Simple epidemiological evaluation: manual of procedure

ORGANISATION },IONDIALE DE LA SANTEI^IORLD IIEALTI{ ORGJû{IZATION Simple Epideniologieal Evaluation },IA}IUAL OT PROCEDURE Edited bY G. De Sole Contributore: J. Frazer, Dr.0. Bar*Dr. K.Y. Dadziar* Dr' DI' Karamr* Dr' I{' Remme'* A.B. Kambour* B. Sawadogor* Ki Brunor* C'S' Karobour* J'-C'Kafando'* R" Batlonor* erciasis Control Programme :in lJest Afri.sa. OCP/EPI 1986 Page 2 1. PREPARATION OF THE TRIP In preparing the plan for a simple evaluation round t,he team leader should bear the following points in nind: 1.1. Evaluations must be conducted during the dry season. In the rainy season farmers are busy in the fields and only a few people would be available for examination. Moreover, some villages are inaceessible at that time of ÿBâf. L.2. To ensure maximum collaboration by the population, village authorities should be inforrned of the impending evaluation and if possible of the precise date of the teamrs arrival. 1.3. The team should arrive in each village during the afternoon of the day precedi-ng t,he evaluation in order to mobilize the population. 1.4. Even an experienced team cannot examine uore than 3OO people in a day. 1.5. A pattern of one dayts travel alternating with one day of evaluation is ideal unless Ehe evaluation of one or more villages with populations of over 3OO is planned. 1.6. Informati.on should be collected on the negotiability of roads and tracks so that. travel times can be calculated realistically. L.7 . In case of a follolr-up evaluation obtain frou the statistical uni.t the li-st of all people examined during the baseline survey of all vtllages included tn the Eravel plan and carry thoee lists in the fi.eld. 2. APPROACH TO THE VILLAGE 2.1. As soon as the team arri.ves in a village, Èhe Chief and the Secretary of the vi.llage should be cont,acted, together with any other persons of note (e.9. teacher or health assistant) who are present. Explain to then the purpose of the evaluaÊion and mention that treatment of all sick people will be given free of charge at the end of each dayrs llork. 2.2. In most villages the key person will be the Secretary, whose responsibility it will be to tnform heads of families of the impending examinati,on and arrange for thern to be prêsent the following morning with all the members of their families. 2.3. If the village is being evaluated for the first time, eollect information on the number of farnilies, their size and duration of their residence in the village fron the Secretary and compile a list of fanilies selected for the examination following the criteria expressed in paragraph 5. In the case of a follow-up evaluation this informat.ion and the list will be available from the previ.ous survey forms. 2.4. Give the list of famili-es to be examined to the Secretary and ask hin to contact the head of families included in Ëhe list and arrange for them to be present the following day early in the morning (at least by 8.00 a.m.) at Ehe survey site (for the choice of the survey site see paragraph 3.I) with all members of their farnily. 2.5. Page 3 If the vi-llage is too large for the aurvey to be completed in one day, make sure that the famil"i.es convened for Ehe nexr morning do not total ruore than 300 indi.vidualsr leaving the rest to be examined the day after. N.B. Because of the longitudinal nature of the study (villages are followed for 15 ffirs), it is essent,ial to impress upon the team's cênsus officers, upon the villageChief and Secretary, and upon heads of fami.lies the need to examine the enti.rety of the population selected in each village. If the percentage of non-attendance ,is too high, E.he data collected wlll be meantngless. An additi.onal effort should be rnade to examine all i.ndividuals of each of the vi.llages thât are included i.n the list of all the people exami.ned during Ehe baseline survey (see paragraph 7). 3. SET.UP OF THE TEAM FOR AN EVALUATION -» I.AI,IILY ITINERÀRY ----» ITINERARY- OF rORUS STAR:] !' o l{icroucopic làçanirnEian talcing \li.qtal I Â{uiEy TesÈ I E<æ:rer vHo E6tr59 ,È.f4 3.1. 3.2. At the top left hand: Name of StaÊe (followed by corresponding code). Name of nunber) Latitude Council District Region. river or Èributary At the top right hand: village (followed by its code and longitude situation river. Nearest entomological code). Use a shady ouËdoor area or the school bui.lding Families will be called one at a time, but some so leave suffi.cienÈ space bettreen the different Page 4 or a combination of both. may contain over IOO people exanination posts. 4. GUIDELINE OF A VILLAGE FOR},I 4.1. To facilitate the filling of the "village form" which must be prepared after each visit (simple or detailed evaluation) the nain items are enumerated below. Please treat Ehem in t,he order indicated below so as to standardise the present.ation of the forms.Each form whether summary or detai.led, should be signed by its author(s). 4.2. 4.3. DaEe of visit and no.of passage. Purpose of visit: Si.mp1e and/or detailed evaluation (wiEh possible Justifi.ca- 4.4. Onchocerciasis Focus: Name of 4.5. 4.6. 4.7 . 4.8. 4.9 . catching point (with ro. of Access: Itinerary: staËe of the road. I{orking conditions: Settlement Naroe of the village chief Ethni.c Group(s) and sub-groups Population:- Available census data (showing source and date) - EPI census data (with conments) N.B.: As much as possible, these dat,a should be sunmarized in one table. 4.lO.tlistory and structure of the village (possibly with plan in annex). 4.10.1. Origin of the inhabitanEs, stages of settlement, contacts with the natives and/or modes of land occupancy, iuportant events. 4.1O.2. Layout of Ehe houses, inter-connection between Êhe hamlets and the village. 4.1O.3. Social facili.ties: school, dispensary, youth clubs, êtc. 4.IO.4. SociopoliÈical structure: Social units (family, lineage, clan) and poliÈical organizaEion (traditional authorities, uodern authority). Page 5 4.f1. Activities, resources and. economic Problems 4.11.1. Agri.culture: Land tenure system, location of farms, modes of work (men, hromen, ch'Lldren), extension service bodies (governmental or non* governmentat), Products har:vested. 4.11.2. 6ther acttvities: antmaL husbandry, handicrafts, fishi.ng, etc. 4.11.3. Infrastructures and structures for trade: roads, markets, market'i-ng bodies, etc" 4.L2. Present mtgrati+ns 4.L2.L. Immigration: Si-nce when? Origi.n and motivations, modes of settleruenL, n,rmertcaT vbtume, agê groups and sex concerned, envisaged duration of resi.dence , activi,ties of immi-grants. 4.12.2. Egiggfr^: Sinee when? numerical volumer aBB groups and sex concerned,destination, motivations, envisaged duration. §.E. As much as possible, a1l these data should be summarized in one table. - 4"13. Parti"cular problems 4.13.1. lrtater: What water is used (for what) during the different periods of the year? Relation to t.he river and backwaters (men, women, children). 4.L3.2. Schootchildren: The youth in general. 4.13.3. Other partteular problems (modes of sleep, food, dress, pleasure, etc.) 4.L4. {r"g.g!^""gg.:__"q!_-"_: Questi.ons -ln abeyance concerning the study, epidemiologY ' Êtc. 4.I5. 4r{gIesi }4ap of the area, photographs (aerial or others), translaEi-ons of recorded d'Lscuss ions , age pyr:arnid, etc. 4.L6. For an example of the collection of general information on a village see Annex l-. 5. CENS'JS PROCEDURE FOR SII'IPLE EVALUATION (FORI"I 5602) 5.1. Fi.rst passage 5.l.L.Theequtpmentrequiredconsistsof:Atabler'r'ehair'someball-potntpens, and a suppJ.y of 5602 forms (see Annex 2 for specimen completed in French). N.B. An interpreter, preferr,bly native to the viltage, will be rreeded to help the ie-tr"1rs of f icer cope wi-th laoguage problerns and distingu i-sh t-ndigenous f rom non- indigenous persons. 5.1.2. OnIy families that have been residing in the village for a minimum of five years and .-ntenC to stay permanent-ly are included. N.B. If the trend of onehocerciasis prevalence is to be properly reflected, Lhe pîpulatlon studied must be stable. Visitors, nor:rads, government of iLeials and other persons only temporarily in the vtlJ-age selected must therefore be excluded froü the sample. 5.1.3. 5 .1.4 . 5.1.5. 5.1.6. Key:HF = Wi= Ch= Sib = "FR"= ENs (t pa= 5. 1.8 . Page 6 The first task in any vi-llage is to conduct a census of the enËire population, broken down into r:esidents present, residents absent and non- residents. Each family unit is al-located a separate form (or forms i.f the number of family members exceeds the spaces allocated in one form). On each form are set out daca concerning the administrative di.vi.sion (State, vi.Ilage and section) , the f amity ( ident i.ty nurnber and ethnic group) , and t.he indi.vidual (name, sex, age, presence or absence, and results of skin-snip and vi.sual examinations). First i"dentify the data sheet by filling in the boxes at the top: 5-8 Date of survey, 9-lO Passage No., 11 State, L2-L4 Vi-l1age, 15-16 Section (to be compleLed only i.f the village contains more than one) , L7-L9 Family No. and 20-22 Ethnic group (using the OCP/EPI list of ethnic codes). The body of the form consist-s of eleven columns (see annex 2), to be compleEed as foLlows: 5.1.7. Second column : Name of person. In the f"-rst line write the name of the ext that of Èhe first wife, followed by those of her children in order of decreasing age, then those of the second wife and her children, etc. AII persons shari.ng the householdrs dai.ly meal (e.g. nephew, gnandchild, wtdow) are counted as mernbers of the family. N.B. Adults are i-dentifted by their position within the family, and children by Eflerence to their parertts. Example : First column: Provisional number. the seti"lffi. those indi.viduals who present for 1. Coulibaly Omer 2. Ouattara Zenabou 3. Coulibaly D6sir-e 4. Traorê Bernard 0n the right-hand side of the eolumn write , and on the left-hand side, only for exaruination, Ehe skin-snip nurnber. HF \{i I Chl-x2 .FR,. I Head of FamLly lrl't fe Son or daughter Brother or s isl-er Cousin Nephew, niece, grandson or granddaughter W,Ldow or widower Father or mot.her 23-28 Individual numb_er. The indi-vi.dual number is assigned later on at the be processed by computer.office to enable the data to 5.].9. 29 Sex. Âssi.gn code 1 for matre and 2 for female. not neeessarily reveal- his or her sex anrl et:rors are AJ-ways ask whether a child i.s a boy or a g,irl. birth certifi.cate or identity paper ts avai.Iable, record the If not, estimate by reference to a person of the sarne does have one. Otherwise ask the person his age and take N.B. À personos name does frequent'tn this regard. 5.1.10. 30-31 Age. If a â?âïtâÎ3ated. generation who Page 7 the average between his reply and Èhe census taker's guess' children's ages are Ceter:mined by the dentaL formula' 5.1.11. 32 Already registered. The eoding is as follows: O = Never registered before (First survey in the village) I = Àlready regisrered in the vlllage 2 - Born s Lnce the last survêY 3 = Born before the last survey 4 - Already registered in arrother EPI vt'llage' N.B. As this is a first passage, codes 1, 2 and 3 will not be used. 5.I.12. 33 Exam Status. The codi-ng is as follows: 1 = Present during the vtsiE and exami-ned 2 = Present. but refused examinat'ion 3 = present. but not exami.ned because of old age, illness, pressure of work, etc' 4 - Absent from the vi-llage for less than a year 5 ' Changed residence Lo another village 6 = Deeeasecl 7 = Absent from the vi"11e"11r: for more than a year' ' N.B. codes 5 and 6 will be used only on second and subsequent passages. 5.1.13. 34-3g Iltac erest sktn-snips. Report the results of form ocP/D3 (annex 4) on the famil-Y form. 5.1.14. 40 V.i.sual acuity. The census clerk ensures that everyone presenting for exam.Lnat--Lon rs Eested for visual acuity, except for children aged o-5 years. Thecodesthâtwi.Ilbeusedbytheexaminerareasfollows: O - Good vision I = Blind 2 = Severe vtsual i-ruPairment 3 = Visual imPairment 8 = Does not understnnd the test untest-able 9 = Not tested for visual acuity but underwent ski-n-snip examination (i'ncluded chi-Iclren aged 0 - 5 Years)' 4 = Not tes"ed for visual acuity but reported blind by relatives. N.B. Information for code 4 comes from observations (5'f'15)' Code 9 and 4 are ffied i-n by the census clerk. 5.1.15. 41 Method. Thts column is completed only where a skin-sni-p that was negative on the fLrst reading (aft,er 3O mi-nutes) is found positive on the second(after 24 hours). Code 2' 5.I.16. Last column : Observations Speci-fi.c mention should be made, i'n part-icular, of : (a) The whereabouts, if lcnownr of anyone who is t-emporarily absent or has left the village for good; (b) Any persolt not prêsenting for examination but resident in the village and known to be blind. Page 8 AfEer you have entered all the particulars for an indivi.dual, and before he passes to the isolation tent, put on his left wrist a piece of sti.cking plaster marked with his skin-snip nuruber. 5.2. 5.2.L. 5.2.2. 5.2.3. 5.2.4. Second and Subsequent Passages (see Annex 3) The census officer's work begins in the office with the preparation of an updated file. Indicate on the Jacket the scheduled date of the vLsiE and the passage number (second, third, etc.). Copy on to nêh, forms from t.he prevtous fi.Ie the data in the second, third and fourth columns: "Name ofpêrson", *23-28 Indivi-dual number" and "29 sex", except for persons who were coded 5 or 6 under "33 Exam. status" on the previ.ous passage. In the fifth column, increase the ages by the time elapsed sinee the previous vi-s.it. In Ehe sixth column, "32 Already registered", code I for all persons listed. The skin-snip numbers will not be assi.gned until the examination t-akes place. 0n a second passage, neld registrations will include: children born since the first passage; htomen newJ.y marrted into a family and coming from another vtllage; any family rnembers overlooked on the fi.rst vistt; and fami.li.es that I./ere present during the first visit but had not yet completed five years of residence. On a third or subsequent passage t,he list is closed excepl for new children and new wivr.s. Newly registered persons must be coded 21 3, or 4 in the sixth column to disttnguish them from those already regLstered on the first visit. In the seventh columnr "33 Exam. status", codes 5 and 6 are used for eliminating from the sample persons who have left the village or died si,rrce the previous visit. N.B.Often a person eoded 5 on the previous visi-t reappears in the village: in that case the earlier fi.le should be corrected, code 5 betng replaced by 4 or 7 depending on the lengEh of the absence. 5.2.5 . Any correction needed to the daEa recorded on the previous passage must be made in the field and then broughÊ. to the attention of those responstble for the computer processi-ng. Fo": this it i.s essent.ial that the census officer keep a notebook in whic.h all such correcEions are recorded, e.g.: Individual nuuber 138432 - Sex I on P/1 Indtvidual number 138720 - Age 4 instead of 9 on P/l Indtvidual number 139002 - Exam. status 7 tnstead of 5 on P/t 5.2.6. lrlhen an individual changes family, moving for example from Family 4 to Family 12, enter al-l his partieulars on the data sheet f,or Famil-y 12 and cross them out under Farn.:Iy 4, noting in the respect-ive "Observations" columns "Transferred from F/4" and "Transferred to F/L2*. 6 .1. 6,2. 6.5 . Page 96. SNIP TAKING AND TTME RECORDING The following equipnent is needed - A table; - A canvas sheet with which to rig up an isolation Èent; - A Holth type eelerocorneal punch, diameter 2.5cm; - A lancet; - Curved trrêezers - A felt pen; - A watch or chrononeter; - A dropper bottle of distilled water; - Cotton-woll swabsl - Grass slides with shallow wells formed by 12 rai.sed ceramie rings arranged in 3 rows of four. - Slide trays each holding 3 slides. Before taking any skin-snips, mark the nunbers l- - 4 with the felt pen inthe left-hand column of four rings on the first slider 5 - 8 on the secondellde and so on. The corresponding rings in the rniddle and right-hand columns are for the snips frorn the left and right iliac erêsts respectively:Put one or Ëwo drope of dietilled water inËo each. !ÿhen prepared, the firsttray will therefor:e look like this: tecTl! ioocirccc iocpi ioôolttloccllanoliv \J vlocolL= 6.3. CaIl out the name of the first person listed on the cenaus form. Be carefulto checl: hie ident.i.ty by comparing such features as age and sex with theindications on the form and make sure the number he carries on his wrist. corresponds to the serial number on the slide (nunber 1, as he is the first examinee). 6.4. In the isolation tent, disinfeet both iliac crests with an aleohol-soaked swab. Leave to dry for a few seeonds, thên take a snip from the right erest, lift it from the punch wirh the point of the lancet and, with thehelp of the tweêzers, put it in the first ring of Ëhe righË-hand column.Take a snip from Ëhe left iliae crest and put it in the first ring of the middle column. Proceed in the same r^ray with eaeh examinee. NJ. Take care to check each personts identity characteristics and the number on his arm and to put the snips i.nto the correct rings. As each slide is filledr i.ê. after every four pairs of snips, mark besideit on the tray the tine i.n hours and minutes so thêt the microscopi.e reading can be made 3O minutes later. Then, as each tray of three slides is filledl send it to the mieroscopistee tabre to await examination. loooi l@oc1 i9??i 6,6 . 6.7 . 7 .2. 7 .3. If a person li.sted as present name i6 called, lêave the two next number. for examination does not come eorresponding ringÊ unused and Page 1O forward when hts pass on to the 7. VISUAL ACUITY TEST 7.L. For this, use sjügrenrs hand test types V E 5/30 and V - 5/10, two standardcards depÏ.cting a large and a small È,rrrn hand in black sirhouerlte on awhite background. You also need a measuring tape, preferabry et least 5metres long for convenience, and a stool, ràr ttre'examinee to sit on. choosea shady buE not too dark place and mark out distances of 3 and 5 metres fromwhere the exam.i.nee will be sitting, thus : Exanining 0f f :icer Exaninee *I: Make sure Ëhe examinee is not facing thê sun so that he wilr not be dazzLed..Remember, too, to check childrenrs ages à* o"rv those over five years ol-d should beexamined. Use an interpreter if necessery. Explain to the examinee that to test his eyesight you are going to ask himin which direction the fingers of a hand u." plintirrg. shàw him first yourown hand from close up in directlng the finge"" .rp, down, to the left and tothe right, and ask hin eaeh time tà :i.naicatl uy a geeture which way they arepointing. Then do the same with the cards untit you are sure he hasunderstood. you are ready to start t,he test. stand on the line you have marked five metres from the examinee and take thecard acuity with the laber 5/3o. Turn the card different rdays. holding itbehind your back so that the examinee cannot see your tuovements and guess,then hold it in front of you and ask him each time where thê fingers arepointing. N'B' You should previously have practised on your own turning the card behind yourback so that you- yourself always know without iooking which way it -Ls oriented (butif in doubt check rather than risk making a mistake). Take caie too, to Èurn t,hecard at random and not follow any regurer pattern (e.g. cloekwise, anti-clockwise,up-down 1eft, right), which would also enaLle the e*arirree to guess. Lastly, takecara always to hord the eard vertically when you show it so tirat t.he examinee doesnot shift his posit.ion to see it better. 7.4. 7 .5. 7 .6. Repeat the operation with the small hand, with the rable 5/1o at fiveEetres. rf the exaninee ansrrers correctly eaeh time for both eards, his visualacuity is 6/18 or better. Enter in column 40 (Acuitê visuei.te) of theexamination form the eode number 0, rneaning gàoa vis;ion. rf the examinee ansrr/ers correetly for the large hand but not for the smarlone' his visual- acuity is 6/60 or better but Iess than 6/rg. Enter the codenumber 3, mearr.ng impaired vision. If the examinee fai.l_s the test withÈhe 3 metre mark and test him again both cards at 5 metres, move forward toç'ith the J-arge hand. If he cân nord see 7.7. Page 11 which way the fingers are pointing his visual acuity is 3/6O, enter the codenumber 2, meaning severely inpaired visi.on. 7.9. 7 .9. 8. l. 8.1.1. Lastly, if the examinee fails the test ueaning blindness. To sum up : at 3 metres, ênter the code number l, Test passed at 5 metres wi.th large and small hands = Good vi.sion - Code OTest passed at 5 metres wi.th large hand only = Inpaired vi.sion - Code 3Test passed at 3 metres with large hand = Severely impaired vision AII tests failed Code 2 - Blindness - Code I 7'I0' In addition, code I is used for persons failing to understand Ehe test and code 9 (generally filled in by the census clerÈ) for those who undergo ski.n-snip exami'nation but do not prêsent for the visual acuity test (incfuaea children aged o - 5 years). Use code 4 (generally filled by census clerk)for person not examined buÊ reported blind by relâtives. 7.LL. Test to confirm the diagnosis of a reported blind person present in the vi.llage but unable to aÊtend the evaluation. 7.11.1. Visit the patient in his hone and br.i.ng with you a flash Iight and thevisual acuity test cards. Shine a torch in the eye of the pàtient reportedto be blind if the house is suffi.ciently dark. Ask Ehe question "Do you see my light?" Repeat the procedure several times. If the answer is consisEently "ro", the patient is blind, assign the code l. rf the answer is consistenÈly "yes", proceed to test the visual acuity of the paÈient. 7.LL.2. rf the insi-de of the house is too bright to uake the test with the torchl-ight in effective, do the hand movement test. Hold your hand 3o - 4o cm infront of the patient eyes and ask the question "I{hat âm I doing?" If he is unable to tell you what you are doing he is blind, assign code l. If he recognises what you are doing, proceed to test his visual acuiÈy. N.B. The hand should be moved slow1y to avoid generating air current in front of theface of the patî,ent which wilt ai.d him to guess what you are doing. 7.11.3. If you test the personrs visual acuity, report the result as usual. If you are unable Êo conduct the test report code 9. 8. MICROSCOPIC EXAI'{INATION After 30 minutes The followi.ng equipment is needed: A table; A binocular loupe; Curved tweezers; A watch or chronometer (set to exacËly Èhe same time as Èhe snip-takerrs watch); A number of plastie microtitration wells arranged in 8 rows of twelve etc.; trays each containing 96 round-bottomed serially nuubered Al - Al2, BI - Bl2, 8.1.2. Page 12 - Saline solution; - A hypodermic syrlnge and needle size 1; - A ro11 of adhes.tve tape (as wide as possible); - Microscopic exami,nation forms (for completed specimen, see Annex 3); - A black ball-point pen; - I,Iater and detergenÈ. Prepare for the exami.nation by marking in the left-hand column (headed "Numéro") of the form the serial numbers of the skin-snips. t{ith the hypodermic syr.i.nge fill the 96 weLls of the microtitration tray with saline. Clean and focus the lens. ülhen 3o minutes have elapsed from the time marked beside it on the slidetray, begi.n the examination of the first slide. If the first result isposi-ti.ve, enter in the second column of the form the number of microfilari.ae counted in the left snip and in the third column the number in the right snip, thus: 8.1,3. N.B. Before decidi.ng with the tweezers and under the snip. that a specimen is negative, lift the skin-snip out of the ring examine the liquid alone, as microfilariae may have been hidden 8.1.4. If the result is still negative, take both snips with the tweezers and put Ehem in Èhe first saline-filled well (A1) of the microtitration tray. Then mark the number Al in the sesond column of the form and leave the third column blank, thus: N.B. Take care to wash the tweezers after each use so as not to contaminate succeeding specimens. Proceed i.n the same rùay, using the wells i.n the order of Eheir serial nurnbering, so that after a while your form might look like this; 8.1.5. Village: ZORGHO Nuuêro I A1 2 8.1.6. 8.2. 8.2.1. 8.2.2. 8.2 .3. Page 13 hlhen you have examined all the slides, wash them with rrater and detergent and stick adhesive tape over the wells of the microÈitration tray so that they will not dry out overnight. After 24 hours (check) For this you need the following addit-ional equipment: an Eppendorf pipetEe(50) wiEh disposable tips, six clean ringed slides and two slide trays, afelE pen and a red ball-point pen (so that Êhe results are easily disEinguishable from those of the 3O mi.nute test, marked i.n black). Number the rings in the left-hand columns of the first three slides from 1 to L2, as illustrated in sect.ion 5 on snip taking (para 6.2). The middle columns will be used for Ehe specimens frou wells Al - 412 in the microtitrati.on trays and the right-hand colunns for specimens 81 - 812. While the examinati.on i.s proceeding, a second tray of three slides will be prepared for specimens C1 - D12. Then the first three trays can be washed and used agai-n for specimens El -F12 and so on. With the pipette, transfer li.quid fron the wells in the microtitration tray to the corresponding rings on the slides and examine. 8.2.4 . N.B. Change the disposable tip of Èhe pipette after each speciman to avoid eontaminat.ing the next one. 8.2.5. If the result is negati.ve, mark 0 with the red pen the form, which you left blank after Èhe 30 minute the number of microf ilari.ae counted. Finally, dispose of all specimens and wash slides, pipette tips. in the third column of reading. If positive mark microEitration trays and8.2.6 . Village: ZORGHO Numero L 1 A1 2 A2 3 6 L2 4 A3 5 o 2 6 A4 7 A5 I A6 9.1. 9.2. 9.3. 9.4. lo. l. LO.2. 10.3. Page 14 9. CHILDREN BORN AFTER THE START OF THE PROGRAUME One of the ways of determining whether transmission is occurring in afollow-up vi.llage i.s to investigate the presence of infection in childrenborn since the start of the vector control programme. This requ.ires an addiËional effort from the census officer and the microscopist. As the census of f .icer f ills in form 5602, he should note dordn on a separate sheet of paper t.he skin-snip number, namer agê, sex and fanily nurnber of every child whose age is equal to or less than the number of years of vector conErol i.n the vi.llage. For example, if vector control began in 1976 andthe survey is bei.ng conducted in 1986, all chi.ldren aged ten years or less should be listed in this way. AE the end of each dayrs work the census officer checks the results recordedby the microscopist against his list of children. If any of them i.s foundpositive, a new pair of skin-snips is taken from the child and examined using the usual procedure; i.ê. after 30 minutes in distilled water andthen, if negative, after 24 hours in saline. This verification is needed to avoid errors due to mislabelling. rf a child on the list is found positive a migration history must be established at the same time as the second pair of snips is taken, to ensurethat he has not been residing in an area where onchocerciasis transmissionis occurring. Note down where Èhe child was born and any other places wherehe has li.ved, with the period of residence (e.g. L975-L977). In recording aprevious place of residence be sure to specify name of vi.llage, subdistrict,district, region and country so that it can be located. 10. DATA ORGANIZATION. (DEPOUILLEMENT) After the sutvey of a village has been completed the consolidated results are entered on three special forms (for completed specimens see Annexes 4, 5 and 6). The ftrst form is for the census data, the second for the results ofthe parasitologi.cal examinatî.on, and the third for the results of the vi.sual acuity test. First cornplete on all three forms the spaces for the name and identity number of the village and for the date. First form: Census results In the first column write the i.dentit.y numbers assi.gned to the families andin the second column the number of individual members in each family. In thethird to eight columns enter the number of persons coded Lr2 or 31 41 51 6 and 7 respectively for "Exami.nation staEus". In Ehe last column enter Èhetotal number of persons in a family who are known to be blind, whether or not they presented for the vi.sual acuity test. Finally, add up the fi.gures i.n each column and write the totals at the bottom. Second form: Prrasilglgglggl_leqllrs results of the skin-sni.p reading by age-group and sex. (a) rf a person is negative for both snips, use the notation /o/.(b) If a.person is positive for at least one enip, record both figures,e.g./o-Ll or /9-L5/ Count the total number of persons found positive and the total examined in each age and sex sub-group and write the two figures in the bottom right- hand corner of the corresponding box: e.g. o/L7 for age o-4 I'lale. 10.4. Page 15Ff'nally' at the bottom of the form, record on the left the total nuuber ofmales posirive and rhe ror;i;;mber examii"à; ;" rhe righr Èhe rorar number ::.j::.,"s posirive and "*",oinuà, and in i[u'*iàaru .r," grand roral for borh rt is very easy to miscount so always count twice and write down the resultonly i.f it i.s the same both times. Otherwise re_count. Third form: V.i.sual acuit_v Enter .n the appropriate box the number of cases of blindness (code 1) andvisuat impairmenr (codes z ^nà i) to" u."i ;;;-1.,a "g"-group, and ar rheÏilT:i":t the rorm'the tofai--irina and rhe ;;;ri visuarly inpa,.red in rhe 11. DATA STORAGE 1r'1' rt is of-vitar importance to organize a.data bank for storing theinformarion correcred. use toxer "ir" :+ * 25-;--i;-Jr. ,uu"y folrow_upvillage should be alloealed a ""pài"t. box to "riàr-"ï"m for the results ofthe subsequent surveys' The."".rit" ro,, t.serio" riri.ges.rot folrowed upcan be grouped, e.s. five "iliü;;-ti-" uox. The i;;;;i.ty n,rrber(s) of rheYir,à:tir;: |,.à:î5;À.should ue mfrrceà-on .r,u uact or-tie box, ê.g. ,.135,. or 7L'2' As the data bank may be damaged or destroyed by termites, fire, etc., makeiÏi:ïË:es or e'"tvthing and esËabrish a duplicate uanr in anorher 11'3' computer sotrage should be used if avairabre. 12. ANALYSIS 12.1. The basic uni.t used in the analysi.s of OCp/EpI evaluations is the village.Two types of analysis are routinely carri.ed o,rr, èio"J-sectior,al see annex gand longitud'inal see annex 9. whereas the former i"-based on the totalpopuration of Èhe vi'llage the laEter concentrates on the adurts population(2o to 99 vears)' The irinciples ana-Jarculation ;; ;;; cross-secrionaranalysis are straight forward and can be.found in any beginner manual ofstatistics' The pr:i'nciples ,"a ".i"rrriion of th"-1;nJia,roirrrr analysis aremore cotrprex and require understanaiiÀ-àt cohort analysis. N.B.: I0.5. OCP/ d3 Annexe Flche de Vtllage GBANDo (190) 1. 2. 3. 4. Date de vlsite et No. de Passage :24 -Fanni -Bamba Prêfecture de Bondiali Sous-.Préfecture de Bondiali Canton de Tenhoure (Gbando) eE 25 avril 1976. Premier 6. 7. o passaSe. Obiet de Ia visite : Evaluation détaiIlée' Foyer d'onchocercose : Gbanoni ou Bagoué à 6 kms envlron et Passa' so" affl"e"t, à 0,1 km du vlllage' Accès:RoutedeBondialiàMandianani'EnpartantdeBondiali' 6Ëffio'";;-i; ààuxieme vlllage que l'on trouve après Ie pont' de la Bagoué. I1 est sur Ia droité de Ia route' la gauche de celle-ci étant occupée par les hauteurs Nyaoro et Nyafara au flanc nord desquelles coule le Passê. CSldilion§-lg3Sêvail : Installation de séjour et de travai'l dans une cour intérieure Ou vittage située au nord de 1a malson du chef' Nom du chef de village : Manudio Fane Ethnie : sénoufe (code 060), sous-ethnie des Nyoudougou' ES-11fl-gqg! : EPI a recensé 127 personnes ' en a examinées 90 en parasitotogie et.... en ophtalmologie. 11 y a 55,? I d'hommes et|tl,t% de femmes. La pyra*idt dt= âges est donnée à.1'annexe II à titred.information.Elleprésentedenombreusesdistorsionsmaissa taille limitée interdit des commentaires pertinents. La distribution par âge et par sexe est donnée à I'annexe I' Recensement ào*i.,I=t..tif d'avriI 1975 : 126' Histoire et strucLure du village' tr 9. 9.1 orisine des habitants : Les habitants de Gbando déclarent et"Ë-"2= au.o fuur village lequel a passage de Samory. AutrËfois chef-lieu du canton de mème nom.ilperditcetitreauprofitdeBondia}i,aprèsla g:uerre. Eànfiguration Oe f'naqitat-: Gbando a un habitat relativement groupé. Les *ui=o.,s d6=îénages Lout comme les quartiers i'o,',i pas de délimitations matérialisées' pgq-p,e!91!-9-9ç]-eui : néant' Il faut se rendre à Bondiali' csryr-]€,lq-.r " Leeç]e; rE!-ls!e.' ^L 1 ctr g I f e r I e - : : t ^ I : . s v s tème politico adnrinistraËT'--Ë;hefl de village est assistê d'un secrétaire' f-. *enâÀe-est Ia celtule sociale êIêmentaire' le clan, cell. a. teiàience, celui des Fanni agquel appartient 1e chef et celui à.= S"*Ut" dont fait partie le secrétaire du vl11age. 9.2 9.3 9.4 10. OCP/ a: Annexe 1page Z 11. 4 c !.i vilÉq,_rwt _§§ elgrn r qg_e s . 10'1 Agricultu.e : Le chef de village est également re chef deLerre' Les champs se trouvent du côté opposé à ra rivière.Cependant les femmes de Gbando ont, depui" Iongtu,rps et cejusqu'à ra saison 1975-1976, entretenu une rizi.ère au bord de1a rivière passé. to-2 Au!rc§__cçl§i_lgg : élevage de mourons, de chèvres et ctevolailles. 11 y a également. des boeufs, tous propriété desPeu1. 10.3 qSre : rien à signaler. @. 11.1 Immigratjt-rn : néanL.lL.2 Erig_rg!_l-c! : sur lJ personnes absentes, 20 sont enémigration, ce qui représente 15.77.. Les directionsprincipares- sont Bondiali (B) nuiajan (4) yamoussokro (3) etDivo (2). Les principares trancheÀ d'âge concernées sont :10-14 (3), r5-r9 B). zo_zu tal "i-25_:ô"flil ProbI èmes parLi-qql_ler§ l2.l Jusqu'en 1975, l'eau de boisson du virrage provenait de rarir.,ière. 1) ======= ocr / eeu / ('i) PllC GnÂ-.l'l's DE 5*'ïî::"li*.. riltlltenquête: I Y I' mols 15-16. Quartier: tuTlE COlilB-E ,9m arlne e It cliolocDRcosE 9-10. Passage Tf-rg. Fan1lle . B.{SSIN nr.rné ro : nu:cé ro : DD T,À VOITÀ - ÉvEr."trow 11. Etat: 2C-22. SII,{PI.,E Ethrlle: - FoFr .;riRE' lsls lole I IJ 12-14. Vil1age, W 41 I Ob se ri s i iongo)i .+tE m.r: 40Âcuité vi suel 1e ,c-1tl 12 ^b'e ! »e iU ,enre - . §:- stro 23_28 Itr':.né ro lndivlCueIlloa de Ia Pereonne liu!e ro provl- .-rlre 0û t4 I t3tî tôtg o 'c) _b(*) o x o i-.J /r3tîto8tû 0ér4 5-8. Date Ce L'enquê'-e : l5-16. Quartier PRO6RA}}1E DE LUTTE mBfafa *rt w année [,YALUAT:tTiI ll. Etrt: COHTRE L'ONChJCERCI'SE - BÉ.5S]I( T: LA VOLT . 9-lo. Passage nmêr'o , ftW l7-19. Farnllle nr,^éro , 6:{,7F]| StHFLt - f Urlt{ulnr 17 ,Ç 16rÔt-zl l-+v tr ra't1 Yirrrse 'DW1 ?0-22. Ethnle : liunÉro provi - soi re 0bservatl ons ,1-19Salpr - crStaalIllaquoa ?3-?g li'*nêro I ndl vl duel Hmr de 1a personne o C) À UJ o x o(, oCP/d3 Annexe 4 o!(dÊ X § I§l s § I I *,1 s\ 1 J ul lt *i'l \ \. (-. §i 'l c"| -l §l "l § I X .ù\ \ -t\ t,\ \ -1-\ *lI l()\ U!\ § \ § § ê \ -àê ai â \1t:. o r{ r\U E. \l§ \ §\\ IM -§l -l I § \l\l .ti .\t § §:\ § \ § t,,\\ t,'rl\ u\ u \ \ t §\ §.l^\ r{ +\ z c, ôo(E X l \ \l \ Àill \ \s §'l s \ çY. § ?\fb ô§ rta în {§ \ \ \ § oq X q tq §0q "Jfq (ù\ IE -ltr l1 oq \l 8II .t tâ a qO crt -§ \ §. fu §( c( Tq \\ ok\0) IJÈ \ \ "+\ §r| \ù \ I <){ \ t. ,\- §(\ § \ \ \(I\\ tô\ §\ \ c Cr\ x\ c.l O( §\ T \ \ ôcçt ( t{h) 0, +J(n Êr X § 1§ \ § \è §> § \ § § § \ \ §J \ \ \ \. \ X \ôï cl.T \1 ôô J- l<] -_lri a \ E §I \q +q .1q {t ha \D§ .t§ ooq §\q. a {\ ofr Él {j\ § ùa\ x \l.1 ! \\ èi\\ ù §\\ \l.] \ t\§ §r)\ §\ \ ô §(\- § §T 0Jr ô0(! i X q § § § (\ § § §] c) § \ § § -t \ § § \c § X .ô, §q § -r(r h'v \§ § èo\ §\:l §§ \ \ I M .ï. { -{-} \ h\ otr ââ §ô(i (,\r§E (Y!o.J {t(x c() \§§t ùJ O.gr- a-lclo §(yl §- .iù- vî I§, Lcr: vs Ê\(ÿt ô\q'r (r'tJ- §§ sq .t\ t}k . tt I .§È n , !.. JIlurnéro I o3Z ocP/d3 Annexe 5 __1-- 3t lrl*î --tLV- -_Jh _) 23 __)3 ) n-l f -.-i - I - I -+ / ----'--r-- .4 i i 3l,t t-t- -rlæl,l ,_[:r rl: I I 4_ -lttâ-L-r-i l--2-EI I -1.0* ': . I I -llL- \, - l§-L , l--fi,-l r (_ Noro Numéro o32 DaÈe : 41 f8E oô 'dÈ(, I o x o o\ Age H F o-4 lpl cl üi[;l c/ ol ct/of o'f ;/ t;/ o/ ,/ Di t; o/t z o lol cl 0l ol ci o/ o/ o/ o/ c/ ol i-9 )|il;fol clol ol ololo/o1o/ y'o/o/oic/ ,://pl ;f ,/ol oit t ôf r.>i t:/ o/ t7 o/ ,t/ a/ o / o/ o/ ,/ o/ c/ a/ o/o/1 c/tr 10 -14 ololo/ololo/ "l c/ L,/;/ -'/ a/tt r/ cl u/ c/ ,ci o/ o/ o/ a/ a/ a/ ,/ ,- / o/ o/+ 1915 ol Dlo/ o/,t/D/ "z/c/ c/o/ o/c/il o/ îf ù - 2/r ic/ -/','/û/ -i/ir of /s- .f , f ,^/ o,/ o/ rt/o/ o I D/c/ a/''1,;1 o / o f 20-29 i,f cl o1-/s/c/c/o/i'i-i / - rt /./,/"it'1 zs'- i f /. / / / ,rl4 - 3ltoz-i(I Ç/'t t cl c,l,_,iu/ cl ol ùl ;;1t'/;'/ o/ ,:/ c:/ )/ ,-/ ;/:,/ '/ -J/ 4/4ÿ 30-49 olslOicl;- 16/ 2/ o/ ->/,:1 2i -t; l,:'l -;1o1 .r/,;/,:i / -i,j//r ol ,'lri,lo/./clùlo/ rZ - i/,'/.r/,;l /,I..1'l /.,/,/ 1/t o 50 4i/,i Q c1 c1 o1 ,?/ )/ cl llf .'/ ,: I r.t/ t; / ,;l; - 'l/ o/.tq :.tf ul ,ti "/ t:,i./' ,/ ,1.'l ,./, /..)/ -,/,// 1/rat af a*t KOtl Rtoçu t N ocP/d3 Annexe 7 r0ôo F\' rl§l f'] H H () f'l () I rl1 É Ê{ a Él È ü fl frl I{ a t 5\5 o aào >1. a I I ; t= P <u E I I I I