ISSUE NO. 13 | JULY TO DECEMBER 2020 Malaria and neglected tropical diseases WHO Western Pacific Regional Office Email: wpromvp@.who.int NTD News NEGLECTED TROPICAL DISEASES NEWSLETTER The Papua New Guinea National Department of Health (NDOH) began the first lymphatic filariasis (LF) transmission assessment survey (TAS) in the country, which determine whether the LF infections have been reduced below the target thresholds at which mosquitoes are unable to continue spreading the parasites from person to person and new infections are prevented, and thus MDA can stop, in New Ireland Province in December 2020. TAS training for the provincial team was held on 4 December 2020, facilitated by NDOH, WHO and Japan International Cooperation Agency (JICA), following which school-based TAS started. @ M ak ot o Se ki ha ra (J IC A) 2 Western Pacific Region Neglected Tropical Diseases Western Pacific Region Neglected Tropical Diseases 1 NEWS FROM MEMBER COUNTRIES American Samoa In September 2020, the US Centers for Disease Control (USCDC) and the Pacific Island Health Officers’ Association (PIHOA) led a virtual training to prepare the Department of Health to carry out an impact assessment following the second round of mass drug administration (MDA) using the triple drug therapy with a combination of ivermectin, diethylcarbamazine (DEC), and albendazole (IDA) against lymphatic filariasis (LF). During September-October 2020, the Department of Health conducted the impact assessment in eight villages known to have persistent LF transmission. During this time, 837 participants were enrolled to provide fingerstick blood samples to test for circulating filarial antigen (CFA) using the filariasis test strip. CFA positive individuals were asked to provide a second blood sample to test for microfilariae. Dried blood spots were also prepared for laboratory-based antibody testing. Data analysis is ongoing and results will be shared once finalized. Together with local health authorities (provincial, district and commune) and school teachers, the National Helminth Control Programme assessed the prevalence and intensity of soil-transmitted helminthiasis among school-aged children to monitor the impacts of semi-annual school deworming. The assessment was carried out in 12 primary schools of Siem Reap, Koh Kong, Kampong Speu, Prey Veng, Battambang and Kampong Thom provinces from August to September 2020. Cambodia The CL-SWASH (Community-led multi-sectorial plan to eliminate schistosomiasis and other parasitic and waterborne diseases) was implemented in six new schistosomiasis villages (four in Kratie province and two in Stung Treng province) in August 2020. The National Helminth Control Programme of the Ministry of Health coordinated the work, in collaboration with the Department of Rural Health of the Ministry of Rural Development, the Provincial Health Department, the Provincial Department of Rural Development, the Provincial Department of Education Youth and Sport, the District Office of Education Youth and Sport, the District Office of Rural Development, Health Centres, Operational Districts of Health and commune leaders. The National Helminth Control Programme, together with local health authorities and with the support of the University of Ghent, Belgium, conducted a survey to assess the efficacy of albendazole (400 mg) against soil- transmitted helminthiases in 914 school-aged children in Kampong Chhnang province in October 2020. Preserved stool samples were sent to the University of Ghent for further analysis to detect genetic markers related to anthelmintic resistance. Soil-transmitted helminth prevalence survey among school-aged children, Kampong Speu province, Cambodia, August-September 2020 Together with local health authorities (provincial, district and commune), the National Helminth Control Programme conducted a survey, using Kato-Katz, to detect Taenia spp. in stool samples in five provinces (Kratie, Stung Treng, Rattanakiri, Mondulkiri and Preah Vihear). Taenia spp. were found in 4.2% of the 1 316 participants. The prev- alence was the highest in Rattanakiri (10%) followed by Mondulkiri (9.3%). Survey on efficacy of albendazole among school-aged children in Kampong Chhnang province, Cambodia, October 2020 CL-SWASH activities in schistosomiasis-endemic villages, Kratie and Stung Treng provinces, Cambodia, August 2021 @ Vi ra k K hi eu @ Vi ra k K hi eu @ Vi ra k K hi eu 2 Western Pacific Region Neglected Tropical Diseases 3Western Pacific Region Neglected Tropical Diseases A trachoma survey refresher course for trachoma graders, recorders and research teams was held on 10 – 11 December 2020. The actual survey was not done owing to two severe tropical cyclones that hit Fiji in December 2020 and January 2021. It is now rescheduled for completion by May 2021. The National Helminth Control Programme provided training on the Kato-Katz stool examination technique for 45 laboratory technicians from the referral and district hospitals of five provinces (Kampong Chhnang, Pursat, Battambang, Banteay Meanchey and Oddor Meanchey) from 18 to 19 November 2020. Taenia spp. survey in five provinces of Cambodia, October 2020 Kato-Katz training for laboratory technicians at provincial and district referral Fiji MDA against LF using triple drug therapy (IDA1) was completed in Serua (Talenaua) and Malolo Islands in November 2020. LF MDA training for Eastern Division was organized in December 2020. MDA using triple drug therapy in Eastern Division (IDA1) is expected to commence in February 2021. MDA training in Lomaiviti, Eastern Division, Fiji, December 2020 French Polynesia The Ministry of Health implemented the LF MDA campaign using DEC and albendazole between October 2020 and January 2021, targeting two remaining implementation units, namely Huahine (an island in the Leeward archipelago) and South Marquesas. Treatment coverages of 91% and 83% respectively were reported. The protocol for management of patients with LF- associated morbidity was updated, with the introduction of ivermectin for individual case treatment. Kiribati The island-wide targeted deworming campaign was carried out with support of WHO. Preschool-aged children, school- aged children and women of childbearing age were treated in March and September respectively. Coverage of 29.70% and 5.14% of the target populations was achieved in each round. Implementation of the MDA campaign against trachoma continued between May and December 2020. Following the analysis of the 2019 impact assessment by WHO and Tropical Data, Kiribati will continue its second additional round of MDA in 2021. Lao People’s Democratic Republic A health education package on rabies prevention and control was developed to become part of the primary and secondary school teaching curriculum. Support was provided by WHO and the Global Alliance for Rabies Control. The package was finalised at the workshop on 14 and 15 July 2020, convened jointly by the Ministry of Education and Sport, the Ministry of Health and the Ministry of Agriculture and Forestry. Training on the integrated curriculum used the curriculum first developed in September 2020 for school principals and teachers from 40 schools (20 primary and 20 secondary) in Xayabouly province, which records the most rabies cases. The integrated curriculum will be used in these schools in 2020-2021, and the outcomes will be evaluated in early 2021 before expansion to other provinces. @ Vi ra k K hi eu @ Vi ra k K hi eu @ M O H , F iji 4 Western Pacific Region Neglected Tropical Diseases Western Pacific Region Neglected Tropical Diseases The National Strategic Plan on Rabies Prevention and Control in Lao PDR, 2020-2024 was finalized and endorsed in October 2020 by the Minister of Health and the Minister of Agriculture and Forestry. The meeting to disseminate the strategic plan was held on 21 and 22 December 2020 in Vientiane. It was chaired by the Deputy Director of the Communicable Diseases Control Department and attended by the Director, Deputy Director and technical staff from the Ministries of Health, Agriculture and Forestry, and Education and Sport. The NTD Annual Partners Meeting was convened in Vientiane from 14 to 15 December 2020 to share progress, challenges and lessons learnt in controlling priority NTDs, namely soil-transmitted helminthiasis, schistosomiasis and opisthorchiasis. The meeting was chaired by the Vice Minister of Health, Vice Minister of Education and Sport, and the WHO Representative and attended by representatives from both ministries at national and provincial levels. A World Rabies Day event to raise public awareness about rabies prevention and provide free dog vaccination was held in Vientiane Capital and Xayabouly province. The event was chaired by the Vice Minister of Health, Vice Minister of Agriculture, WHO Representative and FAO Representative in Lao PDR. It was held on 28 September 2020 in Vientiane Capital, and on 1 October 2020 in Xayabouly province. Participants at the training session on the integrated school curriculum on rabies prevention and control, Xayabouly province, Lao PDR, September 2020 Free dog vaccination, World Rabies Day, Vientiane Capital, Lao PDR 28 September 2020 (Credit: WHO) Malaysia Despite the COVID-19 pandemic, MDA using triple drug therapy for LF elimination was carried out in 20 hotspot localities in Sabah State (4 308 people) and 16 hotspot localities in Pahang State (2 528 people), and further hotspot localities in Perak State (1 862 people). The drug distribution modality was adapted to the new normal. Epidemiological coverage of above 90% of the eligible population was reported from all localities. Poster and flip book produced in July-August 2020 on rabies prevention and control for use in primary and secondary school curricula in Lao PDR NTD Annual Partners Meeting, Vientiane, Lao PDR, 14 - 15 December 2020 The annual MDA against schistosomiasis was carried out in all schistosomiasis-endemic communities in Champasak province in October 2020. Stool examination was carried out at seven sentinel sites and 12 spot check sites in September 2020 to monitor the impacts of interventions on the prevalence and intensity of the disease. @ M O H , L ao P D R @ M O H , L ao P D R @ M O H , L ao P D R @ W H O 4 Western Pacific Region Neglected Tropical Diseases 5Western Pacific Region Neglected Tropical Diseases The LF transmission assessment survey (TAS) overcame significant challenges arising from continuing school closures due the COVID-19 pandemic. The LF team in Sabah organized home visits to conduct the survey, while in Sarawak students were gathered at the community hall, keeping social distance and ensuring preventive measures against COVID-19. LF MDA campaign with triple drug therapy, using preventive measures against COVID-19 in Sarawak State, Malaysia, December 2020 LF TAS conducted at community halls owing to continuing school closures due to COVID-19 in Sarawak State, Malaysia, August 2020 Papua New Guinea The Papua New Guinea National Department of Health began the first LF transmission assessment survey in New Ireland Province in November 2020. A refresher training session on TAS for the national NTD team was held virtually on 28 October 2020. TAS training for the provincial team was held on 4 December, facilitated by NDOH, WHO and Japan International Cooperation Agency (JICA), following which school-based TAS started. The survey was interrupted before the end of 2020 and was to be resumed in February 2021. Philippines The National Filariasis Elimination Program (NFEP) continued its campaign in spite of the Covid-19 pandemic. The Department Circular for the Delivery of Routine Services under NFEP during the COVID-19 Pandemic and the Department Memorandum Interim Guidelines on the Delivery of Routine LF MDA under NFEP during the COVID-19 Pandemic were both issued to ensure safe and effective delivery of routine services amid the pandemic. Accordingly, scheduled activities such as community- based TAS, special surveys and MDA campaigns were carried out by the Filariasis Program. Kick-off ceremony at the Provincial Filaria MDA, Sultan Kudarat, Philippines 17 August 2020 LF TAS training for the provincial team, New Ireland Province, Papua New Guinea, 4 December 2020 @ M O H , M al ay si a @ M O H , M al ay si a @ D O H , P hi lip pi ne s @ M ak ot o Se ki ha ra (J IC A) 6 Western Pacific Region Neglected Tropical Diseases6 Western Pacific Region Neglected Tropical Diseases DOH Memorandum 2020-0260 (Interim Guidelines on Integrated Helminth Control Program and Schistosomiasis Control and Elimination Program during the COVID-19 Pandemic) and DOH Circular 2020-0302 (Delivery of Routine Deworming Services under the Integrated Helminth Control Program during the COVID-19 Pandemic) laid out options on how to conduct routine deworming for the July 2020 Deworming Campaign, using a fixed-post approach (barangay health centres, barangay outposts, private clinics and churches) along with outreach or home visit approaches. These strategies were discussed virtually with the regional implementers and various programme stakeholders on 26 May 2020. A two-day schistosomiasis multi-stakeholders virtual forum was held on 9-10 September 2020. The forum aimed to present, discuss and address ongoing issues and challenges, and identify current and future needs of the programme in achieving the target of transmission interruption by 2025. A total of 70 participants from national government agencies, non-government organizations, and academic institutions attended the forum along with international collaborators. The Provincial LF MDA kick-off ceremony was held on 17 August 2020, with the army’s 7th Infantry division participating. The ceremony was initiated by the Sultan Kudarat Provincial Health Office in partnership with the Department of Health of Soccsksargen. The event aimed to publicise the most cost-effective way to control and eliminate LF and to raise awareness of the MDA that would be conducted throughout the province of Sultan Kudarat from August 17, 2020 to September 17, 2020. The ensuing province-wide MDA achieved 84.9% coverage. The administrative order declaring November as Filariasis Mass Treatment Month was signed by the Secretary of Health in July 2020. In addition, an executive order was signed by the President of the Philippines in support of the administrative order, stipulating the different roles and responsibilities of government and attached agencies in the elimination campaign. Elimination strategies and activities were stepped up accordingly. The 2020 Filariasis Awareness Month theme was Sa Panahon ng Pandemya at Krisis, Tuloy-tuloy ang Serbisyo Kontra Filariasis which translates to “In Times of Pandemic and Crisis, Continuous Service Against Filariasis”. Endemic provinces developed their own IEC materials using local dialects and emphasizing the importance of participating in MDA and LF surveys, using mosquito nets, wearing long sleeves and trousers in endemic areas, and timely consulting with doctors in the health centres. Radio interviews and the Facebook pages of the local health office also helped to bring focus to the month-long November events. National and regional department of health: LF awareness campaign on Facebook, Philippines Virtual consultation on routine community deworming, Philippines, 26 May 2020 Schistosomiasis virtual forum, Philippines, 9-10 September 2020 @ D O H , P hi lip pi ne s @ D O H , P hi lip pi ne s @ D O H , P hi lip pi ne s 6 Western Pacific Region Neglected Tropical Diseases6 Western Pacific Region Neglected Tropical Diseases 7Western Pacific Region Neglected Tropical Diseases In order to align with Philippine Republic Act No. 11223 – Universal Health Care Act, the National Dengue Prevention and Control Program expanded its scope to become the National Aedes-borne Viral Diseases Prevention and Control Program (NAVDPCP) under Department Order No. 2020-0670, published on 9 November 2020, whereby the programme will address not only dengue but also chikungunya and Zika. Despite dengue being treated as an endemic infectious disease year-round, precautionary measures are still needed to make sure there are no surges in cases during the rainy season, especially during the COVID-19 pandemic. With this in mind, the Department of Health released Department Memorandum No. 2020-0357 on 18 August 2020 that spells out guidelines for dengue management such as (i) continuation of the advocacies and implementation of the Enhanced 4S strategies, (ii) intensification of vector surveillance activities, (iii) initiation of Integrated Vector Management; (iv) monitoring of possible cross-reactions between dengue and COVID-19 and (v) submission of reports to the NAVDPCP. The NAVDPCP, working with WHO, held a series of meetings to develop rapid advice guidelines. With the assistance of the DOH-Health Promotion Bureau, the programme finalized and published Rapid Advice Guidelines aimed at community and barangay health workers, containing key messages and guidelines on what to do and what to look out for when it comes to dengue. The materials were disseminated digitally to the regional coordinators for reference and to be sent on to their respective local government units. NAVDPCP held a virtual programme implementation review with regional coordinators on 9 December 2020 to discuss the current status of the programme in relation to fund utilization, the implementation plan for the new policies, and activities planned for 2021. Digital rapid advice guidelines for dengue prevention and control developed by the Department of Health in the Philippines National Aedes-borne Viral Diseases Prevention and Control Program, implementation review meeting, Philippines, 9 December 2020 Solomon Islands The Solomon Islands Ministry of Health and Social Welfare organized a training session on 19 and 20 November for skin NTD trainers. The purpose was to strengthen primary health care capacity in the diagnosis, treatment and reporting of the skin NTDs, yaws and scabies. The training was attended by provincial NTD focal points from all ten provinces and facilitated by external partners and experts, including the World Scabies Program led by the Murdoch Children’s Research Institute, and WHO. Training modules with job aids and flipbooks to assist primary health care workers were developed specifically for the Solomon Islands and printed for dissemination to all health facilities in the country. @ D O H , P hi lip pi ne s @ D O H , P hi lip pi ne s @ D O H , P hi lip pi ne s 8 Western Pacific Region Neglected Tropical Diseases8 Western Pacific Region Neglected Tropical Diseases Virtual training of skin NTD trainers, Solomon Islands, 19-20 November 2020 (left) and a Skin NTD flipbook for primary health care workers (right) Health education against NTDs and COVID-19, Sanma province (above) and Shefa province (below), Vanuatu. The Ministry of Health and Medical Services, in collaboration with the Ministry of Education and Human Resources and with support of WHO, set up a technical working group to lead the implementation of the school deworming programme in November 2020. A national training of trainers (TOT) for countrywide education authorities and school representatives is being planned, but as COVID-19 social distancing is still enforced in the country, it has been deferred. Tuvalu Tuvalu planned to implement the second round of LF MDA using triple drug therapy in the fourth quarter of 2020. However, disruption of international flights to Tuvalu delayed the shipment of medicines and the MDA campaign is still pending. Vanuatu The Ministry of Health held a provincial malaria and NTD training workshop in Torba province for provincial health officers and health care workers on 8-9 September 2020. The training covered global, regional and national updates, diagnosis, treatment, prevention and reporting on malaria and NTDs, and benefitted from WHO support. The national NTD programme team also met with staff from the provincial education office and livestock office to discuss working together to enhance health education on NTDs and malaria. The Ministry of Health carried out the second round of school deworming and screening for yaws and scabies nationwide between July and December 2020. During this period, 349 suspected yaws case were identified, nine of which were confirmed as active yaws infection by DPP test. Eight were from Shefa province, and one from Tafea. Also 1 104 suspected cases of scabies were found, with the highest number reported in Tafea province, followed by Shefa and Senma provinces. A total of 30 761 children aged 1 to 15 years were dewormed against STH nationwide. The Ministry of Health organized health education on NTDs and COVID-19 in five communities in Shefa and Sanma provinces from September to November 2020. This involved a 12-week programme with the community health workers explaining the transmission and prevention of NTDs and COVID-19, and reminding people of the importance of personal hygiene, particularly hand and face washing. They were also given deworming medicines, and screened for yaws and scabies. Each household actively participating received a donation of soap. @ Fa si ha h Ta le o @ W H O 8 Western Pacific Region Neglected Tropical Diseases8 Western Pacific Region Neglected Tropical Diseases 9Western Pacific Region Neglected Tropical Diseases 2 REGIONAL NEWS The Programme Managers Meeting to Accelerate Control and Elimination of Neglected Tropical Diseases in the Western Pacific Region was held virtually from 1 to 4 September 2020. Almost 80 participants from 18 countries in the Western Pacific Region attended, along with eight temporary advisers, 28 observers and representatives, and 16 members of the World Health Organization (WHO) Secretariat. The meeting provided a venue to foster sharing of achievements, experience, common trends and challenges among NTD programme managers from health ministries, catalyse discussion to identify innovative practices and options to effectively engage multisectors, stakeholders and communities and enhance delivery of essential and comprehensive NTD interventions across countries and areas in the Region and leverage further innovation to enhance various programmatic components and strengthen whole-of-system multisectoral approach for accelerating control and elimination of NTDs in the Region. The Programme Managers Meeting to Accelerate Control and Elimination of Neglected Tropical Diseases in the Western Pacific Region, virtual, 1 to 4 September 2020 @ W H O
ISSUE NO. 12 | JANUARY TO JUNE 2020 Malaria and neglected tropical diseases WHO Western Pacific Regional Office Email: wpromvp@.who.int NTD News NEGLECTED TROPICAL DISEASES NEWSLETTER Vanuatu integrated NTD interventions with COVID-19 community awareness campaigns and Tropical Cyclone and other disaster responses In March 2020, the Ministry of Health in Vanuatu mobilized all the public health programmes to focus on COVID- 19 community awareness activities. The national NTD programme joined the campaigns by integrating NTD activities such as yaws treatment, deworming and hand hygiene and face washing demonstration in NTD endemic communities in Port Vila municipality. Integration of NTD activities continues with the Tropical Cyclone Response in April-May 2020 and the Volcano Ash Fall Response in May 2020. 2 Western Pacific Region Neglected Tropical Diseases Western Pacific Region Neglected Tropical Diseases 1 NEWS FROM MEMBER COUNTRIES Cambodia The National Helminth Control Programme performed monitoring and evaluation surveys to assess the infection rate of schistosomiasis and soil-transmitted helminthiases in 30 sentinel and spot-check villages in Kratie and Stung Treng provinces from May to June 2020. This was done in collaboration with the Provincial Health Department, Health Operational Districts, health centres, village health volunteers and village chiefs in the endemic provinces. China Surveillance and public health control activities against schistosomiasis were held in the flooded provinces from June to August 2020. Anti-cercaria cream and leaflets on self-protection against schistosomiasis were distributed to the at-risk population. Warning signs were displayed in the areas of the water body where the risk of exposure to Schistosoma parasites was deemed to be high. They also conducted mass drug administration (MDA) and health education on schistosomiasis and soil-transmitted helminthiasis in all schistosomiasis-endemic villages in the two provinces over the same period. In June-August 2020, the National Institute of Parasitic Diseases (NIPD) in China Center for Disease Control and Prevention (CDC) joined with the Shanxi Provincial CDC in conducting visceral leishmaniasis vector (sandfly) surveillance in an endemic focus in Wuxiang county, Shanxi province. 5000 Phlebotomus chinensis sandflies, the major vector of visceral leishmaniasis in China, were collected. The surviving flies will be used in insectaria for further insecticide susceptibility testing. Schistosomiasis surveillance and control activities in the flooded provinces of China, June-August 2020 Collection of sandflies by light traps in the caves of Wuxiang county, Shanxi province (left) and gathering engorged Phlebotomus chinensis for colonies (right) Stool examination in schistosomiasis-endemic villages in Kratie and Stung Treng provinces, Cambodia, May-June 2020 MDA and health education in schistosomiasis-endemic villages in Kratie and Stung Treng provinces, Cambodia, May-June 2020 @ Vi ra k Kh ie u @ Vi ra k Kh ie u © N IP D © N IP D 2 Western Pacific Region Neglected Tropical Diseases 3Western Pacific Region Neglected Tropical Diseases To celebrate the milestone of 20 years of work by the Regional Network for Asian Schistosomiasis and other Helminthic Zoonoses (RNAS+), a special issue of the Advances in Parasitology was published. RNAS+ was established in 1998 in Wuxi City, China, and now has a membership of 12 Asian countries. The special issue reviewed the journey from the very beginning of the network to its recent development, with a focus on its translational research, capacity building activities, multi- disciplinary collaboration, and the impact in research and control programmes. It also proposed a research agenda to fill the current gaps and to address challenges. @National Institute for Communicable Disease Control and Prevention The National Meeting on Vector Surveillance and Control held virtually, 29 June 2020 ©National Institute for Communicable Disease Control and Prevention A special issue for the 20th anniversary of RNAS+ published in 2020 On 29 June 2020, the National Meeting on Vector Surveillance and Control was held virtually. Over 4000 participants from the National Health Commission, China CDC, and provincial, city and county CDCs attended. The meeting summarized the national progress of vector control in 2019, briefed on vector surveillance and control efforts in 2020, analysed the epidemic trends of vector-borne diseases and shared vector surveillance experience among institutions within China. Lymphatic filariasis mass drug administration campaign in Malolo Islands, West- ern Division, Fiji, July-August 2020 Outreach test and treat activities for lymphatic filariasis elimination in the coastal Talenaua village facing Serua Island in the Central Division, Fiji, 14 February 2020 Fiji The Fiji Ministry of Health and Medical Services implemented its LF MDA campaign using the triple drug therapy in Serua island in Central Division on 13 February 2020. Testing and treating in the adjacent Talenaua villages on the mainland took place on 14 February 2020. Treatment coverages were 96% and 90% respectively. An MDA campaign in Malolo island in Western Division was also implemented in July and August 2020, for which treatment coverage data is awaited. @ M OH M S, Fi ji @ M OH M S, Fi ji 4 Western Pacific Region Neglected Tropical Diseases Western Pacific Region Neglected Tropical Diseases The trachoma baseline survey recommenced in February 2020 after being interrupted by the measles outbreak, but it was brought to a halt once again by the COVID-19 pandemic after the completion of the survey in Eastern Division. The survey in other Divisions will start in October 2020. Kiribati The Kiribati Ministry of Health developed a national trachoma action plan in February 2020 and started the third round of the nationwide MDA campaign against trachoma in May 2020, with support from the Fred Hollows Foundation Australia and WHO. The MDA campaign covering all the outer islands should be completed in October 2020. National Competition for Parasitic Disease Control and Prevention Techniques, Jilin, China, 21-22 August 2019 The national meeting to finalize the national strategic plan for rabies prevention and control 2020-2024, Vientiane, Lao PDR, 27-29 May 2020 A refresher course on school deworming for health and education staff at the provincial and district levels, Vientiane, Lao PDR, 8 to 10 June 2020, Lao People’s Democratic Republic On 5 May 2020, the Centre for Malariology, Parasitology and Entomology (CMPE) organized a meeting to finalize the dengue vector surveillance and control guideline for central, provincial, district and village levels. The guideline was approved by the Director of CMPE and disseminated across the country. The Ministry of Health held a national meeting in Vientiane from 27 to 29 May 2020 to finalize the national strategic plan for rabies prevention and control 2020-2024, and to establish the national Rabies Committee and Taskforce. The meeting was attended by the key stakeholders from the Ministry of Health, the Ministry of Agriculture and Forestry, the Ministry of Education and Sport and the Ministry of Defence. A refresher training course on school deworming for health and education staff at the provincial and district levels was conducted from 8 to 10 June 2020, followed by a course for school principals from 15 to 19 June 2020 in Vientiane. Both sessions were facilitated by the central team from the Ministry of Health and the Ministry of Edu- cation and Sport. The school deworming campaign was carried out across the country from 15 to 26 June 2020. Adverse events occurred in two provinces where 129 out of 7376 school- age children dewormed (1.7%) were admitted to hospital. Most of the children with adverse events were aged between 11 and 15 (lower secondary school) and nearly 90% of them were female. There was one severe case which is still being treated in hospital. In response to this, the Ministry of Health (i) conducted a press conference to explain the situation to the public immediately; (ii) temporarily interrupted the nationwide deworming campaign; (iii) investigated all cases admitted to hospitals; (iv) collected medicines from all levels of the supply chain in the country for quality testing using the WHO protocol; and (v) submitted the samples of medicines for drug 4 Western Pacific Region Neglected Tropical Diseases 5Western Pacific Region Neglected Tropical Diseases field survey was carried out in three selected soums of Bayankhongor province to determine the infection rate in dogs: 345 samples of dog faeces were collected, and 276 dog owner questionnaires were completed. Currently, the project team is preparing training for parasitologists of each of the 21 provinces’ veterinary departments and centres for zoonotic disease, to create a nationwide surveillance network and identify the definitive host of Echinococcus spp. Creating a surveillance network and training skilled workers for detection is considered vital for the implementation of the Action Plan. Nauru Following the results of a national trachoma prevalence survey carried out in July 2019, which confirmed the endemicity of trachoma in the country and determined the need for at least one round of MDA for trachoma elimination, the Ministry of Health in Nauru conducted microplanning for a trachoma MDA campaign in January 2020, and carried out a training workshop virtually in May 2020, facilitated by the Fred Hollows Foundation Australia and WHO. This was immediately followed by implementation of a nationwide MDA campaign in May- July 2020. Treatment coverage of 81% was achieved. Impact assessment is planned in January-March 2021. The press conference on adverse events associated with the nationwide deworming campaign, Vientiane, Lao PDR, on 25 June 2020 quality testing at a WHO-accredited laboratory in Australia. The results are awaited. Mongolia Every year around 7000 people receive the post-exposure rabies vaccine after a bite or scratch by a suspected rabid animal. In January-June 2020, 3719 people had received post-exposure rabies vaccine. According to the report of the National Center for Zoonotic Diseases (NCZD) under the Ministry of Health Mongolia, 75 suspected animal rabies cases have been identified from 42 soums within Arkhangai, Bayan-Ulgii, Bayankhongor, Dornogovi, Dundgovi, Govi-Altai, Khentii, Khovd, Umnugovi, Sukhbaatar and Uvs provinces. This represents a drop of 29.9% from the previous year’s levels. Pre-exposure and post-exposure vaccination activities are improving. No human rabies cases have been reported since 2013. Cystic echinococcosis (CE) is most common in poor pastoral communities, being highly endemic in most areas of Mongolia where it is a major health burden, especially to the nomadic communities. In the last few years greater efforts have been made to control echinococcosis in Mongolia. In October 2018, the NCZD, with the support of WHO, organized a multi-sectoral workshop to develop the National Action Plan for Control of Echinococcosis in Mongolia. Following the workshop, in 2019, a cross- sectoral Action Plan for the control of CE in Mongolia was elaborated. Responding to the Action Plan, quarterly deworming of dogs with praziquantel was approved by the Director General of the Veterinary Services in 2020, and so far, 344 300 pet dogs have been treated. Prior to this, a total of 1977 children aged 6-18 were examined by ultrasound in the three soums of Bayankhongor province, and doctors and veterinarians from that province were trained in the prevention and diagnosis of communicable diseases in October 2019. The screening identified eight cases of hydatid echinococcosis. In the same month, a @MOH Nauru rachoma MDA campaign reaching work places, Nauru, May-July 2020 © M OH , L ao 6 Western Pacific Region Neglected Tropical Diseases6 Western Pacific Region Neglected Tropical Diseases Philippines The Integrated Helminth Control Program (IHCP) of the Department of Health (DOH) made a series of monitoring visits to selected schools in Central Luzon and National Capital Region during the school deworming campaign in January 2020. This was primarily done to assess the im- plementation of MDA in schools, identify best practices, issues and challenges, and provide support and action to address them. One of the recommendations to emerge from the three-week visit concerned the need for health promotion and education to correct misconceptions and provide information to parents and children, which will eventually help to widen the MDA coverage. Teaching schoolchildren about deworming, Caloocan High School, Caloocan City, Philippines, 5 February 2020 The Global NTD Day celebration in Efate island, Shefa province, Vanuatu, 23 January 2020 The COVID-19 pandemic affected most programme activities. Nonetheless, in Department Circular 2020- 0167: Continuous Provision of Health Services during the COVID-19 Epidemic the DOH firmly stated the importance of maintaining essential health services during the crisis. In response, the DOH, through the IHCP and Schistosomiasis Control and Elimination Program (SCEP), issued guidance on the implementation of routine deworming services during the COVID-19 pandemic in accordance with the minimum public health standards. It emphasized that despite postponement of mass gatherings, delivery of routine deworming services would continue through the fixed post (facility-based) or house-to-house approaches, following appropriate Infection Prevention Control (IPC) measures. In addition, critical interventions, such as (a) prompt diagnosis, treatment and care of patients with NTDs presenting at healthcare facilities, and (b) essential vector control measures should continue wherever possible. Vanuatu On 23 January 2020, the Ministry of Health Vanuatu celebrated the first ever Global NTD Day in selected communities in Efate island, Shefa province. The events included hygiene awareness by a livestock officer, demonstration of handwashing and distribution of soap for communities. The Ministry of Health organized the three-day national NTD training workshop from 18 to 20 February 2020. Over 60 participants from provincial health departments, local NGOs and UNICEF participated and learnt about detection, treatment and response to NTDs in Vanuatu. This was followed by a three-day health zone workshop in Shefa province, Zone 1, in 5-6 March 2020. © Pa ol a A lp ay @ Fa sih ah Ta le o 6 Western Pacific Region Neglected Tropical Diseases6 Western Pacific Region Neglected Tropical Diseases 7Western Pacific Region Neglected Tropical Diseases In March 2020, the Ministry of Health mobilized all the public health programmes to focus on COVID- 19 community awareness activities. The national NTD programme joined the public health team and integrated NTD activities into the COVID-19 awareness campaign in Port Vila municipality by supplying over 4000 posters on face and hand washing along with hand washing demonstration tools, and carrying out deworming and yaws treatment within selected NTD-endemic communities. The three-day national NTD training workshop in Port Villa, Vanuatu 18-20 February 2020 COVID- 19 community awareness activities integrated with NTD community outreach activities in Port Vila, Vanuatu, March 2020 The three-day health zone workshop in Zone 1 of Shefa province, Vanuatu, 5-6 March 2020 On 3 April 2020, tropical cyclone Harold hit Vanuatu. In April and May 2020, the national NTD programme integrated deworming, NTD screening (for yaws and scabies), and bednet distribution in the Tropical Cyclone Harold Response in the hardest hit provinces, namely Malampa, Sanma and Penama. Tropical Cyclone Harold Response integrating NTD activities in Senma Province, Vanuatu, April-May 2020 @ Fa sih ah Ta le o @ Fa sih ah Ta le o @ Fa sih ah Ta le o @ Fa sih ah Ta le o 8 Western Pacific Region Neglected Tropical Diseases8 Western Pacific Region Neglected Tropical Diseases Deworming and yaws and scabies screening integrated with measle vaccination and disaster response activities against volcano ash fall in Tanna Island, Tafea Province, Vanuatu, May 2020 Deworming against soil-transmitted helminthiases and yaws and scabies screen- ing in schools in Efate island, Shefa province, June 2020 In May 2020, a volcano ash fall brought disaster to Tanna island, Tafea Province. The national NTD programme integrated deworming, NTD screening (for yaws and scabies) and a measle vaccination campaign into the disaster response activities. In all, 12 mobile teams were mobilized throughout Tanna island for the integrated campaign. Between February and April 2020, Tanna reported more than 400 suspected scabies cases through the national health information system. In June 2020, three mobile teams were mobilized to carry out deworming against soil-transmitted helminthiases, and yaws and scabies screening at communities and schools in Efate island, Shefa province. On 17 June 2020, a training course to launch the Health Promoting Schools (HPS) was conducted in Norsup in Malekula island, Malampa province. 21 schools were selected to pilot the HPS in Malampa. From 20 to 23 July 2020, practical sessions were conducted within the selected four schools and implementation of deworming by school teachers was integrated in the HPS pilot. @ Fa sih ah Ta le o @ Fa sih ah Ta le o 8 Western Pacific Region Neglected Tropical Diseases8 Western Pacific Region Neglected Tropical Diseases 9Western Pacific Region Neglected Tropical Diseases