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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.

Le défi que pose la pandémie de la COVID-19 sur le système de santé en Afrique est énorme mais pas bien quantifié en ce jour. Nous avons évalué les conséquences de la COVID-19 sur les activités curatives et préventives des formations sanitaires sur une période de six mois au niveau de 17 centres de sante intégré au Niamey de manière en comparant la première moitié de l´année 2020 à celle de l´année 2019. Les différences furent plus prononcées au deuxième trimestre 2020, avec une réduction de 34% (95%IC: -47% à -21%) pour les soins curatifs, 61% (95%IC: -74% à -48%) pour la vaccination aux pentavalents 1 et 3 et de 36% (95%IC: -49% à -23%) pour la VAR 1. Un gain quasi nul de 1% (95%IC: -2% à 4%) fut noté pour la fréquentation à la consultation prénatale annulant ainsi les acquis du premier trimestre. La pandémie de la COVID-19 impacte négativement sur les prestations de service destinées aux groupes les plus à risques de la population à savoir les femmes et les enfants. Des nouvelles stratégies comme l´engagement communautaire sont urgentes.

The implementation of electronic data collection during supportive supervision visits (ISS) using the Open Data Kits (ODK) Collection in Niger has provided a factual basis for monitoring the performance of the Polio eradication program (PEP) and the immunization program. With the notification of the first case of COVID-19 on 19 March 2020, there was a rapid need for quality knowledge to monitor the pandemic. For the first time in Niger, we initiated a six-month (May to October 2020) joint ISS-COVID-19 surveillance program to improve and monitor healthcare workers' performance to efficiently investigate COVID-19 cases in eight provinces. Overall, 1,378 ISS visits were performed through 390 health facilities, during which 4,638 health workers were trained and 527,151 medical records were reviewed, of which 28 suspected cases of COVID-19 were found. Field visits for contact tracing in their communities were accomplished and closed monitoring ensured until full recovery. Building on the tradition of PEP, a problem-solving process, feedback and on-the-job training on COVID-19 surveillance is set to enhance notification in the coming weeks and months. This is facilitated by accurate use of ODK Collect for real-time data surveillance successfully implemented. Other topics in the briefing included fundamentals of infection prevention and control for COVID-19 for both health professionals and community leaders. From this experience, the ISS has emerged as a key component of COVID-19 surveillance, especially in regions with a fragile health system. Our observation is a step forward for pragmatic interventional studies.