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The COVID-19 infection has highlighted the most vulnerable patients. Indeed, COVID-19 patients suffering from another pathology including NCDs such as Arterial Hypertension (Hypertension), diabetes, cancers and respiratory diseases are paying a heavy price for this pandemic. We undertook a study in Niger to better document this comorbidity in a cross-sectional study that brought together patients hospitalized at the Niamey General Reference Hospital for COVID-19 infection and suffering from one or more NCDs. Among 273 patients hospitalized from March 19 to June 03, 2020, 34.8% had a non-communicable disease associated with COVID-19. The average age of the patients was 55 years (22 years to 94 years) and the sex ratio was 2.64 (72.5 % men and 27.5% women). Hypertension was the most represented NCD with 24.5%, followed by diabetes in 17.9% of cases, respiratory diseases 3.66% and other diseases (Heart disease, Obesity, Dyslipidemia, Gout, Chronic renal failure) with 3%. Health workers were the most affected by the disease with 38.6% of cases. The average consultation time was 3.77 days with extremes ranging from 1 to 8 days. The clinical symptoms characterizing the two main groups of patients (hypertensive and diabetic) were almost identical. It consisted mainly of cough, fever, chills, sore throat and rhinorrhea. According to the WHO clinical criteria for the severity of COVID-19, 34 patients or 16.11% were severe and 177 patients or 83% moderate. The clinical severity of the disease is significantly correlated with the patient's age (over 50 years) and the presence of an NCD associated with COVID-19. A total of 35.8% were hospitalized in intensive care in the NCD and COVID-19 group and 14.6% in the NCD group (p

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.

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.