impact assessment., (Copyright © 2011 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.)

Background: In a context of scarce health resources and varied medical practices, the aim of this study was to compare cost-effectiveness of different screening strategies for hepatitis C virus among blood recipients., Methods: A cost-effectiveness model was used to test nine screening strategies in three survival categories. Three Markov models were used for three methods of follow-up. The marginal cost-effectiveness ratio was estimated to compare the screening strategies., Results: Hepatitis C virus serology by enzyme-linked immunosorbent assay and confirmation by detection of the virus RNA was proved to be the dominant strategy. The marginal cost-effectiveness ratios were for subjects under 40 and low-volume transfusion patients, 776,474 and 2,636,500 French Francs-1996 (about USD 111,000 and 376,650) per life-year gained, respectively. Sensitivity analysis showed that the marginal cost-effectiveness ratio was influenced by the prevalence and the survival rates. The lower marginal cost-effectiveness ratio was estimated at 690,221 French Francs-1996 per life-year gained., Conclusion: This study showed high costs and few life-years gained for the dominant strategy even for the more favourable risk group. New studies may be carried out for new screening and therapeutic strategies.