In Mangaize, Tillabery region, western Niger, around 15000 people have been vaccinated against measles. Photo: Augustin Ngoyi/MSF

With simultaneous epidemics of meningitis and measles in Niger, teams from Doctors Without Borders (MSF) have been supporting the Ministry of Health in its efforts to bring them under control, while taking steps to prevent cholera spreading from neighbouring Nigeria. The areas most affected by the outbreaks are sheltering large numbers of refugees and people displaced from their homes by violence in the region.

In the west of the country, there have been 1,409 recorded cases of meningitis C since January, and 94 people have died from the disease. Just as the epidemic began to ease off in mid-March, measles broke out, affecting 1,921 people so far this year and causing five deaths. MSF teams have been treating patients and vaccinating people in communities to prevent both diseases from spreading further.

“In trying to prevent the epidemics from worsening, our current priority is to administer vaccinations in areas where displaced people are coming into contact with the local population,” says MSF emergency coordinator Augustin Ngoyi.

MSF teams and the MoH vaccinated 254,000 people against meningitis in a campaign which ended in April, so the meningitis epidemic is now on the decrease.
 
MSF teams are also working with health authorities to provide vaccinations against measles in the Tillabéry region, near the border with Mali. Around Mangaizé, where many refugees from Mali have settled, teams have vaccinated over  15,000 people, while a second campaign aims to vaccinate 35,000 people in Abala, about  250 km to the east.
 
Further afield, in the Diffa region, in the east of Niger, several measles cases have also been reported.  


The priority to prevent outbreaks from multiplying is to vaccinate in areas where mobile populations are living alongside indigenous people. Photo: Augustin Ngoyi/MSF

Teams from MSF and the MoH are now vaccinating people against measles in Diffa and running a preventative cholera vaccination campaign in the region. After a cholera outbreak across the border in Nigeria, there are fears that Diffa – where 240,000 refugees from Nigeria are sheltered after fleeing Boko Haram-linked violence – could become an entry point for the disease.
 
A total of 391 MSF and MoH staff vaccinated some 105,000 people over three days in late March. “Using vaccination as a preventative approach is our best solution, given the issues related to insecurity in the region, which would make access difficult if a large-scale epidemic broke out,” says MSF’s medical coordinator Dr Jeff Mutombo.
 
MSF is also helping health authorities prepare a strategy to manage any new cases of measles and meningitis by increasing epidemiological monitoring and providing treatment support. “New cases must be detected quickly if we are to stop diseases from spreading, says Ngoyi. “Information must also be collected and shared, and patients must be treated as soon as possible.”  
 
Across the country's eight regions, MSF has trained 80 laboratory technicians in 32 medical facilities and donated equipment to increase laboratories' capacity to monitor meningitis. MSF has also upskilled 148 people who manage health centres and 51 medical staff on treating patients, while also providing them with equipment.
 
In addition, MSF has supported 73 health centres in treating patients with measles, which can lead to complications that are fatal in children, especially among those who are malnourished.
 
In 2015, MSF's teams supported Niger's MoH in responding to a meningitis epidemic that broke out in the regions of Niamey, Zinder, Tahoua, Tillabéry and Dosso, with 8,500 recorded cases and 573 deaths. 
 
Find out more about MSF’s activities in  Niger
Learn more about  meningitis and measles