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Annual Board Meeting 27 th June 2013

Dr Giuseppina Ortu SCI Programme Manager (francophone countries). Donor supported programmes. Annual Board Meeting 27 th June 2013. SCI programmes. Burundi. Rwanda. Mauritania. Senegal. Donor supported programmes. OUTLINE. Year 2011-2012: Gaps & needs

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Annual Board Meeting 27 th June 2013

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  1. Dr Giuseppina Ortu SCI Programme Manager (francophone countries) Donor supported programmes Annual Board Meeting 27th June 2013

  2. SCI programmes Burundi Rwanda Mauritania • Senegal

  3. Donor supported programmes OUTLINE • Year 2011-2012: Gaps & needs • SCI contribution in year 2012 – 2013 • Current needs / current situation • Next steps / SCI support for year 2013 - 2014 • Treatment • Disease mapping • M&E • Surveillance & Schistosomiasis elimination • Capacity building Activities

  4. BURUNDI Year 2011-2012 Gaps & needs • PZQ and ALB treatments at national level • PZQ treatment of adults in some areas • Drug coverage surveys for validation of MoH reported treatment • Analysis of disease mapping needs • Capacity building and training needs

  5. BURUNDI / SCI contribution / treatments Treatments in BURUNDI • On-going MDA for the administration of ALB to children and mothers • June PZQ administration postponed to Dec 2013 (PZQ tablets not available)

  6. BURUNDI / SCI contribution / surveys National drug coverage survey • Why do we need this survey? • To validate the number of people treated for worm infections reported by the MoH • In Burundi: • PZQ and ALB coverage survey was integrated with vaccination and vitamin coverage surveys to validate the campaign performed in June 2012 • Organized in collaboration with: • - EPI (Expanded Programme of Immunization) • - MoH • - ISTEEBU (Inst. of Statistics in Burundi) • Over 15000 people were interviewed on PZQ and ALB treatment treated individuals total population requiring treatment Drug coverage =

  7. BURUNDI / SCI contribution / surveys • EPI coverage survey report /preliminary results: • Further analysis will be done to assess: • Coverage by commune for PZQ – (important information for drug coverage calculation) • Place of PZQ and ALB distribution for children between 5 and 14 years • ALB coverage in women – the results are very different from those reported by the MoH!

  8. BURUNDI / SCI contribution/ risk maps Risk map/SCH (2011) Risk map/SCH (2007) Note range of prevalence

  9. BURUNDI – Current needs & next steps • Current situation • New funding in place for years 2011 - 2015 from a private donor • A new contract between SCI and the MoH will be signed in the next few weeks • A Programme Manager will be hired for the coordination of activities in Burundi Drug Coverage Survey: Further analysis to assess PZQ coverage • Schistosomiasis/STH • Ensure delivery of PZQ in those communes where schistosomiasis is present, but have never received PZQ • Continuous support for PZQ and ALB treatment for the next 2-3 years • Re-evaluation of schistosomiasis in areas where more detailed information is needed • Capacity building • Support of a PhD student on Evaluation of health centre capacity in rural areas in detection and management of schistosomiasis cases (project already started) • Creation of an NTD laboratory reference in Bujumbura? • Surveillance & Schistosomiasis elimination • SCORE project ?

  10. Rwanda Impact survey in 5 districts • Year 2011-2012 • Gaps & needs • The MoU between the MoH and SCI was not signed • A Programme Manager was needed in the country because of lack of human resources at the MoH • The country needed a comprehensive evaluation of what was done on prevention and control of NTDs to understand the current gaps and needs Nkombo Island Mappingof schistosomiasis (2008) STH: endemic in the whole country NTDs situation analysis

  11. RWANDA – SCI contribution/ Situation analysis • Not all districts at risk of schistosomiasis infection were systematically treated every year • It is not possible to calculate PZQ coverage • Not all SAC at risk of infection received the requested treatment • Adult treatment was not done every year

  12. RWANDA – SCI contribution/ Situation analysis • Schistosomiasis and STH: • Impact surveys in 5 districts: positive impact of PZQ treatment (schistosomiasis is now below 10% in those schools where annual surveys were done), but 1.5 million of people still at risk of SCH infection • Outbreak in the Nkombo Island (2011): • 62.1 [56.4-67.5] % of the population assessed (n=311) was infected with schistosomiasis – this disease is focal and foci can be missed! • The whole country is still at risk of STH infection as intensity of Ascaris has not decreased as expected in school aged children Cases of worm infection reported by the health centres in year 2012

  13. RWANDA – SCI contribution/ Situation analysis • Trachoma • In 2 districts of Gatsibo and Nyaruguru- no intervention was initiated • Lack of awareness of this infection and capacity for diagnosis • Lymphaticfilariasis and podoconiosis • LF not a public health problem • Risk of LF introduction because of cross-border immigrations (from DRC) • Non-filarial elephantiasis still exist - no care provided to the affected individuals • Human African trypanosomiasis • Endemic areas along Akagera National Park • Lack of knowledge and understanding on how to detect cases

  14. RWANDA – Current situation & Next steps • Current situation • MoUbetween SCI and MoH has been signed • END Fund has pledged support for Rwanda for the next 3 years • A Programme Manager in place at the MoH • MDAs • Schistosomiasis • Improve drug administration coverage • Ensure treatment in 38 sectors within 9 Districts at risk of infection • > next MDA in August 2013 • STHContinue drug administration as done before in the whole country • Schistosomiasis Mapping • Remap districts where as per mapping done in 2008, were cases were reported in areas not targeted for schistosomiasistreatment • > planned for end of the year 2013 • M&E and Surveillance • Consider to increase surveillance capacity for worm infections, trachoma, LF, and HAT

  15. SENEGAL • Year 2011-2012 • Gaps & needs • Epidemiological on schistosomiasis and STH was missing in many districts and mapping was required • Reassessment of areas at risk of infection in the whole country and possibly, re-evaluation of the treatment strategies, were also needed

  16. Senegal - SCI contribution / Mapping Mapping of schistosomiasis in 21 districts Data collected in the field is currently under evaluation

  17. Senegal – Current situation & next steps Current situation SCI has extended the agreement with the MoH for another year • Country risk maps • Review all cases of schistosomiasis and investigate the areas where found • Create geo spatial risk maps for schistosomiasis for the whole country to clarify the endemic areas in the country and reassess the treatment strategy • MDAs • SCHISTOSOMIASIS • PZQ distribution will continue to be supported by Child Fund, and in part by SCI when possible and in those districts currently mapped and at risk of infection, if any • M&E • A) impact of mass drug treatment: impact surveys • Assessment in 22 schools in the whole country every year for 4 years is needed • (The protocol has not been developed as the mapping data has not been analysed yet. Estimated budget: $50k/year) • B) Analysis of snails and schisto hybrids in some schools – WHY?

  18. Senegal – Current situation & next steps • Based on the following study: • Research done by Natural History Museum /Imperial College • cercariaefrom infectedB. globosus(host of human schistosomiasis) and • B. truncatus(host of bovine schistosomiasis) • miracidia from human urine samples • Results: • 1) Host switching! • B. truncatussnails are shedding S. haematobiumcercariae. • >>> increase of transmission of S haematobium • >>> increase of disease prevalence • 2) Miracidia from one patient found to be S. haematobium/S. bovishybrid M&E SCI is planning to include in a few schools cercariaeand miracidia genotype assessments SCI is currently looking for funds to support this project in Senegal

  19. Mauritania • Gaps and needs • Both S. haematobium and S. mansoni are present in the country • 900,000 SAC at risk of infection • ~ 200,000 SAC & 80,000 adults in 13 districts treated by OMVS twice. However, for year 2013, the OMVS have not made available financial support for PZQ distribution • Need for training of nurses in decentralized health centres Population 3,340,627 Oasis MDAs OMVS OMVS Mapping 2010 OMVS = ORGANISATION POUR LA MISE ENVALEUR DU FLEUVE SENEGAL

  20. Mauritania – Current situation and next steps • Current situation • SCI offered support for delivering PZQ in these areas plus 8 oases where schistosomiasis has been reported (between 20 and 80% prevalence) • Support has been made available also for training nurses on NTDs • Next steps • Considering that: • The MoH needs to improve the PZQ delivery system (= villages as implementing units instead of entire districts) • Although cases of schistosomiasis were frequently reported in oases, a systematic mapping of schistosomiasis was never done • The OMVS support will be available in year 2014 again; however only for MDA in the Senegal river basin

  21. Mauritania – Current situation and next steps • Schistosomiasis mapping in oasis • The mapping of all the oasis currently inhabited has been considered • (possibly 29 oasis?) • Schistosomiasis elimination • The specific ecosystem and the limited environment of an oases could make elimination of schistosomiasis feasible in some of these oasis • Proposals and Budgets • A proposal and budget for mapping of these oasis and for one treatment of the estimated affected population are under evaluation($USA 150 – 200K) • (This protocol includes also snail evaluation) • A proposal and a budget for elimination of schistosomiasis in oases is under development • SCI is currently looking for funds to support this project in Mauritania

  22. THANK YOU FOR YOUR ATTENTION AND YOUR SUPPORT

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