TONIRA : towards better medical care of acute respiratory infections among children in Niger

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In Niger, respiratory infections and pneumonia are the second cause of hospital infant mortality (10 to 20% of deaths according to health authorities information). As in most African countries, few data on surveillance and etiology of these infections are available whereas they are essential to guide public health policies. In addition in Niger, antibiotic treatment for acute respiratory diseases is often based on clinical signs without prior biological analyzes.

On 21 July, the Centre for Medical and Health Research (CERMES) in Niamey organized the closing ceremony of TONIRA project. Led by Dr. Jean- Paul Moulia-Pelat, who was celebrating on this occasion his departure from CERMES, this project initiated in 2013 evaluated the effectiveness of enhanced monitoring of under 5 children hospitalized for respiratory infection.

791 were included in the project, half of which was see again after six months and the other half  benefiting from a closer monitoring with visit at 1, 3 and 6 months in order to determine the optimal strategy of care.

"We have implemented a unique organization in Niger. In each partner site, we used the Binax test. This allows, from a urine sample, to suspect in 10 minutes the presence of pneumococcus in children. Doctors informed promptly, can direct their prescription to choose the right antibiotic "says Jean-Paul Moulia Pelat.

In fact, pneumococcal turned out to be the most frequently observed infectious agent especially in the first half of the year. This bacterium is also responsible for meningitis. The project has also shown the need to encourage the practice of blood cultures in pediatric services of the National Hospital in Niamey and Lamordé Hospital for better specific diagnosis.

In 3 years, TONIRA has strengthened technical capacity and training of CERMES and main hospitals of Niamey staff. He initiated a true collaboration dynamic between these structures on which it is now possible to consider building further public health actions.

A report giving detailed results and recommendations of the project was submitted to the Ministry of Health of Niger and partners. it also calls for the establishment of a health card which would allow all health care providers (hospitals, NGOs , first aid ... ) to have a better knowledge of the patients history and thus a more efficient monitoring .

Tonira project was funded with support from the Total Foundation

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Updated on 23/08/2016

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