Second meeting of the National Onchocerciasis Task Forces (NOTFs) representatives, Abuja, 17-22 June 2002: extract from TCC14 on ultimate treatment objective (UTO), annual treatment objective (ATO)

African Programme for Onchocerciasis Control (APOC) Programme Africain de lutte contre I'Onchocercose National Onchocerciasis Task Force (NOTFs) of Nigeria Second meeting of the National Onchocerciasis Task Forces (NOTFs) Representatives, Abuja, 17-22 June 2002 EXTRACT FROM TCCL4 ON ULTIMATE TREATMENT OBJECTIVE (uTG), ANNUAL TREATMENT OBJECTTVE (ATO) ETC. DIR/APOC 04106/02 eeg l rt Other matters (agenda item 22) (iii) rg6. Dr F Richards gave the TCC a presentation on the use of the annual treatment objective (ATo) and ultimate trfatment goal (UiG) in Carter Center assisted projects in Africa and the Arnericus. He pointed to the utitity of the ATO as a management tool, being the one fixed and accountable number used at all level for the ordering of ivermectin by each project from the Mectizan Donation programme (MDP). TCC agreed that it would monitor ATOs, comparing corresponding data from MDP, more closely for APOC projects. lg7. TCC requested the representative of MDP to bring.to the next TCC meetings information about 2003 ATOs to enable the committee to see if the increase in treatments projected in the programme Document for Phase tI and the Phasing out period is taking place. lgg. TCC reaffrrmed five key indices (listed below) and noted the fundamental importance of the total population to calculating any of these indices. Total population figures must be accurate and based on REMO findings i'nd tensus data from known or suspccted meso/h1?er-cndemic communities. TCC also reafirrmed key indices of therapeutic covcrage (based on total population) ;il il;;phic coverage (based on the number of communities that must ultimately be rbached with CDTI in the Projec$. fg9. TCC recommended that the following indices be rcported in future reports: (l)Totalpopulation:thetotalpopult!9n-]ivinginmeso/h1per-cndemiccommunitics *itt 6ffi.-p area (based on REMO and census taking)' (ii)Eligiblepopulatiqn:calculatedasSf%oofthetotalpopulationinmeso/hyper- endemic communities in the project area' Annual Treatment Objective: (ATO):-the estimated number of persons living in meso/h1per-.nd.ri.iilr-th"t a CDTI project intends to treat with ivermectin in a $ven year. (iv)UltimateTrcatmenlGoal(UTG.|:calculatedasthemaximumnumberofpeopleto , b" t "u@ endemic areas within the project area, ultimately ,o u" r.""n"A *rUJn tir" pt"6ihas reached full gcographic coye-rasllnormally thepr"jJ;i;ia Ue cxpectd ; reach the UTG at the cnd of the 3- vear of the Project). (v)Therapeuticcovqraeg:..numbcrofpeopletreatedinagivenyearoverthetotal @ bc expressed as a percentage). (vi) Geosraphic coverage: numbcr of communities treated in a given year over the total nu*ufoffi.-*myp.r-endemic communities as identified by REMo in the proiect . area (this should be expressed as a percentage)' 190. TCC noted that it was important that population figures be accurate' based on REMO findings and or ".nr* taking. tcc therefor.'r..o*.nded that all projects should complete registration (census) of all ,iUogr, .na f.rtons. in meso/hyper-endlmic. zon:: within' their respective areas. ero;""t, ,"uchiig full geographical coveragl- must complete this exercise by December 2002. Th; i.tutt. of this ixercis" should be made available to TCC' I OTHER MATTERS (agenda item 22) 186. Dr F Richards gave the TCC a presentation on the use of the annual treatment objective (ATO) and ultimate treatment goal (UTG) in Carter Center assisted projects in Africa and the Americas. He pointed to the utility of the ATO as a management tool, being the one fixed and accountable number used at all level for the ordering of ivermectin by each project from the Mectizan Donation Programme (MDP). TCC agreed that it would monitor ATOs, comparing corresponding data from MDP, more closely for APOC projects. 187. TCC requested the representative of MDP to bring to the next TCC meetings information about 2003 ATOs to enable the committee to see if the increase in treatments projected in the Programme Document for Phase II and the Phasing out period is taking place. 188. TCC reaffirmed five key indices (listed below) and noted the fundamental importance of the total population to calculating any of these indices. Total population figures must be accurate and based on REMO findings and census data from known or suspected meso/hyper- endemic communities. TCC also reaffirmed key indices of therapeutic coverage (based on total population) and geographic coverage (based on the number of communities that must ultimately be reached with CDTI in the project). 189. TCC recommended that the following indices be reported in future reports: (i) Total population: the total population living in meso/hyper-endemic communities within the project area (based on REMO and census taking). (ii) Eligible population: calculated as 84o/o of the total population in meso/hyper- endemic communities in the project area. (iii) Annual Treatment Objective: (ATO): the estimated number of persons living in meso/hyper-endemic areas that a CDTI project intends to treat with ivermectin in a given year. (iu) Ultimate Treatment Goal (UTG): calculated as the maximum number of people to be treated annually in meso/hyper endemic areas within the project area, ultimately to be reached when the project has reached full geographic coverage (normally the project should be expected to reach the UTG at the end of the 3'd year ofthe project). (v) Therapeutic coverage: number of people treated in a given year over the total population (this should be expressed as a percentage). (vi) Geographic coverage: number of communities treated in a given year over the total number of meso/hyper-endemic communities as identified by REMO in the project area (this should be expressed as a percentage). 190. TCC noted that it was important that population figures be accurate, based on REMO findings and or census taking. TCC therefore recommended that all projects should complete registration (census) of all villages and persons in meso/hyper-endemic zones within their respective areas. Projects reaching full geographical coverage must complete this exercise by December 2002.The results of this exercise should be made available to TCC.