[Survey on the prevalence of sequelae of poliomyelitis of the lower limbs in school-age children in rural areas of the Department of Niamey, Niger]

An investigation of lower limb motor disorders among school age children in three rural areas of Niger has demonstrated a prevalence rate of approximately seven per thousand in the 5-9 and 10-14 years age-groups, with no significant difference in rates for boys and girls. Although severe (bilateral) paralysis is encountered only among non-attenders, no significant difference in overall prevalence is found with regard to school attendance status. Eight per cent of affected children are unable to walk and a further eight per cent need crutches or other aids. Patient histories indicate that over 90 per cent of cases occur before the child’s fourth birthday; there is no indication of a modification in incidence over the past nine years. Extrapolation from the observed data indicates an annual incidence rate for paralytic poliomyelitis of the order of 45 per hundred thousand population, i.e. about 2,500 cases a year for the whole of Niger, approximately 2,000 of whom survive with a permanent disability. These rates and figures are similar to those calculated for several other african countries and are seven to ten times higher than the figures gathered from routine reports of poliomyelitis in Niger. The total number of children unable to walk unaided among the 5-14 years age-group can be estimated in 1981 at 1,600, half of whom are paralysed in such a way that they are unable to walk at all. Other preventable causes of paralysis of the lower limbs encountered include i.a. tuberculosis of the spine, sequelae of cerebrospinal meningitis and, second only to paralytic poliomyelitis in importance, trauma to peripheral nerves through faulty injection technique.