%0 Journal Article
%T Evaluation and use of surveillance system data toward the identification of high-risk areas for potential cholera vaccination: a case study from Niger
%A Jose Guerra
%A Bachir Mayana
%A Ali Djibo
%A Mahamane L Manzo
%A Augusto E Llosa
%A Rebecca F Grais
%J BMC Research Notes
%D 2012
%I BioMed Central
%R 10.1186/1756-0500-5-231
%X We evaluated the cholera surveillance data using a standard CDC protocol, through interviews with heads of the system, and a review of cholera data collected between 2006¨C2009. The surveillance system was found to be sufficiently reliable to be able to utilize the data for the detection of high risk areas for cholera vaccination. Temporal, geographic and socio-demographic analyses of cholera cases indicated that between 2006 and 2009, 433 cholera cases were reported in the Maradi region of Niger. Two deprived neighborhoods of the region¡¯s capital city, Bagalam and Yandaka, represented 1% of the regional population and 21% of the cholera cases, reaching a yearly incidence rate of 3 per 1000 in 2006 and 2008, respectively.The results of this evaluation suggest that the reporting sensitivity of the surveillance system is sufficient, to appropriately classify the region as cholera endemic. Additionally, two overcrowded neighborhoods in the regional capital met WHO criteria for consideration for cholera vaccination.In 2008, Africa accounted for 94% of the cholera cases reported to the World Health Organization (WHO). Niger reported a small fraction of these cases, although certain areas of the country face repeated epidemics [1,2]. From 2000 to 2008, Niger reported cholera outbreaks every year, mainly in the south of the country and totaling close to 6000 cases [2]. The region of Maradi has the highest population density in the country and regularly reports cholera cases [2].Two safe and effective oral cholera vaccines (Dukoral and Shanchol) are now available and prequalified by WHO [3-5], with some evidence of induced herd immunity [6,7]. To optimize implementation in cholera-endemic areas, WHO guidance recommends targeting oral cholera vaccination to areas where culture-confirmed cholera has been detected in at least 3 of the past 5£¿years; and incidence rates are at least 1/1000 population in any of these years or high-risk areas or groups have been identified using in
%U http://www.biomedcentral.com/1756-0500/5/231