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Introduction: Rotavirus vaccine was introduced in Mauritania in December 2014. We investigated hospitalizations with diarrhea during pre and post-vaccination periods among children aged 0-5 years in Nouakchott, the capital of Mauritania. Methods: We conducted a retrospective review of hospital admission registries from November 1st 2012 through October 31th 2017 at all referral hospitals in Nouakchott. We described admissions of children aged 0-5 years by diagnosis, data of admission, age and sex, and compared the proportion of all childhood hospitalizations with diarrhea before and after rotavirus vaccine introduction. Results: In total, 6552 (19%) of all 34,329 hospitalizations in 0-5 year-olds had diarrhea. Of these, 3523/16,952 (20.7%) were recorded during the pre-vaccine period, 1373/6897 (19.9%) during the transition period (November 2014-October 2015), and 1656/10,480 (15.8%) during the post-vaccination period. The proportion of all childhood hospitalizations with diarrhea during the pre-vaccine period was 22.6% among males and 18.7% among females. Approximately one third (32.3%) of hospitalizations with diarrhea occurred in children aged 6-11 months. During the post-vaccination period, the proportion of hospitalizations with diarrhea declined by 24%, and the highest reduction (74%) was observed in children aged 2 to 5 years (P < 0.001). Conclusions: The proportion of childhood hospitalizations with diarrhea in Nouakchott was reduced by about one fourth after introduction of rotavirus vaccination in Mauritania, indicating a major impact for public health for children in the capital city. (C) 2019 Elsevier Ltd. All rights reserved.

Introduction:neonatal mortality remains a significant public health burden worldwide, with about 4 million deaths per year. To provide evidence for the implementation of prevention measures aimed at the reduction of neonatal mortality, we performed a study on factors associated with neonatal mortality at the Referral Hospital in Nouakchott, Mauritania. Methods:we conducted a cross-sectional study between January 2013 and December 2013 and included neonatal patients hospitalized at the National Referral Hospital (NRH). Data were collected by reviewing the medical charts and through questionnaires administered to the parents. Results:two hundred and thirty-two (34.7%) of the 669 neonates included in the study died; 159 (71.3%) of deaths occurred during the first six days of life. Most neonates that died were born outside the hospital and admitted to NRH after birth (71.7%; 142/198). About 1/3 were transferred from other parts of the country outside of Nouakchott. Thirty (13.4%) of deaths were neonates born from teenage mothers. In bivariate analysis teenage mothers (RR=1.54; 95% CI: 1.15-2.05; p = 0.004), illiteracy of father (1.61; 1.13-23.0; p = 0.007), birth outside NRH (1.65; 1.28-2.13; p < 0.0001), low gestational age (3.28; 2.40-5.50; p < 0.0001), and low body temperature at admission (1.42; 1.11-1.83; p < 0.004) were significantly associated with neonatal death. In logistic regression analysis, low birth weight (adjusted odds ratio = 3.91; 95% confidence interval 1.69-9.05; p = 0.001), hypothermia (2.40; 1.12-5.14; p = 0.025), and birth outside the NRH (2.13; 1.02-4.45; p = 0.044) were independently associated with neonatal deaths. Conclusion:neonatal mortality remains a significant burden in Mauritania. We identified different socioeconomic and clinical risk factors indicating the need for more intensified prenatal care and improved transport of high risk neonates, especially in the regions outside the capital.

Summary Although malaria has become a serious public health problem in Mauritania since the late 1990s, few documented data on its epidemiology exist. The objective of this study was to assess the morbidity of clinical malaria among children in Nouakchott. Three hundred and one febrile children, consulting at three health facilities of Nouakchott, were screened for malaria in 2009 (n = 216) and 2010 (n = 85). Plasmodium species identification and parasite density were determined by microscopic examination of Giemsa-stained thin and thick films and confirmed by rapid diagnostic test and nested PCR. Of 301 febrile children, 105 (34.9%) were malaria-positive by nested PCR and 87 (28.9%) by microscopy. Plasmodium vivax represented 97.1% (102/105) and P. falciparum accounted for 2.9% (3/105) of positive cases. All positive children under five years old were infected with P. vivax. The highest numbers of malaria positives were found during or shortly after the rainy season and the lowest during the dry season. Fifty-four of 105 (51.4%) malaria cases, all with P. vivax, had never travelled outside Nouakchott. Individuals belonging to the Moors ethnic group represented 97.0% of P. vivax cases. Results of the present study indicate that malaria is endemic in Nouakchott and that P. vivax is the principal causative agent. Regular surveillance is required to monitor malaria prevalence and incidence, and further measures are needed to counter the possible spread of malaria in the country.