Progress report: January - March 1975

(@) .r"41\ a.'...-6),\-.\.-lwoata nmrlw ocP /PRl75.L ORTGINAI: ENGLISH ONCTIOCERCIASI S CONTROL PBOGRAUME N IIIE VOLTA RTVER BASIN AREA Progress Report. Januarv - l,[arch 1975 The Onchocerciasls Control Prograrme in the Volta River Basi-n area is planned as a collaboratlve undertaking betrileen the Participating Governoents of Dahomey, Ghana, IvoryCoaet, Ma1L, Niger, Togo and Upper Volta, to ie cairied out with the assisiarrce oi rg.rrti."l of the United Nations system and the support of the international comrunity. The main activities of the Progranrme for 1975 are the continuat,lon of vector control oPerations in the Phase I area, and technical, logistic and adilinistrative preparations for extengi.on of the area of treatment to include Phase II (the White Volta and its tributaries and the River Uaka); initial steps will also be taken to set up the infrastructure for the entouologi.cal surveillance netrrork for Phase III which covers the entire Programe area. An evaluatl.on of the result.s of insect.icide t,reatment and the efficacy of the entomblogical surveillance netlsork will be undertaken in the lat,ter part of the year. Similarly, the suitability of the type of ai-rcraft used for aerial spraying will be revi.ewed beforepreparation of the second international tender for the aerial spraying contract conrmencing inL975. ThG Econooic Development Unit will be established. Epidemiological lnvest,igations will eo,'rneuce in the Phase I area and work will be extended to Phase II in late L975; the second uoblle epideoiological evaluation teamwill be fielded. Training activities, limitedin L974 to entomological and administrative personnel, will be extended to include hydro-biological, medical and paramedical personnel. Construction of the building to house Progra'nme X,eadguarters in Ouagadougou will begin. The Programe is carried out by WIIO as Executing Agency with FAO as Associate Agency. The Programe lleadquarters located at, Ouagadougou under the auLhorlty of the Prograr*eDirector comprises Vector Cont,rol, Epidemiology and Economi.c Developrment Units supported byAdminlstrative Services. Ihis Africa Intercountry Progranrme is backed by a Special Unit in WIIO headquarters. A number of WIIO and FAO staff members also contribute to the activities of the Programe. (The presentation of the quarterly Progress report,s follows the order of the main budget, headings folLowed by the activities financed under the IINDP project number R.^F174/OO4.) A. PROGPJ|UME HEADQUARTERS 1. Activities during the quarter were concentrat,ed on the vector control operations, the setting up of the radiocorrnunicatj.ons network, and the preparation of the contract for the const,ranction of Prograarne lleadquarters. The first epidemiologieal evaluation team becaoe operational in February and began surveys in Upper Volta. The remaining vacant post, in theAdministrative Services Unit was filled and, with the exception of the Economic DevelopmentUnit the Programe is'now fully operational. -_- ' Th'" Urrited Nations Development Progranrae, the Food and Agriculture Organization of theUnited Nations, the World Bank and the World llealth Organization. 2. Aerial spraying acEivities were interrupted from 3 January to 10 February following accidents to the fixed-wing aircraft and helicopter. Spraying resumed on 11 February throughout the Phase I area, with the exception of Mali where oPerations, which had been suspended since end November 1974 due to overflight restrictions, resumed on 18 March. 3. By 28 March seven weeks of spraying had been completed and control results are verypromising. Treatments were carrj-ed out on the River Banifing and its tributaries as well as the Black Volta, Comots-L6raba, the Bandama and their t,ributaries. Three helicopters and one aircraft are now operational in the Prograrune area. The improvement in coumunications following the establishment of the radiocomnunications network has considerably facilitated the work of the Vector Control Unit. (a) office of the Prograuure Director 4. The Prograrmne Director was received by the President, of the Republic of Upper Volta on several occasi.ons and meet,ings took place with high level Government officials in Upper Volta regarding Progranme acti-vities and settlement of the onchocerciasis-freed zones. 5. The Independent Chair:rran of the JCC, Dr M. G" Candau, visited the Programme on 7 and 8 January and had discussions with staff in Ouagadougou and Bobo Dioulasso. 6. The Programre DirecLor and the Chief of the Vector Control Operations parEicipated in the First Session of the Joint Coordinating Cournittee held in Abidjan on 11-12 February and opened by H.E. the President of the Republic of Ivory Coast,l and the Twelfth Session of the Steering Connrittee also held in Abidjan" Meetings took pLace with staff from WIIO headquarters in Abldjan, and subsequently in Ouagadougou and Bobo Dioulasso, when adninisErative and operational matters were reviewed, solutions to various technical problems discussed and ways of improving liaison and coordination generally rrere considered. 7 " From 23 February to 5 March the Prograrmre was visiEed by two members of the Ecological Panel who paid particular attention to the aquat,ic moni-toring aspects of the Prograrune and the collection and storage of relevant data. 8. The Executive Director of the Ghana National Onchocerciasis Counrittee, accompanied by a socioeconomist, visited the Progranrne from 18-25 March. During their visit to the Prograune area they vritnessed larviciding operat,ions on the lower Como'd and the Black Volta (Samand6ni). 9. At the end of March four members of the Scientific and Technical Advisory Co{mittee arrived in the Prograrmre area to cofl!trence a visit lasting approximately one week. During this period they will review Ehe different aspects of the work of the Prograrune, and report to the Organizatior. on their observations. 10" Contact was maintained with representatives of the other sponsoring agenci-es in the seven participating countries. 1l-. Authorization was received from the Government of Mali for spraying operatioos to be resumed, however, it is at present necessary to use Korhogo (lvory Coast) as embarkaLion- disembarkation point, with a resultant increase in operating costs. 12. An approach was made to the Government of Ghana regarding payment of the rerr,ainder of their contribution to the Onchocerciasis Control Progranrne (2OO OO0 cedis in all). The init,ial paymenL is being used to cover the costs of construction of the Bole and Yendi Sub- Sect,or offices; it is planned that the remainder should be used to finance the construction of the Sector and Sub-Sector complex at Tamale. 13. In accordance with Section I of the Ivory Coast Country Prot,ocol, notification $ras received from the Government of its inEention to deposiE into a WIIO account the salaries of personnel detached from the Government and employed by the Prograrure. oc? /PRl75.L Page 3 L4. Delays have occurred in customs clearance of supplies received in Bobo Dioulasso, and,in particular, matssial destined for the aircraft, such as spare parts. In most instances it has been necessary t,o request the intervention of the Director of Customs in ouagadougou.Since delays are already experienced in the receipt of such ^terial, due to irregulai airfreight services between Europe and the Progrannne area, additional hold-ups could seriously affect the continuity of the aerial operations. 15. Similarly, problems have been encountered wtren vehicles carrying equipment and fuel crossthe border into Upper VoLta from lvory Coast and Ghana. On occasion it has proved necessaryto request the intervention of the Director of Customs to obtain their release. 16. Discussions with national officials revealed that the question of the economic develop,ment of the zones to be freed of onchoceriasis requires further clarification. Matters presently causi.ng concern to the Governments are coordination among the sponsoring agencies, the danger of unnecessary duplication in development projects, and the procedure for project, planning. L7. A technical assistant was engaged to look after docuaentation and is in the process of asseobling and classifying material concerning all aspects of the dj.sease and its iontrol andall documentation concerning the Prograruue. The post of administrative officer attached tothe Directorrs office was filled and the incumbent will report for duty during the secondquarter of L975. 18. Iqfomalion Officer: A news bulletin on Progra e activities, trOncho Flashr is nowprepared oonthly and issued t,o National onchocerciasis cornnittees. 19. In collaboration with the national authorities and loca1 infonoation media in IvoryGoast, the Information Officer arranged for coverage of the First Session of the JointCoordinating Gornmittee including Mnterviews, radio broadcasts and press releases. 20. Televisi.on te4ms from Japan and Germany visited the prograrnne area and had di.scussionswith staff on the disease and the control operations. 2L. During the period under review the Information Officer visited Togo, Dahomey and Ghanato establish contact with Government officials, national infor^uation services and AgencyrePresentatives. In Togo discussions took place with the President of the NationalOnchocerciasis Conrmit,tee and the Director-General of the Ministry of Information. IE wasagreed not to undertake i.ntensive Press aetivities in Togo until a few months before the startof control operations, scheduled for November 1976. the President of the Noc proposed thatthe Ministry of rnfomation should be represented on the comit,tee. 22. As a result of a meeting with the Mioister of llealth of Dahomey, it is planned that anofficial from that Ministry should visit the Programe area. ftre suigesti.on was made, and watmly received, that prior to the start of control operations in Oahonrey a special onchocerciasis rnfomation Week should take place featuring Lectures, radio ti1ks, film shows,photographlc exhibitions, etc. The question of costs was considered. rt was pointed outthat little exPense was involved and it was agreed that, further information would be providedto the Governnent. As in Togo the Minister of Information wiit be invited to send arepresentative to the National onchocerciasis conrmittee. 23. In Accra contact was rnade with the Director of the Information Servi.ces Department whoindicated his willlngness to assist when necessary and ntro appoinEed one of his AssistantDirectors as Liaison Officer for direct contact. The rnformation officer of the FAo RegionalOffice expressed interest in visiting the programne area. 24. From discussions in all three countries i.t rilas apparent that there is considerableinterest in the Programe, and a desire to collaborate. It was also evident that there was aneed for wider diffusion of information. Consideration will be given to the holding of anOnchocerciasis rnformation Week in each of the participating counfri.es. ocP/PR/7s.1 paSe 4 25. Visits will shortly be made by the Information Officer to the other participating countries. (b) AdminisErative Services Unit 26. Notable developments during the period under review were the approval of the avant projet for the construction of the Prograrmne lleadquarters building in Ouagadougou by ASECNA;1 the inst,allation of the radiocorrnunications network linking Bobo Dioulasso, Sikasso, Korhogo, Bondoukou, Dabakala, Tamale, Bo1e, and Ouagadougou; the pre-selection and medical examinat,ion of personnel for the Sub-Sectors of Bolgatanga, Yendi and Tarnale, and initiation of training courses for typists and drivers. Ln addition five professional posts were filIed in the Epideniological and Administrative Units and over 8O General Service staff were recruitedl 66 candidates were interviewed 1n Ghana (Bolgatanga and Yendi) for posts of drivers, vector collectors and laboratory auxiliaries in the Sectors and Sub-Sectors, of whom 23 were selected to undergo a medical examination. Final selection will be made in consultation with Sector and Sub-Sector chiefs. 27. Staff from the Administrative Services Unit travelled throughout the Phase I and Phase II areaa in connexion with recruitment of staff, briefing of sector personnel, procurement of suppli.es, and financial controls. 28. Government clearance has now been obLained for all Evergreen equipment and personnel to operate in countries covered by Phase I operations. 29. ?ersonnel: Dr C. Pairault, Sociologist, and Dr A. Prost, Medlcal Officer (ParasitologisL) were appointed to the Epidemiological Eval-uation Unit on 1 January 1975 and 15 January 1975, respectivel-y. 30. Mr G. Kux, Personnel Officer, joined the Prograrmne oa 27 January 1975 after his briefing in headquarters and AFR0. Following the arrival of Mr J. Creasor on 24 February 1975 to fill the post of Budget and Finance Officer, Mr F. Geusebroek, Finance Officer from WIIO headquarters who had assured these functions left Ouagadougou on 17 March 1975. Mr J. Donald, also from Finance Section headquarters, visiEed Ouagadougou from Ll-26 March to assist in briefing Mr Creasor. 31. Dr I. ?ons arrived on 1 March 1975 to assume his duties as Public Health Officer. 32. The staffing position as of 31 March 1975 is as follorvs: (i) Professional staff No. of positions authorized to date No. tt It f i11ed rr rr No. tr rr for which candidates have been nominated or selected (ii) General Service No. of positions authorized t,o daEe No. t, rr f illed l' il 255 33. Training for typists began on 10 March for six ParticiPants divided into two groups of three trainees" Each group received three hours of training Per week. The instructor is a Peace Corps Volunteer. 31 24 297 1 nsncue, Dakar, S6n6ga1. Agence pour la S6curit6 de la Na.rigat.ion a6rienne en Afrique et i Madagascar, ocP/PR/75.1 Page 5 34. A training course for drivers began on 17 March at the Training Centre of the Ministryof Public Works in ouagadougou. A group of three drj-vers recelved iraining for half a dayevery day over a period of two weeks. A second group will begin on 1 Apr:.l 1975. Thecourse consists of the teaching of the highway code, basi" r.piirs, maintenance, and drivingpractice. 35. Twenty-eight applications were received from local staff for English lessons. Thisnuober includes 13 individuals classified as beginners. courses are planned to begin in April. 36....SupPlies- and eqtliPnenl: The Supply unit is now fu1ly staffed and individual responei-bllitles have been redefined. A review of all material rlceived by the progranrme is at,Present ln process- A system for frequent physical inspection of inventories in the Sectorsis being developed. A list of Land Rover p"its has beln prepared wtrich takes into considerat,ionincreased sPare part needs. A vehicle 1og book, providing for the recording of daily trips,rnaterial carried and maintenance effected has betn-prepared. 37. An order was placed for the remaining quantity of insecticide (7o 0oo litres) requiredfor the 1975 operations. 38. Dlrrlng the quarter a total of L4 shipnents were received and cleared through customs,excluding Daterial destined for Evergreen helicopters. Report forms have been distributedto Sectors to facilltate monthly reporting on supplies and vehicles (gasolene consuuption,mileage, general coriditions, etc.). 39: .Budget and.fingnce: Considerable effort was put into the submission of the first yearend closure for the Proglame. Enormous difficulties nere encountered, because of thedistances involved and lack of comunications, in obtaining the required certlficates fromutility companles, banks, imprest holders, eic. Iwo 1oca11y uased insurance companies havebeen approached regarding the insurance oi cash in safe and Lash in transit. afi. lJH,o internal auditors visited the Prograrme during March and most of thelr time was spentreviewing financial controls and procedures. Several suggestions rcere msde and their visltie considered to be of considerable help to the administration. 4L. Installations: (i) Ouagadougou: Modifications to the interior of the villa to beoccupiF6ffi!!fr Finance-iiffiEpiderniological Evaluarion/puulic tlealr,h unir werecoopleted and the Units were i.nstalLed. A contract was signed to recondition the buildinglocated on the ProPerty acquired for the Progranme Headquariers; this building wi1l. serve asa Pernanent office-examinat'ion facility for the Epidemlological Evaluati.on Unit. otherexisting Etructures (excluding the garage) on this propertt have been demolished and the propertycleared for constructi.on. A calL for tenders waa sent to three contractors for modificatlon ofthe garage. 42. An Agreement, was signed between oCP and ASECNA whereby ASECNA is charged with theresponsibllity of conducting the architectural studies, preparing the documents for the callof blds, aesisting in contractuaL preparations and supervision oi the construction work forthe lleadquarters building ln Ouagadougou. Ihe avant proJet was recelved fron ASECI.IA and aPProved. 43. (ii) sectors: Bids were received and the contractors selected for the construction ofthe Sector offit Tarnale and the sub-sector offices at Tamale and Bole (ctrana).-- il;-Government of Ghana, through the offices of the Regional corunissioner, will sign the contracts.The construction of a hangar workshop-warehouse at Taur,ale Airport is ilanned. Sub-Sectorofflces have been located at Leo and Tenkodogo. B. VECTOR CONTROL OPERATTONS (a) Aerial operations l+4, Personnel: In January Evergreen Helj-copters Inc. appoi.nted captain L. price as ChiefPilot @A Major M. R: Purvis who resigned his appointment towards the end of ocP/PR/75.1 page 6 December 1974. Other staff assigned by Evergreen llelicoPters are four pilots (three helicopter pilots and one fixed-wing pilot) and two engineers. Ihe Chief Pilot is qualified as reeerve for either type of aircraft. 45. Aircraft: Three Bell 2068 helicopters and one Turbo-Porter fixed-wing aeroplane are now area. The original Turbo-Porter which was destroyed in a craehoperational in the Prograrnrne on 5 January, was replaced on 2O March. Equipment required for insecticide applicat.ion is also available (rapid release system and boom and. nozzLes for helicopter.s, and boom and aozzles only for the Turbo-Porter). 46. Airstrips and helipads: The airstrips and helipads used in the Phase I zone, and where stocks of fuel and in some instances insecticide, are maintained are as follows: Mali: airstrips at Sikasso (insecticide), Koutiala (insecticide) San; Upper Volta: airffilps at Banfora (insecticide), Bati6 (insecticide), Boromo (insecticide), D6dougou, Di6bougou(insectide), Gaoua, Loumana, Orodaral helipads at Dangadougou (insecticide), Folonso(insecticide), Lanvi6ra, Pont Ou6ssa; Ivory Coast: airstrips at Bondoukou (insecticide), Bouna (insecticide), Dabakala (insecticide), Kafolo (insecticide), Kong, Tortyia (insecticide); helipads at Camp km 17, Kakpin (insecticide), Koutouba, Peteye, Tehini and Vonkoro. 47. The only operational airstrips in Northern Ghana are at Tamale, I{a, Yendi and Navrongo. In view of thls snall number of airstrips in the Phase II Sector of Ghana and the great distances between them, consideration is being given to the possibility of building additional airstrips at strat,egic points, e.g. Bole, Mo1e. The Government of Ghana has indicated it8 agreement in principle to this. A study is being made of the cost involved. 48. Aviation fuel: To date no real problems have been encountered with the distribution, recovery and record-keeping of aviation fuel drums. 49. Ilowever, from the start of aerial operations it was evident that both the purity of the fuel and the quality of the drums obtained in Bobo Dioulasso left a lot to be desired; fuel was frequently found to contain water and particuLat,e matt.er while the interiors of many of the drums corroded. Ihe following precautions were therefore taken: - fuel was not taken from drums unless the drums had been sealed by the supplier or by the aerial contractorfs personnel; - fiiters were fitted to all fueL pumps; - fuel was carefully inspected before and while being pumped into the aircraft; - empty drums were i-nspected by the conLractorrs personnel before refilling and either certified as suitable or condemned; condemned drums were painted with a large red cross to ensure that they did not find their way back into circulation; - the refilling of suitable drums was supervised by the contractorrs personnel. 50. While these strict, precautions were Laken, no fuel problems r^rere encountered in any of the aircraft, however, Mobil Oil subsequently decided not to refill fuel drums in Bobo Dioulasso. 51. On 14 March, a meeting was held in Ouagadougou with the Chief Pilot and representatives of Mobil, in an attempt to persuade Mobil to reverse their decision. By the end of March no progress had been made in relieving the situation, and fuel was stil1 being obtained from Abidjan, resulting in increased circulation of Sector lorries transporting fuel between Abidjan and the various refuelling points in the Phase I area, as well as delays at the frontier due to customs formalities. 52. During the month of March the Chief Pilot completed arrangements with Shell Ghana Ltdfor the supply of 25 fuel drums at Tamale. These drums wil-l be distributed between Bole Chache, !.Ia and Navrongo. ocP IPR /7 5.L Page 7 53. Hangar and workshop faciLities at Bobo DiouLasso: Work was completed on the hangar and workshop facilities at Bobo airport, however, one major problem is the shortage of piped lrater during daylight hours. As a regular supply of rrater is essential for washing and decon- taninating the aircraft and premises, consideration is being given to the installation of a water storage tank. As a temporary measure, five fuel drums are filled rsith water during the night and the following day water is drawn from them as necessary by a sma1l electric pumpo 54. Ground to air radio corununicaEions: Five ground to ai.r portable transceivers were received, four in good working order and one with an electical fault. Some delay was encountered in putting them into use but four of the sets are now working admirably on a frequency of L2O.7 lfrlz. 55. Securi.ty: A11 aircraft are equipped with a complete set of maps at a scale of 1:2OO OOO,in addition to rnaps of the treatment zones provided by the Vector Control Unit (1:5OO OOO). The latter are of limited use for ai.r security purposes in the lvory Coast where it is frequently impossible to rnake or maintai-n radio contact with Bouak6 and Korhogo airport,s, but they continue to be used for the planning of treatment circuits and for recording treatment data. 56. Tvro of the three helicopters stiLl lack orange security markings due to difficultles infinding a dayglow paint capable of withstanding the high temperatures experienced ln the OCpElretro Pai.nt, which it is hoped will prove suitable, is on order. 57. The survival kits for aircraft have been supplemented and are now considered to be more than adequate. ALl crash position indicators are working satisfactorily. copies of the safety manual, in English and French, continue to be distributed to alL persons connected with aerial operations. 58. Meteorologv: I{eekLy meteorologtcal reports are received froo Boho and Ouagadougou airports. More frequent reports are often obtained in Bobo. 59. During the quarter under review strong north-easterly llaruattan winds and poor visibility characterized the northern part of the Phase I zone, i.e. north of the inter-tropical front (fm). In the south of Lhe area sorne strong southerly wlnds were encountered, and visibility was generally bet,ter. Ilovever, the position of the ITF lras very variabLe. . During the night of the 4-5 February a sudden shift northwards in its position to latitude 11"N resulted in heavy rain fall-ing in the extreme north-east of the Ivory Coast and in souepdrts of the extreme south of Upper Volta. Ilowever, no flights were cancelled because of bad weather, 60. EydTology: An agreement was signed on 25 January between ttIIO and ORSIOM providing for the lnstalLation of additional hydroLogicat stations in Upper Vo1ta. As a result of this, and the earlier agreements signed Ld L974, the Programe is able to obtain accuratehydrological infomation in Upper Volta and Ivory Coast. Data is collected during catching cycles or teaos are sent for this purpose. The Governuente of Ghana and Mali have been contacted again regarding their gauglng nehlorks. 61. The extremely Low diecharge rates recorded on roany of the rivers have roade the treatment of some breeding stEes difflcult. Despite uodifications Eo treatoent techntques sooebreeding sites sti1l defy successful treatment,, and ln order to try and resolve ttre problems hydrologists are now studying the water flow patterns of some sites (see para. 68). 62. Spraving: The flxed-wing aircraft detailed to treat the larger rivers crashed Lnto theblack Volta near Bormo on 5 January and was damaged beyond repair. An enquiry into the reaaons for the crash irrnediately took place, however, Lhe final conclusions are not yetknown. Ln view of the fact that the helicopter was also out of operation following a crashin late Ilecember all aerial activities ceased temporarily. Following the arrival of two additional helicopters in late January aeri-al larviciding operations rrere resumed on 10 February under dry season conditions. However, because of the appreciable change in hydrological conditions during January it was necessary to re-survey the wtrole of the Phase I zone ocP/PR/75.1 page 8 (with the exception of Ma1i, the Mali-Upper Volta recomenced. Aerial surveys began on 28 January 5 February. fronti-er being closed), before treatment and were successfull-y completed on 63. The leve1 of water courses was found to be extremely low thus affecting the pattern of breedlng sites, and necessitating an increase in the number of treatment points. 64. Using Ewo helicopters fitted with rapid release systeos, seven cyeles of aeriaL larviciding with Abate 2OOEC were completed in the Phase I zone. 65. Ilue to the complexity of breeding sites on the lower Black Volta and the operational difficulties of treating them, aerial mapping of the most, southerly part of this river was carried out. Ttre map is at a scale of 1:5O OOO and covers an area of 1424 l<n' (44.5 x 32 ko) between latitudes 8o 7rN and 8o 3otN and between longitudes 2o 5rI{ and 2" 23rtl. 66. Copies of this rnap are now being used with great success to treat the most southerly secti.on of the Black Volta. 67. Since the start of aerial larviciding operations, dosages have, as far as possible, been accurately determined from available hydrological data. However, during the quarter flow rates were so low and in some places breedlng sites so complex that it ruas extremely difficuLt to determine accurately how much insecticide should be applied and how many points should be treated in order to deal r^rith all larval populations, but without seriously disturbing non- target organisus. ltris applied parLicularly to the Bui Region of the lower Black Volta in Ghana where 198 litres of insecticide were applied, as drops of one, t\iro, three and five litres. Although there was no evidence that this was having adverse effects on non-target. organiems, the number of treatment points and the quantities of insecticide dropped were reducedl drops of three and five litres were eliminat,ed completely. Thus for the second and third weeks of treatments in February, the total quant,ities of insecticide dropped in the Bui Region were 126 and 118 litres respectively (drops only of one and two litres). The situat,ion is kept constantly under review at all sites. 68. Generally, treatments have been remarkably well placed though certain sites have caused difficulty. These si,tes belong to three categories: artj-ficial breeding sites at, dry season causerf,ays, where a pool of semi-stagnant wat,er is formed upstreao into which it is difficult to place the srna11 amount, of larvicide needed in such a rilay that it is carried over the breeding site in sufficient concentration to effect conLrol; natural breeding sites presenting the sane characteristics; trdo sites appearing at the overlap of adjacent maps and overlooked during the fifth week of treatmenE. Dosing of the first two categories necessitated a careful hydrodynamic study to determine the most effective droPPing point. 69. Ihe entomologists responsible for the control operations and surveillance network meet once a week to decide the treatment plans for the following week, taking into account the hydrologlcal conditions and the observations of the entomological surveillance teams. 70. Data recordj-ng: The system of data recording used for larviciding oPerations at the start oE;dtrol ofrations was very simple but proved very accurate. For each weekrs operations, all treatmenE points and quantities of insecticide dropped were recorded on a oaP of the Phase I zone (scale 1:5OO OOO). Ilowever, the overall size of the maPs (110 x 178 cn) ur,ade week by week comparisons of dosage data difficult. To overcome this problem, a new drata recordi.ng system was introduced, although the maps continue to be used for very detailed reference. 7L. For the new data recording system aL1 the rivers of the Phase I zone have been sub- divided into manageable sized zones (which correspond very closely with those of the air secr,rrity naps referred to in paragraph 55 above), and each has been given a code and description. In all, there are at presenE 87 zones, which are distributed amongst the major river systems as follows: River system Niger Black Volta ComoE /Leraba Nzi Bandama 72, At the end of each lanricidlng record sheetrt Countries No. of zones MLI HVO, CTI, cHA IM, CTI CTI crr week treatment data for each of the zones is entered on , each of which ls designed to record two monthsr data. 6 44 24 3 10 d7 ocP/PR/75.1 page 9 an |tAerial 73. Revenue hours flo!iln: (i) Helicopters Month January 1975 February 1975 March 1975 Period totals: (ii)' Turbo-Porter Month January 1975 February 1975 !,larch 1975 Period totals: No. of hours guaranteed 135 180 L42 No. of hours used 26.o L67.7 203.6 4s7 397.3 No. of hours guaranteed No. of hours used 2L.g o o 42 42 42 2L.8 (b) Entomological surveillance 74. On the wtrole collections of adult flies have been very satisfactorily carried out duringthe period under revi.ew. The first cycle of controL in December-early January did not conti.nue sufficlently long enough to eliminate f1y populations wtrich at the t,ime were glnerallydecltning, ag is usually observed from the beginning of the dry season. Follorving tLeinterruption of insectleide treatments it was noted that the S. danErosum adult, population density wae again increasing. After one month-and-a-ha1f or-Gffi, resulls- suggest thatf1y numbera have been greatLy diminished by the control activities and aie rapidly approaching zexo. 7_5. During the quarter an attempt rilas made to increase the number of catching points and thefreguency of catching cycles. This concerns the points where the leve1 of resiaual tranemission is studied, which are deterrnined according to the location of villages selectedfor epidemlological evaluation, and the number of periodic checkg. 76. In addition to the routine f1y catches, 70-90 breeding sites were checked weekly bySub-Sector technicians and other staff, both working from the ground and using helicoiteis.In view of the size of the area, the personnel availabLe and the distances to be covered by each team, this represents a considerable effort on the part of the personnel involved. While the loork carried'out by the evaluation staff is cornmendable, their standard of efficiency could be improved and it is planned to recruit a Training Officer to providein-service field training. L26 ocP/PR/75.1 Page 10 77. The dissection of captured fernales showed from the beginning of treatmeot a raPid decrease in the number of nulliparous females followed by their disappearance, this being evidence of the effecEiveness of the insecticlde treatment. 78. Fly catches: The effects of control on each Sub-sector during the month of March are given below: (i) Bobo Dioulasso: In this Sub-Sector catches were made at 14 sites. At nine of these sites, 23 caiches resulted in no flies being caught. Four catches at Lanvi6ra yielded one f1y. The daily average at this site duringMarch 197O was 5O flies (16 daysr catching). Single flies were aLso taken at Va116e de Kou (three catches) and Samand6ni (five catches). Pre-control- data for Samand6ni from 1973 gave an average of 145 fl-ies per day (1O daysl catching) whilst Ln L97L six days t catching yielded an average of 68 fLies per day. Unfortunately, these excellent results were marred by those from D6dougou-Nouna, Black Volta, where four dayst catching yielded 51 flies. This site is in the extreme north of the Programe area and the problem of successful dosing has not yet been solved. There are no pre-control data available for comparison. At Gu6na Pont, Black Volta, four catches yielded seven flies which had almost certainly originated in the Banfora escarp,ment area. (ii) Banfora: In this difficult Sub-Sector 67 days of catching at 10 sites yielded 28 zexo catches. Four sites produced no flies and two sites - Moussodougou (eight catches) and Badadougou (two catches) yielded one fly. tr'our sites yielded substantial numbers of fLies. Seven days I catching at Karfigu6la Fa1ls yielded 35 flies. It seems likely that in this area there is an undetected breeding site. Radier Folonso-Como'd yielded 39 flies fron eight catches including 27 fLies on I-3 March and nine flies on 21 March. There lras no detected uncontrolled breeding near this point. Pont Routier-L6raba: At this important point 46 fliee werecaughtineightcatches.oneofthesef1ieswasinfectedwithprobab1e@in the thorax. Upstream of this point at Fourkoura, six flies were taken in L2 man-days I catching. There have been several breaks in the control of this difficult section of river. Daily averages for Pont Routier during March L967, L968, L969 were 38O, 265 artd 20, respectively. (iil) Di6bougou: In this Sub-sector a substantial prograune of catching yielded only tnro flies during the month. one f1y at the Dan Bridge (Bougouriba) on 12 March rsas at least 80 km froo the oearest possible breeding site, wtrich night be related to the northward shift of rhe ITF. (iv) og!91<4!4 r44 Altelne: Fifty-nine daysr caLching at. L2 sites: this southernSub.Sector@eroff1ies.seventeenofthecatchesIilerezero.onthedry Nrzi River, 15 catches at, two points yielded 46 flies and only one zero catch. In the northern part of Ehe zone the notorious Gr6chan site produced 49 flies in four days, of which 30% ruere mulliparous. Some uncontrolled breedlng was found earlier in the month. The situation appeared to be improving with a steady increase in the parous rates. (v) Bondoukou and Bole: These Sub-sectors together cover the lower half of the Blaak Volta River. Results in this area \irere exceptionaLly good. In the Bondoukou area 24 daye of catching at six sites yielded only 31 flies, 20 of these from seven daysr catching at PiEye on the Black Volta. In the Bole Sub-Sector 30 catches at five sites yielded 25 flies of which 22 wexe taken in seven days at the notorious Bui rapids. In contrast trtro catches made on a small uncontrolled stream nearby at Kintampo yielded 184 f1ies. (vi) Korhogo: It is clear that the lower Bandama Blanc has not been successfulLy controlled. Twenty-trilo treatoent failures have been detected on the lower Bandama and its rnajor tributary, the Bou. (vii) Sikasso: As aerial control operations have only just recorunenced in this Sub- Sector, no assessment of the situation is given. For security reasons the Banifing regiorn only is treated from the air, the region of Sikasso, being close to the frontier, is treated from the ground. oc? lPRl75.L Page 11 79. Non-target organisms: The effects of controt on non-target organisms generally reflect a very heaLthy situation but results are very variable. For example at two sites in the Bui rapids on the lower Black Volta, carefully examined ln the presence of STAC members, no Sioulium larvae or pupae were found, confitming the efficiency of control measures. One of EEGitea was very rich in non-target ineect fauna while the other had a very few larvae of one insect genus. These sites had received the same amounEs of insecticide on the same days throughout, the control period. Because of the diversity of conditions at the many sites to be treated, overdosage of insecticlde has been necessaly on certain occasi.ons to obtain sattsfactory conErol of the larvae of the vector. (c) General comments 80. Despite the innumerable major problems and setbacks encountered at the beginning of the quarter, the period ended with aerial operations proceeding in a very satisfactory manner. A considerable anount of valuable experience has been gained. 81. One of the most satisfying achievements of the period has been the training of aE least two pilots to a Level of proficiency which enables Ehem to carry out larviciding missions unsupervised. This is a major step fonvard, because it relieves the Prograrnrne staff of a great deal of flight observer/navigator duty and allorss nc,re tine to be devoted to other nntters, such as plans for the Phase II zone. 82. After seven weeks of uninterrupted insecticide treatoent a considerable decreaae was noted in the nuober of fernalee captured in all evaluation points, wi.th zero cat,ches in so,me of these, indicating the interruption of transoission of onchocerciasis in the greaEer part of the Phase I control area. However, present clftnatlc conditions necessitate constant vigilance. Empbasis is placed on collection of cliuatological and hydrological infomation in order to prevent reinfeatation of perennlal tributaries, C. EPIDEUIOIOGICAL EVAIUATION AI{D PUBLIC HEAIIII I'NIT (a) Epidemiological evaluation 83. The first epidemiological evaluation teao, consisting of an ophthalmologist,, aparasitologist, a sociologist,, technical officer, laboratory assistants, census clerks anddrivers, became operational during the quart,er. The uain activiti-es of the Unit during theperiod under review were basic and detailed surveys in Upper Volta (Bobo Dioulasso, Banfora, Gaoua and Dangouadougou), and planning of the evaluation work to be carried out in the next area wtrich will be northern lvory Coast. The iategration of basic and detailed evaluation worlc proved feasible and had the advantage of enabling the team to compLete one area during one visit. 84. Basic studies were carried out i"n seven viLlages of Upper Volta (sub-prefectures of Fada N-Gourma and Gaoua) and in two villages of Lvory Coast (sub-prefectures of Dabakala). The participaiion of the populat,ion can be considered excellent. The uaxioum infection rate obsenred vas 67%, and the naxiraum rate of blindness 8.57.. A heavy parasite load was generally obsenred, for example, in a village in Upper Vol"ta 53% of the infected persons had ovei 10O microfilartae per skin snip, of which 32% exceeded 2OO. In certain villages, up to 5O7. of children in the age range of 5-9 years were lnfected; the youngest i-nfected being Z-Z-Llzyears of age. 85. CooPeratlon from the national medical servlces was good, and general agreement was reached on future collaboration with the medicaL serrrices of Gaoua, Fada NrGourma, Banfora and Korhogo-Kong. Basic evaluation has already begun in all these areas. Close contact was oaintalned wlth the Groupe Ophtalmologique Mobile, in Ouagadougou. 86. During the period 15 February - 1 lv1arch, the ophthaluologist visited the Brirish Medlcal Research Councit Unit in Kumba, Cameroun, for training in field evaluation work. The Technical Officer received laboratory training in Ghana and training in parasitology at theCentre Muraz, Bobo Dioulasso. Training of the census clerks was arranged at the Centre Muraz, Bobo Dioulasso, and the eye clinic, Ouagadougou. ocP/PR/75.1 Page 12 87. Various supplies were received, i.neluding three slit lamps, generators, laboratory and medical equipment. (b) Public llealth 88. Following his arrival on 1 March the Public llealth Officer began to familiarize himeelf with all asPects of Programre activities. Contact was made with Governoent officials andAgency rePresentat,ives in Upper Volta. Between 9-14 March a visit was paid to the I,IIIO RegionalOffice for Africa Ln Brazzaville for briefing on liaison between the Prograrme and the RegionalOffice in the field of basic health services. 89. Ihrring the return journey Ehe opportunity was taken to pay a visit to Ivory Coast wtrerediscussions took place with officials of the Ministry of Public Health and WIlg plreonnel. D. I{HO HEADQUARTERS SUPPORT UNIT 90. The main activities of the Support, Unit during Lhe first quarter of 1975 were Preparations for the First Session of the Joint Coordinating Conmittee and the Twelfth Segsion of the Steering Conrmittee, finalization of research agreenents for studies in the field of, aquatic monitori.ng and on S. daonosum sampling (see Section E), procurement of supplies for research institutes, negotiations with Evergreen llelicopters following the aircrait accidents, and arrangements for the visit of Ecol-ogical Panel and STAC meubers to the progranure area. 91. A medical officer has been recruited to handle epidemiological aspects of the Unitrs work and will assume his functions during the second quarter of L975. 92. A Research Coordinating Cormritt,ee has been set up in WI1O headquarters to review aLl- research proposals submitted to OCP and decide on the allocation of research funds. This Comnittee met twice during the quarter. 93. In connexion with the First Session of the JCC visit,s were paid by Headquarters staf,fto discuss arrangeoents with Government, officials, review conference facilities and investigate the availability of equipment and personnel. Docuoentation was prepared for both the JCC and the Steering Comnittee Sessions whieh met on 11-12 and 1O-12 February, respectivel-y in Abidjan. Folloruing the JCC the Chairmanrs Report of Proceedings was prepared for circulation to aL1 ParticiPants in draft form. 94. A series of meetings took place with Evergreen llelicopters Inc., the company under cont,ract for the aerial operations to revierir the possible reasons for the accidents and to discuss measures which might be taken to safeguard against future incidents. The necessityfor a standby helicopter in the Prograrune area was agreed. A meeting also Eook place with an avaiation specialist from the World Bank to review procedures. 95. From 26 to 28 February a sma11 working group met in Geneva to review the unused footage of filn on medical and entomological aspects of onchocerciasis taken by the IBRD team when preparing the film 'rA Plague on the Landrr. This meeting rdas attended by the Director of theWorld Bank fikn team and three temporary advisers, an ophthalmologist, a parasitologist and a clinical pathologist, and materiaL ilLust,rating certain specific aspects of onchocerciasis was selected for the preparation of slides to be used for teaching purposeso 96. An internal IIIIO r,rorking group met on tro occasions during the quarLer to consider the implications of the combined use of Abate and metrifonate in the Volta River Basin. The group reviewed the toxicological data available on these compounds. It was noted that no combined toxicity data exists and steps will be taken to promote this work. 97. Advantage was taken of the presence in WIIO headquarters of the Chief of Vector Control Operations in connexion with a meeting on insecticides oa 25-26 March (paragraph 105) and the visit of the Programe Director, to arrange a meeting of the OCP Coordinating Comaittee with the participation of the Dj-rector-General of WIIO. The experience gained during the first year of operations and the problems encountered were reviewed. ocP/PR/75. I Page 13 the and I{IIO, 99. Discussions took place with staff of the Department, of Hydrology and l{ater Resources ofthe World MeteoroLogical Organization regarding possible coordinatioi- of hydrological acti.viti-es in the Progranme area. Details of the type of information required by the Prograrrne were provided to WM' for consideration. 98. Two engineers from SOFRECOM, the company radiocorrnrunications network, visited Geneva onprior to their visit to the Prograrune area to 1OO. In liaison rrrith the programne Progranme area by two ueabers of the of approxlmately one week conrnencing Advisory Co ittee. responsible for the establishment of 19 March for discussions with IFRB1 set up the network. I t Director arrangements were made for a visit to the Ecologtcal Panel from 23 February to 3 March and a visit 31 March by three members of the Scientific and Technical a I 1O1. FolLowing discussions between staff froo the IIeaLth Statistlcal MethodoLogy,Epidemiological Mdthodology and Ctinical Pathology and Onchocergiaiis Control froiiarme Units,it rras agreed that a joint HSM/EMP mission would visit, ouagadougou to finalize the nethodologyfor the epidemiological evaluation, and assist with the selection of villages to be examined.At the satre tirne consideration wouLd be given to the question of handling epidemiological and entomLogical data. Loz. As a result of certain observations made at the Firsf Session of the JCC concerning admlnistrative costs, preliuinary talks nere held with the Management Divislon at WIIOheadquartera concerning the possibility of a mission to the Prograrme area to review certain organizational aspects. E. APPLIED RESEARCII (NUIOIIOIOCV/ECOLOGY) 1O3. In connexl-on with the research into the S. damnosum complex a small working group Ied by a cytogeneticist recruited as a Teoporary Advis; reE i" Bouak6 to dlscuss the studies aLready undertaken, both under the Research Agreement with ORSTOM and by a consultant, and formulatefuture ProPosals. The distribution of the different cytotypes on the princiial rivers ofLvory Coast is no!, establiehed and material has been collected from other sites 1n phase I andpart of the Phase II area for subsequent, identification. To maintain continuity in this work, a cytotaxonomlst is being recruited by the Organization and lsil1 be based in Tana1e in NorthernGhana. the ORSTOM group based in Bouak6 has continued observations on the comparativebi.onomics of the cytotypes in selected foci where they are apparently isolated. 1O4. Research has continued oo the iumature stages of S. damrosurn as well as on the adultsin order to try to devise a suitable sa,mpling nethod tor-EffiEE and adults respectively.Following the signature of an agreement with the centre for Overseas pest Research in theUnited Kingdm, two biogeographers conmenced a review of past entomological and meteorologicaldata available in the 0nchocerciasis Control Progranrne area to clarify whether S. damnosug maybe borne considerable distanees by the anjor wind currents, and, in particularr-Tffih-in the Inter-Tropical Front. 1O5. A lrorking grouP met in Geneva to develop a rnore suitable protocol for test,ing differentlneecticides and formrulations which may be used in OCP. Ihe regard was paid to the need for a enall 8ca1e methodology to permit prior asseasment before fieLd testing, and the properties requlred of an acceptable insecticide formulation (good rrcarryrr along the rivers toi rainy season control, imediate effectiveness for individual site treatment, during the dry season, selectivity for Simnrliuu larvae and minimal effect on non-target organisras). 106. A contract was drawn up with the Institute of Aquatic Biology in Accra, to undertake the monitoring of the rivers flowing into the VoLta Lake in Coneultant Biologist/EcoLogist was recruited to assist the -- I International Freguency Registration Board, Geneva. Ghana. In this respect a scientists responsible in ocP lPRlT 5.L PaSe L4 establishing the monitoring programme and to train them i.n the methodologies recofimended. In Ivory Coast the ORSIOM Ilydrobiological Unit have responsibility for monitoring the Como€, Nzi and Bandama Blanc Rivers. Concurrently this group is collecting comparative basellne data on a sinilar untreated river, the Bandama Rouge, and carrying out definitive studies on general- river ecology. Contact was made with an ichthyologist in Upper Volta who will study the riveri.ne fish population in that part of the OCP area. 107. Work on the biodegradability of insecticides has continued in the'Centre for Disease Control, Atlanta, Georgia. An acceptable methodology has been developed for preserving oud and fish for later analysis to determine wtrether the insecticide lreine used, which is Abate I tat present, is accumulating in the environmenr :"' *i11 be introdi. Prograrme. 1O8. Fol1ow;- )va with an industrial representative on the possibility of .1|ryr1''' . ,5irtiiiiraLE i't.... i ,ns of larvicides foruse in the Progranrme, arrangements lrereEfde.tor a specialist to go ' , - ..st Africa to deterrnine the si-ze-range of particles ingestedby the different instars of S. --mnosum larvae. APPLIED RESEARCII (TPTOTUTOT,OGY/CHEMOTEERAPY) AND TMI,NING: IINDP PTOJECt NO. RAF/74IOO4 , ' ,oy/Che-lffrrgp.rz 1O9. Following the establishment of a contract with the MobiLe OphthalmoLogical iitliu in Ouagadougou, further t.rials are being undertaken with Suramin and Diethylcarbamazine in villages located in valleys where the vector is under control. 1L0. The Royal Coumonwealth Society for the Blind team in Northern Ghana carried out a detailed epideuiological study of Awrigu village near the White Volta which was found to behyperendemic" This team is continuing research into the feasibility of mass treatment of onchocerciasis with Diethylcarbamazine over a prolonged period and is also engaged in detemining the difference in microfilariaL Load per skin snip when examined in water and saline. (b) Training 111. Five Ghanaian and four Vol-taic candidates were approached concerning posts of entooological technicians in the Sub-Sectors of the Phase II zone of the Prograrmre. A decision is awaited from the respective Governments regarding Lheir detachment. As soon asthis is received the candidates will follow a training course at. the OCCGE Centre Entomolqgique de 1 rOnchocercose, Bouak6 under the 1975 Agreement for entomological training between WIIO and occ@. I t