Progress report on the implementation of transfered activities to the national onchocerciasis control programmes (1st September 2000 - 31 August 2001): Sierra Leone

Onchocerciasis Control Programme in West Africa (OCP) Programme de lutte contre l'onchocercose en Afrique de I'Ouest JOINT PROGRAMME COMMITTEE JPC - CCP COMITE CONJOINT DU PROGRAMME Office of the Chairman Bureau du Pr6sident JOINT PROGRAMME COMMITTEE Twenty-second session Washington, l0 - 1l December 2001 IPC22.8 C) ORIGINAL: ENGLISH September 2001 Provisional aeenda item 7 PROGRESS REPORT ON THE IMPLEMENTATION OF TRANSFERED ACTIVITIES TO THE NATIONAL ONCHOCERCIASIS CONTROL PROGRAMMES (1st January - 31 September 2001) SIBRRA LEONE MII\-ISTRY OF IIEALTH AI\D SAI\'ITATION ONCHOCERCIASIS CONTROL PROGRAMME PROGRESS REPORT ON THE IMPLEMENTATION OF TRANSFERRED ACTIVITIES OF TIIE ONCHOCERCIASIS CONTROL PROGRAMME The Onchocerciasis Control Programme in Sierra Leone suffered severe setbacks in its prograrnme implementation since 1991, two years after the start of programme operations in the country. The 9-year civil conflict led to a disruption of activities with the total cessation of aerial larviciding and suspension of ivermectin distribution in most parts of the country. The signing of the Peace Agreement in July 1999 ushered a new era of hope for control activities in the country. The long awaited disarmament process has begun with the Disarmament, Demobilizat iorU and Re-integration o f ex-co mbatants. Community members are now resettling in their respective village communities, United Nations Peace Keeping Force (JNAMSIL) deployed in most towns and cities. Treatment with ivermectin of affected persons continue in most of the oncho endemic villages in the South and Eastern parts of the country with the active collaboration of our NGO partner, Sight Savers International. During this period, the following activities were carried out: I. TRAINING a. Health Workers Training workshops for health workers in the districts of Bo, Moyamb4 Western Are4 Pujehun, Bonthe and Kenema were conducted on the Management of Onchocerciasis and in the Concept of Community Directed Treatment with Ivermectin (CDTI). A total of 301 health workers had already been trained. District Number of Health Workers Trained Bo 59 Moyamba 46 Pujehun 4t Bonthe 4t Kenema 48 Western Area 66 TOTAL 301 b. Community Ivermectin Distributors Training of Community Ivermectin Distributors was done in the districts of Bo,Moyamba Bonthe and Pujehun in the Southern Province and Kenema district in the East where CDTI had already began. A total of 5316 community distributors were trained. District Number of Commu nity Ivermectin Distributors Trained Bo 904 Moyamba t4t2 Pujehun 1222 Bonthe 758 Kenema 1020 TOTAL 5316 2. Ivermectin Distribution a. CDTI in Bo District Atotal of 55,254personsweretneatedin33l villages. Thetherapeuticcoverageof 620/oand geographical coverage 73Yo were achieved(See Annex I ). b. CDTI in Moyemba District 59,915 persons were treated:rr_542 villages. A therapeutic coverage of 55Yo was achieved with a geographical coverage of 77o/o(S* Annex 2). c. CDTI in Pujehun District@artial Rezuhs) 32,829 persons had already been treated with a therapeutic coverage of 55%o in 307 villages. The geographical coverage was 88%(See Annex 3). d. CDTI in Kenema District@artial Results) 23,242 persons were treated in 186 villages. The therapeutic coverage of 52Yo and a geographical coverage of 80oh were achieved (See Annex 4). 2 3. COMMUNITY TION Public Awareness Raising and Sensitization were carried out at National, District and Community levels through the mass media, radio television news and community meetings. Various IEC messages (Posters) were developed and distributed to health centers and communities. 4. MONITORING AND SUPERYISION Supervision and monitoring activities were carried out by National, District, and Community members, but on an irregular basis. Besides not all villages were visited and therefore a lot of work has to be done to improve performance by community Ivermectin distributors. 5. CONCLUSION The Onchocerciasis Control Programme continues to make steady progress in the implementation of its CDTI activities. The therapeutic coverage rates of 52%-62Yo are a clear indication of the communities' preparedness to accept this new approach. 3 PL+N OF ACTION (2002-2003) Activities Resources requircd Responsible ollicers Indicators Implementation period l. Refresher TOT workshop on CDTI for DHT rnembers in all the districts Facilitators Stationery Office space Transport Per diem National Co- ordinator EPI Technicians 39 Trainers retrained 2003 2. Local training of Community Members on Epidemio lo gical Surveillance @assive) on Oncho Facilitators Per Diem Stationery DHTs PHUs # Trained 2002 3. Refresher Training ofNurses on CDTI in the Northern Province Facilitators Stationery Office qpace Transport Per Diem National Co- ordinator EPI Technicians DIIT 300 Nurses Retrained 2m.2 4. Training ofNurses on CDTI Eastern Province (Kono and Ituilahun) FaciltL Stationery Office space Transport, Per Diem National Co- ordinator EPI Technicians DTTT 100 Nurses trahed 2002 5. Training ofDHT members to conduct Epidemiological Evaluation of Onchocerciasis inthe Soutlrern Province and Northern Province Facilitators, lv{aruals lvlaterials for DEC Patch Test and skin srip, Stationery Transport, Per diem National Co- ordinator EPI Technician DMO 39 DTIT trained 2002 2003 7. Community sensitization sessions For target population EC materials Radio TV DTTT Community Members # of rudiol TV shows # Community sensitized On going 8. Printing of IEC materials Funds National Co- ordinator # IEC materials 2002-2003 4 ti* 9. Community Directed Treatment with Ivermectin (cDrI) Drugs, Measuring Rods, Village Registers, Pencils, Reporting Forms Community Distributors NGOs # of people treated # of villages treated # of tablets used 2002-2003 10. Regular supervision and monitoring on CDTI Vehicle Fuel Per Diem Lubricants National Co- ordinator DHT, Nurses Village Health Committees #of supervisory visits On going 11. Epidemiological evaluation of Onchocerciasis Vehicles, Lubricants Fuel Per Diem National Co- ordinator EPI Technician Evaluation Report submitted 2002-2003 12. Equip National Co- ordination with Epidemio lo gical evaluation tools Microscope Skin Snip instruments DEC Patch Test Emergency Monitoring Kits Incubator Trays etc. GPS Instrument OCP MOH NGO #of Equipment received 2002-2003 I 3. Strengthen National Oncho co-ordination Personnel Vehicles Computer & Printer Radio Photocopier Stationery Fuel Lubricants OCP MOH NGO National Coord- Offrce strengthene d and effective 2002-2003 14. Operational research on CDTI, Black fly nuisance or reinvasion and impact of ivermectin on transmission Research protocol, investigator, interviewers, stationery and funds MOIIA{GO Survey reports 2003 5 15. Training of Community Members on Ground Larviciding Ldanuals, Facilitators PerDiem Entomology Technicians # Trained 2002- 2003 6 oll .6tl-o EE oz CD o o, o)F-(o lr) F lr) @(f) O)(ot CDo @s t i- o)(ooN (aNf-(o $ (o GIr r$to olN F-@ I,-lc' c')o oN(o (f)(o c!c,N T\ c,o at,to s o ED(E L o oo O) ro (f) @ s@ (f)@ ol- (f)to z (f)I- {o) c4,@ @rr) l()ro c\lro (o(o N(o Pt+.6, EEEL r-oF o- @(o$l(o NI-(o @ (o @o N(f) @ F @Nt- (f) O)o(o C\I(f)os o)@(o c\lt f-$rt- (o r-(f, (Y) s@(f) oF- l() o) f-o IttoN rolr, o EEo5Fo. o o. o) s (o (o F- (a @$l o o, c{ n-F-s m c\t(\l @ 1r) z N O) @F-$ lo F-N @o@ ro o,(o o)(o o)r o) c') oootN N o)Ng) @ o EDlll ^bs oo (f,i- oo oo oo (oo, (?)(o (o (o@ oo loco oor oo @r- l()F- N@ = 8E E gE @ (o6t F to t oto C\l(\l (o ro ro\f @ oc\l @C{ ro$ G'G' trt-gE orE =o>+,bootr cio =-t C\I(\ @N r tlo - ro c',t- oF- t- lo (f) ro @ loN (o(o o(o NtI,t E oE's .9Eo (E EDtrg o!G 2 L o EDtr oo G Es IE .? o!ttr o = .g oo (E otrg o tt, o .E CD = o EL E o oxE oI F IU =!oY o4l(9 G E 6 olt EDoo IE oo E ov -g(E z =3 CD J G E o(E E J FoF Fo E,t- 9,o oE =troo z Fo UJ =tr ul Fz ul UIFo UJt. ->XF2=z=<= o Ir. o @ =o IJJt I dll CE !,FG,r.- oq= o z, (olo(olo (o o) (\l$@$(\l (f) (f) @o(\l tolo$(\t tr)s o) (o @i-(o(\I o @ @lr) F*o -o FN(0 - s oE' TEL o oo t- o)tr) t- @6l o@ C\l|r) o(o r@ @lo loro c, 8E EEG () N ro o) It!+ o lt o) o)(Y) ro o N o) (ooN(f) o @ (o(o tr) o)(Y) tlo -o, o,to c o EEOEFCL o o- (o!to@ (o (o rolr)(\t(Y) so(o(o(\t !tN .tto @GI @ () @t\t(o @N @ (()(o (o o G,,(\too !F o CD!E^bs oo (f) o) o@ oo (o(o @F- loo) lr)o, o) FF H 8E ; EEz=F (o to r-(f) (f) o) s!{) o) F-(Y) (f)r- (olr) lr)s Ntlo O- SE(E IE =o>+. ET2s o @ (o v (r) O) olr) (o @$ f-I\ o)lr) r-t() aoor\ E o!,r- .9to Glr E c, TEY (E{.4tr rUo L o CL CL = IE tr = --(E IL (! +atr(Eo Lo =oJ oo6o '6 (E E(EY 'tr oY TU =L ED c,E r! =oY J FoF N x UJzz 8 n OllSu rOo2 oz lt !.- CD(o (\t ol C\t(\t @tN F-s o)o$l t-(oo o)@ o)s @@ lo(f)s@ @(o i-oo s o ED6 o oo ro rr, o(o $(f) rr) -ro rr)@ rt(o rorO tr -9u EEOF o. r r o (o(o i-(o @(o(o o,(Y) F*(o o(o @(f, (")o!'- (o(o N(f,l() o)C!@$t(o tr o EEo=FCL o o. $rtlr) @ r @ C4'() to) (o st(Y) r o (o F- r r @ N @No lr)() F- @ @ F-oo(o s oo6 o o(, (o o) @ oG) (o@ $CD oor ot* @I- @@ E gE ,S E>+. F-o rocr) (o $lr) (9 root F- 6t$ t,-o(f) oE : EE -E o>Ir (Y)s o (f)(o (f)(f) roc{ o $ro CDrt(f) E o!, -9Eo E o!tE o EL6YI(E E'tr(E CLY (E B o U' (E! G CLY 'tr Lo o-tootr -9 6o E -96 = YY -9o o.! o - E 6o J FoF G,i' x UJzz =U' ult. 9 otrFO .;fz N F- o)o - I- O) o)(o c')|r)(o (f, s sN ooo c\l O)(f) o,lr, oooN oo rON o rr)N rr) f-losN oN .(r!t @o(l, @(o o, olG^L-oOo\ >v oo (o rr) (otr) srf) Ns orr) lf)(o (oN lr)@ (f)rO @rO o(o Nlr) tr .9ots =(EAEo+, o. F-(f)os o) c\lsN No @t @oo (f) @f- CO (o @o (o cI) rr) s cf) olr)I- r F-s o) or-(o N stN(v, N tr o EEO3FCL o o- o(f)(ot- o)N(f)t (o N @ @ os(o r NNlf)t- l^r) (f)o(o (o @(\l N o(f, (f, r N CO(o (f) F-N(o rr) @ cI)N NtNtt o E')!E^b;e >v oo l()s $f- rO@ oo - oo oo oo oo o)G' oo i- oC' 0)a E SE ,* E>+. @ (oC! ov (o F-C\l COr (o $r (o o or (o c, Es or sl -g aE =E,>E!roozr' o$ ro(o i-s (o i-c\t (o (o o sr oF'N E o!, .9 .C o o m (E E U' t o!,c(U = otr 5.s!, CLtrct E-3 o E oz G -ttr =F G E IEo .E;(E E'tr tEJ CE oY .E =IE o ot, oo ;tr E€ocED(,z= f oF a =lol 0rl sl .sl EI GI o-l ;l OItl 1-linl old =lUJIzl ul YI =l zl FI ol uJl =ltl nll >l IIFl =lFz ul =F UJEF o ulFo IIJt 6 F =f = =oolr U'FJf U' UJt t xluzz l0