Progress report of the World Health Organization for 1980

Onchocerciasis Control Prognmrre in thc Volta River Basin area Programme dc Lutte contre I'onchoccrcore drns tr R6gion du Bassin dc la volta JOINT PROGRAMME COMMITTEE Office of thc Chairman JOINT PROGRAMME COWITTEE First session JPC.CCP COMITE CONJOINT DU PROGRAMMEBureau du Pr6sident JPCL.2 0ctober 1980 a' Yamoussoukro 24-27 November 1980 Provisional agenda item 4 The Conrnittee of Sponsoring Agencies has reviewed the progress Report of the world Health organization for 1980 and submits it for the consideration of the Joint Prograume Couunittee at its first session. a ocpfpp/ ao.q September 1980 ORIGINAL: ENGLISH ONCHOCERCIASIS CONTROL PROGRAMI'{E IN THE VOLTA RIVER BASIN AREA PROGRESS REPORT OF THE WORLD HEALTH ORGANIZATION FOR 1980 CONTENTS SUMMARY VECTOR CONTROL EPIDEMIOLOG]CAL EVALUATION EXTENSION STUDIES . ECONOMIC DEVELOPMENT APPLIED RESEARCH Entomological Medical DaEa processing ENVIRONMENTAL MONITORING TRAINING LIAlSON ACTIVITIES With the participating countries With the statutory organisms . . With the donors I,trith the general public COMMISSION ON LONG-TERM PROSPECTS . I"IANAGEMENT AND COSTS ANNEX I: MEMBERS OF EXPERT ADVISORY COMMITTEE AND ECOLOGICAL ANNEX II: SCHEDULE OF INSECTICIDE EVALUATION . ANNEX III: TRAINING GROUP Page 2 3 4 t2 13 L4 L4 15 16 16 17 18 18 19 l9 l9 20 2l 22 24 26 octfpn/ ao.q pa$e 2 SIJM},IARY Highlights of 1980 were: spectacular results in the third passage epidemiological evaluation in the west Upper Volta area of Phase I where the incidence of the disease r^ras nil in all age- groups examined; - a successful field trial with a second forrmrlation of Abate insecticide which proved as effective and as acceptable as the Procida product thus giving OCP two sources of supply and greater flexibility for purchasing; - a reduction in susceptibility to Abate in an isolated population of one species of the S danurosum complex, in a forest area on the lower Bandarna in Ivory Coast; the launching of a new programme of training and research in health economics; 12 participants attended the first surrEner seminar atd 24 candidates have been put forward so far for fellowships; the constitution of the Expert Advisory Conunitteel and of the Ecological Group which held their first meetings in Geneva in September; - presentation by the Independent Conrnission of its interim reporE on the long-term prospects. Of particular note were the visit of His Excellency General E1 Hadj Aboubakar Sangoul6 Lamizana, President of Upper Volta to gCP on 1 and 2 September. The progrartrne arranged included a briefing, film show and field visits; recognition of the work of OCP staff members Drs J. B. Davies and J. F. Walsh vrho, together with Dr R. Garms of the Bernhard-Nocht Institute, Hamburg, were awarded the City of Dusseldorf Hygiene Prize for 1980. Expenditures for 1980 are now estimated at $ 15 432 483. INSECTICIDE CONSIIMPTION FLIGHT HOURS AND EPIDEMIOLOGICAL EVALUATIONS t974-t979 l,itres/insec ticide Helicopter hours Fixed-wing hours No. villages examined (EPI) No. persons examined (EPI) L974 L975 197 6 r977 197 8 t979 Total 75 631 2 783 54t 75 L8 7L2 L29 947 4 265 6L4 L22 30 726 155 615 5 358 L O25 107 25 943 2L5 879 5 286 t2& 80 20 944 263 377 5 504 L 371 2 7L L9 086 840 449 23 L96 4 755 455 115 411 1- - List of members - Annex I.)_ ' Th" ZO% increase in insecticide consumption in 1979 is accounted for by the extension of control oPerations in Ivory Coast. ocpfpp/ ao.q page 3 VECTOR CONTROL 1. Vector control operations in 1980 covered a total ground area of 7g+ OOO lsn2 and 18 034 lqn of river Per treatment cycle in the wet season, and 8014 km per treatment cyclein the dry season. Requirements of insecticide for 1980 were estimated at 27O OOO litres and flight hours at 5960. FLIGHT HOURS AND ABATE CONST'MPTION JANUARY I.979-SEPTEMBER 1980 Month He licopter Fixed-wing Abate t97 9 1980 t97 9 1980 t979 1980 January February March Apri 1 M"y June July Augus t September 428.L 3t7 .7 286.O 305. 9 579.4 535,4 526.5 58L.7 483.3 483. o 372.6 359 ,9 42L.3 415.3 530. o 695.9 459,L 44L.3 80.2 67,8 44.9 53.4 89. 6 90. 6 138.7 L92.7 L42.5 80. o 59.3 48.4 4L.7 34.o 57 .4 131. 6 115. 1 130.1 LL 45L.7 5 785. 8 6 003.4 6 6t7.9 16 088.6 25 727.6 30 756.6 45 935.7 34 342.7 L7 2t1.5 11 558.0 8 574,8 9 678.7 10 795.0 L7 479.3 23 883.O 17 485,0 20 63t.6 Total 4 &4,o 4 178.4 900.4 697.6 182 710.o L37 296,9 2. From 1 January experimental interruption of insecticide treatment was undertaken on all rivers in Phase I with the exception of the Bou, the Banifing IV and the Black Volta and its tributaries south of Batie. It was planned to resune treatment only wtren one nulliparous simulium was caught, or wtren catches reached 10 flies a day. 3. In all, treatments stopped for eight weeks on the Upper Comoe and the Black Volta uPstream from Samendeni, and for 13 weeks on the Lotio river near Sikasso and the Comoe river between the tributaries of Kolonko and Kinkene. Treatments were periodicallyinterrupted for a total of nine weeks on the White Bandama. Excellent results in Phase II with zero fty catches in many parts enabLed treatments to suspended throughout most of this phase in August and September. Only short stretchesthe sissili, Red Volta and Upper white Volta remained under treatment. 5. Flooded rivers throughout most of the Prograrrne area in August and September resultedin the disappearance of many breeding sites normally present at lower water levels. In consequence a number of these rivers were left untreated. The Oti, the White Volta, parts of the Black Volta, the Baou16 and Bagoe were so affected and at end September were stil1 omitted from treatment circuits. Aerial contract 6, The second aerial spraying contract terminated on 31 December 1979. The third contract started on 1 January 1980 with the same contractor, the Canadian Conmercial Corpor aciotfViking Helicopters Ltd., and will continue for three years. Under the terms of the new contract there is a basic requirement for six helicopters and one flxed-wing aircraft, the Progranme having the possibility of calling in additlonal aircraft for rainy season operations at one month's notice. From 1 June seven helicopters and two fixed-wing aircraft were in operation. The main operating bases continue to be Bobo-Dioulasso and Tamale. 4. be of owf fl ao.+ pagb 4 7. As a result of experience gained so far certain modifications to the aircraft and spraying equipment were required under the new contract. These included improved ventilation, inst.allation of partitions in the heltcopter to isolate insecticide fumes to the rear of the cabin, positioning of new external mirrors to enable insecticide application to be viewed more easily, addition of tropical mesh seats for pilots and passengers, and new radios to improve conumrnications. Specifications for the application equipment were changed to provide more flexibility in distribution of insecticide. Riverine discharge varies widely between dry and rainy seasons and the new equipment, by offering flexibility in insecticide dosage and flow rate, should enable all conditions of river to be effectively treated. 8. Contract review meetings between CCC/Viking and OCP were held in Ouagadougou from 13 to 19 Febn:ary, and in Ottawa from 18 to 22 August. Progress towards the modj.fications stipulated was noted including the install-ation of a new HF radio system to improve conununications between Bobo-Dioulasso and Ottawa. OCP, for its part, had located and marked 15 power lines in Ivory Coast to reduce flying hazards. The spraying equipment was discussed in detail including the need for a system suitable for both Chlorphoxim and Abate. It was agreed to test a stainless steel tank in a treatment helicopter. 9. The next contract review meeting has been scheduled for the last week of October 198O in Ouagadougou. Entomological evaluation 10. Six sectors and 25 subsectors, including 77 iector collecting teams were involved in the entomological evaluation which covered some 375 catching sites. 11. The periodic rotation of "Sector Chiefs'r, which is intended to provide as broad an experience and knowledge of the Programme area as possible, took place dur:ing the course of the year. L2, The first four months of 1980 followed the same pattern as in 1979, with zero catches of S. damnosum at most sites in the Progranrne area. In March, for example, otly 74 flies were caught in 223 days of catching, with the majority of these occurring along the southern boundary. As before, a few sites on the rivers Kulpaurn, White Volta and Oti presented difficulties but were finally brought under control. In the r.rest, results were particularly encouraging and flies were recorded on the L6raba, Bougouriba and Bandama rivers only after treatments had been deliberately interrupted for several weeks. 13. For the wet season up to the end of July the results in Phases I and II can be considered satisfactory. No catching points registered an Annual Transmission Potential (ATP) of more than 2OO. On the River L6raba, densities were higher than in 1979, probably due to a higher overalL level of reinvasion, but even so the cumulative monthly transmission potential for this point reached on]-y L77 by the end of August, compared with lL22 in 1976, and it is unlikely to climb unrch higher. 14. fn Phase III W reinvasion was particularly heavy with twice as many flies as in 1979 being recorded at Madina Diassa. A similar situation was observed along most of the western edge of the Progranmre. In Phase III E as before, the sub-sectors of Dapaon, Natitingou and Niamey showed excellent results, and it was only to the east of Kan<li, along the river Sota, that f1y densities were persistently unsatisfactory. In the area of Lama-Kara very good results qrere recorded up to the period of reinvasion, r,rhich started in June, and even then Ievels of biting flies were lower than in previous years possibly due to the experimental treatments to the south. ocpf pR/ ao.,* page 5 COMPARISON OF FLY CATCHES - I975-L979 FLIES PER MAN PER DAY L6raba River - Pont Routier 197 5 L97 6 L977 L978 L979 1980 May June July Augus t September 92 L4L 26 50 2 9 115 L29 t34 39 6 18 151 103 60 33 4 19 tL4 86 6 2 4 1 69 54 1 1 1 <1 Bandama River - Bema L975 L97 6 L977 L978 t97 9 1980 57 56 6 33 3 1 94 68 82 18 1 <1 L82 40 t2 7 <1 o 116 34 3 2 <1 <1 35 14 2 1 <1 6 Bcu River - Glte 3 1975 197 6 L977 1978 L979 1980 153 2L9 48 108 6 4 270 170 256 33 10 5 344 IM 58 2L 5 11 LL2 15 11 5 3 66 17 32 7 20 Comoe River - Kafolo L975 L976 L977 t978 L979 1980 15 6 3 5 o <1 4t 8 32 9 o o 15 11 11 39 <1 o 34 7 2 10 1 <-1 2 4 <1 2 <1 <1 Marahou6 River - Glte Mermis 197 6 L977 L978 L979 1980 34L 280 18 2L 271 25 88 5 L4 343 6L 44 1 9 33L L2L 224 10 5 3L6 325 315 9 2 ocnfpp/ ao.q page 6 Re invas ion 15. A team of five consultanEs was recruited for the reinvasion studies rthich this year were divided into four activities: (1) study of the reinvasion in Togo; (2) study of the reinvasj-on in Benin; (3) study to determine the width of territory on either side of the invaded rivers of Mali in rdrich the transmission of onchocerciasis is of epidemiological importance; (4) surveillance of the Phase I and lvory Coast extension area to confirm that the good results of 1979 were not due to exceptional climaEic conditions. 16. The team was based at Lama-Kara from May to July and concentrated its activities in the eastern zone. These activities included the analysis of meteorological data, and the collection and identification of adults and larvae from sites throughout the area. Different identification techniques were utilized e.g. morphological characteristics and enzyme analysis, to enable comparison of results. Eleven additional vector collecting teams were recruited to underEake daily catches at nine sites, four located in Togo and five in Benin and periodic catches at eight sites, four in Togo, two in Benin and two in Ghana' L7. In Togo experimental larvicide treatments Trere conducted on a trial basis for six weeks in the northern part of the extension area. Despite treatment failures due to the difficult terrain, fly numbers in the treated area remained below the leve1s of previous years and declined to about one-quarter in the reinvaded area (from 2OO-3OO a day at I"16 bridge to 5Ofdail. When treatment ceased there was a general increase in fly density' Data are stil1 being analysed. However, the initial conclusion is Ehat although results on the Kara have been encouraging, the area brought under control was not large enough to Protect the M6 va1ley sufficientlY. 1g. rn Benin the investigation concentrated on identifying, through morphologicaL and cytotaxonomical examination of maEerial combined with aerial prospections, the possible sources of invading flies. 19. In the wesE of the programme area, the situation improved considerably Ln 1979 with the extension of treatment in Ivory Coast. Sixteen sites located at special points s/ere care- ful1y monitored. In general the results confirm those of L979 showing that the treatments of the Sassandra, Marahou6 and Bandama basins have almost comPletely eliminated the invasion of the Phase I area. However, the sma1l number of invading flies at L6raba bridge was four ro five times higher in 1980 than in LgTg (see table page 5). IE is considered that this is due to a higher level of invasion from the west than in previous years. In phase III E there was no reduction in the S. damnosum densities along the Baou16, Bagbe and Sankarani rivers of Mali. In fact at Madina Diassa during June and July densities were four !o six times greater than in 1979 with a daily biting rate of 314 in July 1980 against 51 in July last year, again supporting Ehe belief that there was a stronSer western asPect to the reinvasion this Year. 20. In the special study in Mali, catches were made along transecEs running at right angles to the river axis at Madina Diassa, on the river Baou16, Yanfolila on river Sankarani, and at point Faya on river Faya. At all three places biting rates and transmission Potentials at 1 km from the river were about orre-tenth of those at the riverside, and continued to decrease with distance. These figures w111 be used to estimate how wide is the band of dangerous transmission along these rivers' ocpf pp,/ ao.,r page 7 . .t / .,6t' ' \ ! _)t ) ,) i- J \t\ f. tErocEASEssxs aJq o a\ a q l0 z o o = U G, r o FoUrrU caaoe oHA 1 t E, g+@r .o :co .8 a# 96955b "E.;Eae 2f,!iBi l%l \-: .-\ ^.-J - -r ?,J e I E ) I: o {l- ,) I -_.;'{ ,[. { z: I l l_ L I J. ?) .3{\ \t , ;,cL el ll \. ] t,.(t -<) l- 'lt + ( /; I t(1$ L I .t ( ^r--- ,:j I t i( ) ,} I { I I I zl I I I I j( l ')< ,1 ( ocpfpn/ ao.+ page 8 Increased tolerance to Abate 21. The lower Bandama do\^Tnstream from lake Kossou, Ivory Coast, came under regular insecticide treatment .from March 1979. Results vrere very satisfactory and monthly catches dropped to one p". *.rrr/d"y at Taabo and 0.7 at the Gauthier falls. 22. From the beginning of Marcrh 1980, numbers of biting females progressively increased reaching in mid-April 2OOO/mary'day at Gauthier fa1ls, nearly 1+0O at Taabo and around 15O at Tiassa16. isolation of the Simulium populat.ion and it in an area where ttrE-s."Etipauli/soubrense c 23, Weekly treatment was suspended at the beginning of May while a range of possible causes was investigated - faulty treatment, under-dosing, alteration in the insecticide formulation etc. At the end of May susceptibility tests showed the tolerance of S. sanctipaulil to Abate to be from 2.5 to 38.7 times greater than in 1977. It was decided to replace Abate by Chlorphoxim for six weeks'treatment of the Gauthier faI1s. Results were spectacular as catches fel1 from 2377 bitesfnaJday on 14 June to 99 on 7 July and one on 2I JuIy. 24. The situation at Taabo, however, was progressively deteriorating, and pending the arrival of additional stocks of Chlorphoxim, it was decided to return to Abate treatment at the Gauthier fal1s and treat the Taabo reach with Chlorphoxim. 25. Fly levels at Gauthier fal1s subsequently stabilized at a 1ow level, while at Taabo they are being controlled with difficulty due to the logistic problems of spraying. 26. This increased tolerance to Abate appeared after one year of regular treatment on the lower Bandama in Ivory Coast. It seems likely that it is connected with the relative is the first time that larviciding has been done ytospecies are dominant. 27. The phenomenon seems to be confined to the Bandama basin. Biting populations are under strict surveillance and breeding sites are closely observed. These measures are combined with identification of species and intensive susceptibility monitoring. In September treatment rdas suspended on the stretches of river where resistance to Abate had been demonstrated pending the arrival of supplies of insecticide. When fresh supplies of Chlorphoxim are received, the wl:role of the lower Bandama, lower Nzi and lower Marahou6 will be treated. The effect on the aquatic fauna will be monitored. EPIDEMIOLOGICAL EVALUATION 28. Seventy vi.l1ages were visited by the Programme evaluation team this year, of which 31 were siEuated in the extension study zones of Togo and Ghana. 29, The remaining 39 villages in Upper Volta, Tvory Coast, Ma1i, Togo, Ghana and Niger were being revisited for the second or third time. A summary of the epidemiological evaluation activities up to 31 August 1980 is given in the table on page 10 lnformation on villages by country and phase is given on page 11. 30. In the Sikasso focus of Ma1i, under treatment since 1964, the proportion of infected persons did not exceed 10% in any of the villages visited, previously hyperendemic, and it may be sald that onchocerciasis has become sporadic. 31. In the east of Upper Volta, in north Togo (Dapaon and Mango) and in Niger, under treatment since 1977, a definite improvement was observed. The disease has decreased on average by 2d/" as compared to the initial findings. The effects of control were certainly heightened by the drought vtrich preceded the start of operations and during vil:rich natural transmission was reduced. 1, sanctipauli is a spec ies of the S damnosum complex found in forest areas. ocpf pa/ ao.q page 9 32. In Phase I of the Progranme - the west of Upper Volta - the third visit to six villages showed spectacular results. The incidence of the disease r^7as nil in all age-groups and all persons found negative in 1978 had remained so. Only a few cases remain in children under nine years of age. The situation in the age-range 1O to 14 years had greatly improved. 33. In the reinvasion area no significant change was found in the Togolese districts of Kand6 and Lama-Kara vrlnere, despite treatment, an Annual Transmission Potential of 5OO-1OOO/t 1-atvae/manf year r^ras recorded in the villages rof Landa Pozanda and Titira. On the otherhand, on the river L6raba at the Ivory Coast,/Upper Volta frontier, where the reinvasion phenomenon has been controlled since the end of L977, no infection was found in children under four years of age and the incidence of the disease had dropped Eo only 5% a year as compared to the 20% recorded previously. 34. As regards the ophthalmological aspects, a sharp reduction of parasites in the cornea was observed which was doubtless the reason for the absence of new cases of sclerosing keratitis in the sample examined. Very few irreversibLe ocular lesions had appeared and the incidence of blindness due to onchocerciasis has been practically ni1 since the interruption of transmi ss ion. 35. The chemotherapeutic trials carried out in 1979 at Bonga, Upper Vo1ta, in collaboration with a team from the Ministry of Health, were evaluated after one year. Despite the low dose administered, Suramin was totally effective in patients who received 6O ng/kg or more. On the other hand, the worms Idere not completely destroyed in those who received a lower dose (50 mg or less), and one year later a few females were again reproductive. 36. In collaboration with the National Institute of Statistics and Demography of Upper Vo1ta, data collected during evaluations on the birth and death rates of the blind are being analysed. Preliminary results show no effect of onchocerciasis on fertility, birth rates, and child mortality. In general, life expectancy of the blind is reduced. Tn fact the mortality of the blind apPears to be two to three times greater, depending on the age-range, than for sighted Persons of the same age for whom the death rate is consistent with the national average observed by the demographers. 37, Assistance was given to the Institute of Anthropobiology of the University of Utrecht, Netherlands, in the research it is conducting on the debilitating effects of onchocerciasis. The study will be carried out over a period of two years. o*fvxfao.+ page 1O 0) rJ >. .o o c) d .rt 6 IA x OJ o .r{ otr.Og) ..{ (,)uE d"{tr{J .r.{tr; 6dxl{0) c, r-{ c)60) trEtr0)dtr .r{ HE 6dax 'o 0) ..{ >o "{ lr!d ..{ ol q-r Ooolr!q)oa -oEo) trd o o -c q){J _C]J tr^do! c, o@o6 EFr r{J dJd> xoct Eq)dtro, o o,q)E.COIJA oIHlJ o o l{+Jqid -ooE .'ra> C)o> -C r{JJo odoJooO (.)B3uo 0) €0) O+, otr-c ol lJlt '.{OBtNt+{u ,n6d-cu o -C lJHO dfn '+.1 h -o .o q,) lJ d aI d o 0)l] o) B g, CJ b0 d t4 'r{ t{ 0) ,u o F{ c.) c,) H o 6 c)H ol(dEo)Etrd6tib0 c)oEHE0rdl{ obo -doul{p{ pc) * 'U+J 0.) JJ q)6'O5 '.{6 -lcl q,)o 6u 6 .r{>ao UOON dJ OO XF{ tr ..{ €d or a >3eooooc)o rbo q.)I Aq, -trA EJ UE d.-{ .r{ o .r{ F ch > -f{q)il -coJJ Lntg,-t r446tr , o tr o.'.{ -d d b0co0u .c o a,E OHtai t+{ .:io trtrCd '.{ildEoltr O N\trnO O l{ (\INN .r{ o .c]J O0 ]J(d(Bl5 -rx ].rF{F{uq)d '.1-C d> >b0 00Jd() oEld Lrl t4xO\tOgF{ o0O .r{o...{> 6 -C o ZN+r uEo 6 dd A '+l O .r.,lr-{o+J ll (f)\t o\ tl a F{ 0.)rd -t -c]J F{GIO C) .H (d x o C) tr o olr 0) o. q-.1 o l{ 0) -o E z @ o\ F{ H <n I('l ho a azoH H =Flg frl Fl 3H(J o FloH tcaHp{ H ho & a U) H rc Fl tqf .d CJ elr q l] 8.p e35H .n -.u9(dE .5dE! E3'6& ix 'j -oEl?U rr^ .r .6 E3 l{ q.) -o E z o co o\ F{ F\6t cr. (r) J O\@$F{\OOl@6lo@ro\O 6.1 -t t-- O\ O\ (f) Cf) -t cn @ (7) 6lI o\r\ o\ F{ \o @o o\ F{ c!F\nN@Lrl(aF{o\ -) 6{ rn \tcDJ\t @ F\ o\ r-{ -t -tOt oN (n (f) (\l \trt$ l-. O \to F\ -t F F\ o\ F{ r.) -to\ 6l F{Jo\o\t O\ Fr o\NOt\AJ \O f\ F{ tn I-\ @\O F\\O d) NN \o I-\ o\ d \o 6l N o (f) tnNr{$(\61@@\.o\tcOr\ -fF{O-trno\(r) @ o\ rn ca I Itlr\ 6l 14 N @ F{ O'6lJ F\-)O -{$Fr -t co F{ F{ I o d 0)U l.{ o U o h Fq tn 14 F\ ra) c7) Fl (\l rnF- rn ca(f) r) n\too\cn c') r{ r-.1 \o -to F{ F{ @\o o \o 6 N o\ \o oI t4 A I -t N ttt F\\o\o 14 ca -toU1 N F{ o E6q)p 0) E (d lr bo ok P{ h ta (n El oN @ @ @ F\Ln\tt^F{N\.o@O(\l(')rnF.-tdooF.r@'{-t OrnF\LnF{NO\JJr.{NF'{ afrl @ l/1I @ F-{ \O-t-trnLnF\N\Ocar\:\Oo\OF{('t-t\OOF\F- c.l_t(a(f)F{N q-{ o ootrogOlJootr -Otr,Eoo , QOz F{ a 14 F{ o 14 qf o !ioXolEb0 =d7aHJ .r{;>U oH q.) F{od 6 d) q-{ o tr o ..{ u .r{ o o o. Eo c) l.-c.lF\('lF\O\OGlLn\OO\F{@CaO\JN@F{F{@ \O-ld)6\O\tcaJN(\I(Y)JF{ 6l F\(r) F{ ca r-{ N\o rf) \ONOO\6lcaO -t\O\.oO\rnJ(') o LA -t 6 co ciLnO@r--tF{ r46lF{r{J O\F\OF\O\r\F{ Ln0oF\Flr]F.{-t F{ N ort -t ,lJ 6 otrJ(d: oo dxdtrtl .r{trdO..{OOdo6o.rb0b0o>-cad..{o oclfvxfao.+ page I I I CONSTITUTION OF THE SAMPLE Number and distribution by phase and by country of the villages of the sample evaluated by fhe Prograrmne teams 4L9 total should be added 31 other villages evaluated by teams other the Progranrne which brlngs to 450 the number of villages which made II Number and distribution of villages by phase and by date of first examination {c To this than those of up Ehe sample. Upper VoI ta Ivory Coas t Ghana Mali Togo Benin Niger TotaI Phase I Phase 2 Phase 3 Phase 4 Outside prograrnme Study area Iotal 52 35 27 26 5 36 4 lo 29 4 27 28 31 L7 24 23 25 13 3 116 64 L20 36 7 76 r14 7L 70 59 4L 48 16 L97 5 L97 6 L977 L97 8 L97 9 1980 Total Phase I Phase 2 Phase 3 Phase 4 OuEside programne Study area Tota I 45 l6 L2 51 40 27 L7 2 51 10 3 I3 I 5 27 t2 I 26 4 22 2 3 29 t16 64 L20 36 7 76 73 i18 96 45 53 34 4L9 ocef'w.fao.+ page 12 EVALUATIONS Number and dist.ribution, by phase arrd by year Out of 4I9 villages of the sample evaluated by the Programme teams 333 villages were visited once 70 villages h/ere evaluated twice 12 villages $rere evaluated three times 4 villages were evaluated four times EXTENSION STUDIES 38. The collection of entomological data continued in the subsectors of Hohoe and Kintampo in Ghana, Atakpam6 in Togo and Parakou in Benin. Dry and wet season aerial prospecEions confirmed that in Togo and Benin the southern limit of S. damnosum s.1. breeding sites lies further souEh than originally believed, passing through Benin at the junction of the river Ou6m6 and its tributary the Zou, 80 krr from the sea, and including the Sio and Haho river systems 90 kur from the coast in Togo. 39. All six cytospecies of the S. damnosum complex were found in the proposed extens ion q4!e!rPe-s!i,area: S. darrnosum, S. sirbanum, S. s um. S. soubrqnse, S. yahense and S. 40. As regards Benin and Ghana, the national authorities are actively continuing their efforts to find a rapid and sat.isfactory solution to the logistic and financial probleuu entailed in the establishment of hydrological stations. 41. The epidemiological evaluation was concluded and confirmed the hyperendemicity of the disease in most of the main river basins. Between 1978 and 198O, 76 villages were examined of which 27 were situated in Ghana, 24 it Togo and 25 Ln Benin. The epidemiological map fo1lows, j-n most cases, the geographical distribution of the vector. 42. In Ghana there is a hyperendemic zone along the Black Volta river and the lower Pru. In the whole central area of the Brong Ahafo Region, the disease is mesoendemic and affects the upper basin of the tributaries flowing into the Black Volta and Lake Volta, and the uPPer courses of the north-south rivers. This mesoendemic zor.e does not extend south of latitude 7o3ON, below which onchocerciasis is hypoendemic. L97 5 L97 6 L977 L97 8 L97 9 1 980 Total Phase 1 Phase 2 Phase 3 Phase 4 Outside programne Study area TotaI 47 16 L2 55 4U 27 24 6 51 lo 3 13 20 19 29 L2 6 13 26 4 22 L7 5 L9 29 L69 99 138 36 7 76 75 L22 107 80 7l 70 525 ocPfPRfBo.4 Page 13 43. In Togo the riverine villages of the Sio are hyperendemic Eo the south of Kpalim6 as far as latitude 6" 30. The mountainous zone between Kpalime and Badou appears to be free of the disease aE the higher altitudes, the villages affected being situated at the foot of the massif. Ophthalmological findings indicate that the serious, savanna type of onchocerciasis is prevalent as far as the southern limit of the disease. No cases of the mild, forest-type onchocerciasis were found. 44, In Benin there is a vast mesoendemic zone to the north of a line running through Djougou, B6t6rou, Parakou and Nlkki, corresponding to the source of the watercourses flowing from north and south. Ihe Okpara focus covers the middle course of the river along the Nigerian border, while on the Kouffo, onchocerciasis is concentrated in a smal1 discrete focus on the middle reaches to t,he north of Lauta (7'O5N). 45. Ihe largest focus is that of the River Ou6m6, where hyperendemicity extends from B6t6rou (9" 15N) to the confluence of the 0u6m6 with the Zou (7' N) and along the T6rou, the Adjiro and the Terre rivers. This focus is the continuation of that affecting the lower part of the River Zou, the rnin tributary involved being the Agbado. ECONOI'{I C DEVELOP}MNT 46. In 1980 the task of the Economic Development Unit has been to support the training and research programme in health economics. So far four research and two training contracts have been concluded under this progranure and the Unit itself is undertaking one research proj ec t . 47. In the field of research two contracts in the amount of US $g ZOO each were concluded with the University Association for Economic Research Clermont (AUREC), University of Clermont-Ferrand, France, and t.wo others amounting to US $33 572 arrd US $ 44 4O5, respectively, with the Economic Development Research Centre, UniversiEy of Michigan, United States of America The four projects deal with the following topics: (a) a pilot study on the material facilities made avallable to migrants in AW settlement vi1lages, particularly agricultural credits; (b) a piloE study on analysis of the economic role and social status of persons affected by onchocerciasis; (c) two studies on health problerrs and policies in the OCP countries, one on the present situation and the other on comparigon of Ehe policies of sources of financing for health Programes; (d) preliminary phase of a study on the impact of onchocerciasis on labour productivity. Field work for projects (a) and (b) was carried out in the first half of the year. Preliminary work on projects (c) and (d) began in September. 48. The research project being carried out, by the Economic Development Unit concerns the spatlal extent of resettlement in zones freed from onchocerciasis. It forms part of a larger project the next phase of which will be an asaessment of the economic and social gains derlving from land resettlement (positive factors; improvement of living conditions as regards income, education, health, hygiene, etc.). The third and final phase wlll be a specific study of the economi-c and social repercussiong of population movement in the OCP atea. octfYxfao.+ page 14 49. Ihis year the study covered Ivory Coast territory and vras conducted in collaboration wlth the Institute of Tropical Geography of the University of Abidjan, and the Centre r6gional de T6l6d6tection, Ouagadougou, under agreements for $4I OOO and approxinately $3 3OO respectively It is planned to extend the study to other countri.es in 1981 and a further contract with the Ouagadougou Centre for this PurPose is under consideration. 50. As far as Eraining is concerned contracts were concluded with the University of Clermont-Ferrand, France, and the University of Ann Arbor, Michigan, United SEates of America, for the organization of training against pa)rments of US $41 t75 and US $42 64O resPectively. Details of these activities are given in the eecEion on training. 51. This year a study was made of the assistance which the Progranure could give to the countries regarding their health policy. The results of this analysis were rePorted to the meeting of National Onchocerciasis CotrEIittees in June. 52. I,leribers of the Unit continued to exchange information with research workers, students and consultants visiting the area. Among the meetings at which the Programe was represented were the Workshop on the Water and Hygiene Decade organized by UNICEF, Ouagadougou from 11 to 15 February, a seminar on SensitisaLion to Migration Problems in UPper Volta, organized aL Bobo-Dioul-agso from 3 to 8 March by the Demographic Research Department of the Ministry of plan, and the loth l"leeting of the Council of },linisters of the Interafrican Courmittee for Hydraulic Studies, held at Bamako from 13 to 19 April 1980. RESEARCH Entomological 53. Until now the progranme has relied on one formulation of Abate, a 2O"/" emulsifiable concentrate, Produ S. daurrosum larvae an extended field proved to be as ef aquatic monitoring a suitable Product laboratorY rearing ofS damno ced by Procida in France. No alternative equally effective against and as ecologically acceptable had been found. However, in Novembet I979 trial began wiLh a formulaEion of AbaCe produced by American Cyanamid which fective against S. damnosum as the Procida product, moreover results of showed it to u" .q""11y *cePtable. OCP now has two sources of supply of giving flexibility in purchasing. 54. A timetable for insecticide evaluation was dr.*r,,rp.1 A new contract was subsequently signed with the Institut de Recherches sur l'Onchocercose, Bouak6, (IRO) in an amount of $14 5oo for the testing ot 2L products in 1980. For its part ocP has assumed responsibility for carrying out the riverine and final operational tests of Products cleared by IRO' 55. Efforts are being made to establish closer cooperation with industry. The Director of the Headquarters Division of Vector Biology and Control, responsible for the overall WHO insecticide testing prograrme visited Abbott and Sandoz Chemical Companies in the United States of America to encourage continued research into the Bacillus thuringiensiq H.14-which is showing considerable promise as a control agent. The first large-scale field trial of this agent in september was very successful giving complete control of S. damnosum s'1' over a distance of 20 km on the river l'1arahou6 in Ivory Coast' 56. The OCP research entomolo gist at Akosombo is now achieving nearly 1OO% success with sum larvae. An agreement has been concluded with the UniversiEy of I'lassachusetts, United S is taking Place. Under the terms of spend four months at Akosombo in 1981 tates of America, where successful rearing of S. decorum the agreement a technician from l"lassachusetts will 1 Annex II. ocYfwfao.+ page 15 57. The morphological sLudies on Biosysteuratics Research Institute the adults of the S. damnosum complex carried out by the in Ottawa have been terminated. A pictorial key to the six main vector species of the S. daumogum complex was designed and published and is irow being used by OCP field personnel. 58. The nine months' study on the prevalence of cattle filariae and their possible trans- mission by 5 damnosum carried out by a consultant was completed in January. Five species of filariae r{ere found in l"lali of which O. gutturosa, O. armillata and O. ochengi were identified. Amongst, these, only O. oche4gi, histochemicaLly indistinguishable from volvulus develops in S. damnosum. In Togo, O. dukei o. gu tturosa and O. ochengi were found. The consultant spent one month in the field at Folonzo with a team from the Bernhard-Nocht Institute, Hamburg, examining wild animals for trypanosomes. This resulted in the recovery of derural nodules from three species of antilopes. Ihe filariae are now being identified. 59. Following the studies carried out by OCCGE/ORSTOM under an agreement concluded Ln 1979, a report r./as presented on the resting sites of female S. damnosum in the fringing vegetation on one forest and one savanna river in Ivory Coast and Mali. Also under an agreement concluded in L979 with OCCGE a laboratory meEhod was developed for testing insecticides against adult Simulium damnosum. Medical 60. A research contract for the amount of $12 5OO has been concluded with the OCCGE Onchocerciasj-s Research Institute in Bouak6 for the sEudy of the transmission of microfilaria from different geographic origins by the various species of the S. damnosum complex. One of the principal objectives of the study is to evaluate the risk presented by the reimPortation of parasites by infected migrants from outside the Program,re area. 61. A secoad contract for $6 250 was signed with the same Inst.itute for a detailed sEudy of the development of animal onchocerca in vectors of human onchocerciasis to enable a quantita- tive assessment of the possible overestimation of the annual transmission potential. 62. In collaboraEion with the London School of Hygiene and Tropical Medicine and under a research contract for US $5 OOO, studies are being ur,a<ie of isoenzymes in adult worms Eo try and differentiate two or more strains of O. volvulus. This research completes that under- taken in 1979 in Ivory Coast on the clinical differences observed between the savanna and forest forms of the disease. 63. Research continued on causes of blindness other than onchocerciasis, An analysis of lesions caused by avitatrrincsis A is in progress. A review of the ophthalmological records showed that 1% of the individuals examined have an impaired retina reca1l:-ng toxoplasmosis. During a survey in Togo 2OOO blood samples h/ere takerl to determine the prevalence of this disease in the Progranme area. The samples will be tested at the laboratory of parasitclogy of the Faculty of Medicine of Marseilles according to a contract established for $ 3 OOO. 64. An analysis was urade of adult: \^7orms collected from nodules in the Gaoua region of Upper Volta in January thi-s year by a team from the Bernhard Nocht Institute of Hamburg. Ihis area has been under vector control for five years, with interrupted transmission for four. The analysis showed that 38% of the fenale worms were dead whereas in a zone of trans- mission the percentage is nornally in the region of 9%-LL"L. No young parasites were found. These results confirm the interrupti-on of transmission and would seem to irrdicate that the aging of the parasite population will resulE in an accelerated improvement in symptoms and evenEually the disappearance of onchocercal infection. 65- The impact of the nodulectomy campaign which was carri,ed out in this region in 1977 andL978 by the Bernhard-Nocht InstiE.ute, under contract to the progranrme, is also being analyzedIt appears that this therapy has had no significant effect and those treated show no definiteimprovement over the control group. It is planned to continue this work in 19g1. octfexfao.+ page 16 Soc io log ica 1 66. The relationship between onchocerciasis and agrarian practices is being studied under a contract for $ 1O oO0 concluded with ORSTOM, Ouagadougou in 1979. The sturiies, which began on ti-Ie White Volta river, were extended to different bio-cLimatic areas in south-west Upper Volta. In the Bougouriba river basin, levels of endemicity appear to be closely related to agrari-an practices, the most severe pattern of the disease being associated with extensive farming. 0n the other hand, i-ntensive practices reduce the man-vecLor contact and thus are a social factor of resistance to the transmission of onchocerciasi-s. The effects on oncho- cerciasis of an irrigation development scheme were studied in a zole of south west Lrpper Volta and indications are that regulation of water flow increases the duration of Simulium breeding. Data processi ng 67. A seminar on data processing in VJHO Headquarters was held in Ouagadougou on 9-IO ApriI, organized by Progranrne staff from Geneva responsible for these activities. It was attended by the staff of the Epidemiological Evaluation and Vector Control Units, including Sector Chiefs and technicians. The seminar resulted in a greater understanding of the procedures involved which has led to speedier and more accurate processing of the entomological data. 68. The vacant post of statistician was filled in June. ENV IRONI.,IENTAL I',10N I TORI NG 69. The agreements for aquatic monitoring activj.ties between the Prograrmne and the ORSTOM Hydrobiology team at Bouak6, and the Institute of Aquatic Biology, Achimota, were renewed early in the year for amounts of $ 46 65O and $ 5O OOO respectively. The analysis of the aquatic monitoring data continues to be carried out at the University of Salford, UK, following renewal of the agreement in February 198O. The sum of $ ZS OOO paid to the University covers the checking and computer processing of data, preparatio;r of sunrmaries of fish and invertebrate data for ttre monitoring teams, and a detailed statistical analysis of all data. A mission from Salford visited the Programme area for two weeks in late.Januarv to coordinate the collection and transmission of data. 70. As provided under the terms of the agreement with ORSTOM, research workers from Bouak6 travelled to Salford in July to collaborate in the data analysis. 7L. Scientists from the Lhree institutions, ORSI'OM, lAB and Salford, attended the first meeting of the Ecological Cror-rp in Geneva on B-9 September at which monitoring results and their analysis were reviewed. 72. In 1981 the scope of monitoring will expand. OCP is organizing the training of local staff for the creation of national teams which will eventually take over the monitoring frcrm the ORSTOM team in Bouak6. In Gl-rana a team is already operational and by mid-1981, four additional teams should be ready attached to national structures in Benin, Ivory Coast, Togo and Upper Volta. 73. In Ivory Coast the national team of the Abidjan Institute of Tropical Ecology, Ministry of Scientific Research, has taken over the monitoring of ichthyofauna under contract with OCP for $ 48 OOO. Seven sites on the Rivers Sassandra, Marahou6, Bagoe, Bandama, L6raba, N'zi and Comoe are to be visited twice a year in accordance with the recournendatj,ons of the 1979 meeting of hydrobiologists at Salford. Monitoring of entomofauna continues at Bouak6 pending the appointment of a national specialist in invertebrates. 74. In Upper Volta a contract for $ 2OOO was signed betureen the Programme and the Institut Sup6rieur Potytechnique of Ouagadougou for the monitoring of a site at P6 bridge on the Red Volta. 75. The tearns in Benin and Togo will work mainly in the extension zones where they will collect baseline data. 76. The following table shows the present staffing situation of the teams and the needs. ocefenfao.+ page 17 AQUATIC MONITORING COMPOSITION OF NATIONAL TEAI'TS(Personnel available and required) A = personnel available R = personnel required O = not necessary - = candidate sought for training 77. T\uo research proposals were received. Ihe first, from the University of Ghent, Belgium, concerns the analysis of fish and other aquatic organisms for the presence of Abate and possibly other insecticides used in the area for pest control. Ihe second proposal from the University of Wageningen, Netherlands, concerns a cholinesterase study of the fish from rivers regularly treated in the Progranrne area. Ihese studies will be implemented in 1981. TRAININGl 78. A total of 24 training grants in entomology or medlcine were awarded in 1980 to 20 persons, four of whom benefited from grants for both 1evel II and level III trainlng. 79. In addition,198O funds supported the continuation of Ievel I trainingl b"grrn in 1979for one trainee; in 1978 for two trainees ; in 1979 for five trainees; and leve1 IItraining begun in L979 for one trainee. 80. this year sal^7 the launching of the programme of tralning in health economics lntendedfor three types of candidate: (a) holders of a batchelor's degree (licence) to prepare for a master's degree: seven 2-year fellowships at the Universlty of Cleruont-Ferrand (with 3 months atthe University of Michigan, Ann Arbor) and three 2-year fellowshlps at Ann Arbor(with 3 months at Clermont-Ferrand); 1 ,h. levels of training which the Progranrme can offer candidates, details of ongolng training and a statistical sununary of training grants awarded since the inceptlon of the Prograrmne are given in Annex III. Category Benin Ivory Coas t Upper Volta Togo Ghana A R A R A R A R A R Entomology Research workers Technicians logv Research workers Technicians Laboratory assistants Ichth 1 2 2 2 2 t 2 2 o 2 1 2 2 1 2 1 2 2 1 o o o 1 1 o o o 1 I o o o o 1 0 1 1 2 2 2 1 2 o o o o I ocefexfao.+ pege 18 (b) university staff and civil servants who wish to undertake research: ten 12-month fellowships at master's degree leve1: 9 months at Clermont-Ferrand and 3 months at Ann Arbor; (c) senior officials: a 1-month sunrner workshop at Clermont-Ferrand dealing health economics and health planning in the developing countries. This is run jointly by staff from CERDI (Centre d'Etudes et de Recherches sur Developpement International, Clermont-Ferrand) and from CRED (Centre for on Economic Development, Ann Arbor). with workshop 1e Research 81. So far 24 candidates have been put forward for the fellowships available under (a) and (b): Ghana (8), Ivory coast (4), Upper Volta (5), Mali (5), and Senegal (2). 82. Tbelve participants attended the first summer workshop held at Clermont-Ferrand in SepEemben from Benin (1), Gtrana (3), Mali (2), Niger (1), Upper Volta (2), Guinea (2), and Senegal (1). 83. Arrangements have been made for the Institute of Aquatic Biology, Achimota to receive students from other countries for training in aquatic biology and environmental monitoring against payment of $ 3OO per student per month. 84. Within the Prograrmne itself in-service training continues. Forty staff members from the sectors and from Prograrmne Headquart.ers attended two workshops on management organized in collaboration with the WHO Staff Development and Training Team in Geneva. The first course in the French language was held at Lama-Kara, Togo; the second, in English, at Mole in Ghana. In view of the success of these courses' it is intended to arrange another workshop and refresher training sessions in 1981. 85. During I'larch and ApriI three technical training seminars were held in Lama-Kara, Tamale and Bobo-Dioulasso for sector and sub-sector Chiefs. Each seminar was of one week's duration and included a discussion of research results during the preceding year and a brief review of hydrobiology. Practical work on sampling and identification of non-target aquatic fauna was also carried out. g6. Itrree vehicle mechanj-cs aEtended a course in Peugeot maintenance from L7 to 22 March; one mechanic attended a similar course at Mercedes from 16 to 27 Jwe, and the Building and Transport ManagemenE Officer attended a course in vehicle fleet management from 2L to 23 l"lay and from 16 to 18 June at the Centre d'Etudes Sup6rieures de TransPort et de Logistique (CESTRAL), France. LIAISON ACTlVITlES wirh the participating countries g7. On 1 and 2 September the Prograrmne was honoured by the visit of His Excellency General El Hadj Aboubakar sangoul6 Lamizana, President of upper Volta. gg. Following a presentation of the entomological and epidemiological asPecEs of the di.sease at OCP Headquarters on 1 September, the PresidenE, accomPanied by high-ranking Government officials, members of the diplomatic corps and rePresentatives of international organizations, visited the village of Niaogo' some 135 km from Ouagadougou on the White Voita, fot a demonstration of aerial spraying by helicopter and fixed-wing aircraft. The President and his entourage then proceeded to the village of Gaongo to observe a second passage epidemiological evaluation. 89. On 2 September, His Excellency, Mr M. P. Ansah, l'linister of Public Health for Ghana accompanied by other officials from the Ministry and the Regional Medical officer visited the office at Tamale. ocYfwfao.t* page 19 90. Ttre National Onchocerciasis Cormnittees held their fourth meeting at Programme Headquarters, Ouagadougou, from tO to 12 June 1980. In addltion to the seven countries participants included observers from Guinea, Senegal, FAO, IJNDP and the World Bank. Under the chairmanship of His Excellency Dr Tlnga Douamba, Mlnlster of Public Health of Upper Volta, the cornmittees reviewed the progress of OCP operations and reported on their activities over the preeeding year. Posslble asslstance from the Progranune in the health activitles of the States was also considered. 91. the Minister of Public Health of Ghana, attendlng the meeting for the first time, stated that the Memorandum of Agreement for 1980-85 was awaiting the ratification of Parliament prior to its signature. 92. At the invitation of the Government of Niger, the next meeting of the NOCs l^rill take place at Niamey in 1981. 93. As far as the financial contributions of the participating countries are concerned, all payments have been received for the first phase,1974-1979. For the second phase, 1980-1985, the contribution from Niger for 198O has been received. I{ith the statutory organisms 94. At its meeting in Decembet L979 the Conrnittee of Sponsoring Agencies selected a number of spe cialists to form the OCP Expert Advisory Conunittee and its Ecological Sub- group which replace the former Scientific and Technical Advisory Conunittee, the Economic Development Advisory Panel and the Ecological Panel. Following appointment of the members by the Director-General of WIIO Ehe groups met at WHO Headquarters from 8 Eo 12 September. 95. A member of the Ecological group,Dr R.Lennon paid an extensive visit to the Programme area in June, sponsored by USAID, and reported to the group on his observations at the September meeting. 96. The Consnittee of Sponsoring Agencies met on 13 June in Ouagadougou and on 15 to 16 September at IfHO Headquarters. these meetings dealt essentially with the review of documents to be presented at the Joint Progranme Conrnittee, and matters related to the financing of the Progranrme. I{ith the donors 97. Ttre Chief, UN Prograrmne Section of the Canadian International Development Agency visited OCP at the end of January. In addition Eo a comprehensive briefing on Progranrne activlties and discusslons with Prograrmne staff in Ouagadougou and Bobo-Dloulasso, a vlsit was made to a breeding site on the River Kou and the hyperendemic village of Lanviera. 98. At the end of April the Programme received his Excellency the Ambassador of the Federal Republic of Germany to Upper Volta for whom an information session was organized. 99. Ttre representatlve from Switzerland to the 1979 session of the JCC also visj-ted the Programme. Wlth the public 1OO. ltre Progranune continues to attracE visltors from the scientific world who seek lnformation and guidance. This year such visitors i-ncluded an ophthalmologist and a scientist preparing an onchocerciasls campaign in Nigeria, an official from the Mlnistry of Health of Sudan, and research workers from the United States. Participants on a WHO course on Epidemiology and the Control of Conrnunicable Diseases visiEed Bobo-Dioulasso in June. ocefYx/ao.+ page 20 1OI. From within the Prograrrne area 19 medical students from the WHO Training Centre for Health personnel, Lom6, visited the Lama-Kara sector and 34 doctors, pharmacists, nursi-ng and technical personnel from the Regional Centre for Health Services Development at Cotonou came to the Natitlngou sector. Demonstrations of aerial spraying and laboratory work and visits to breeding sites were arranged for each group as appropriate. LOz. In London, the vector control activities of the Prograrmne were presented to 2OO members of the Royal Entomological Society; in Turin, Italy the aerial operati-ons were described to participants at the VI International Congress on Agricultural Aviation, and at Manila in the Philippines a half day session of the lOth International Congress for Tropical Medicine will be devoted to a presentation of the Onchocerciasis Control Programme. 1O3. Audio-visual documentation (text, photos, recording and slides) was provided Eo pupils of the J. F. Kennedy International Primary School, Gstaad, Switzerland, who studied the problem of onchocerciasis in West Africa during the first term of the school year. the children subsequently organized a collection, raising the equivalent of L29 500 francs CFA which Ehey sent to the Minister of Social Affairs of Upper Volta for the benefit of the blind and those with poor vision. LO4. Assistance was given to the Department of Social Affairs in Upper Volta in the preparation of broadcasts in national languages on onchocerciasis and its control. 1O5. A WHO Press Release on the L979 JCC meeting was quoted by several international press agencies. Among the papers which reported the release were the Nigerian trsunday Ti-meslr, t'Africatr, trDemain 1'Afriquer', t'Afrique agricolert, ttAfrica Health'r, ttWest Africatt, the ilPanorama du M6decinrr, and the ilDiplomatic World Bulletin'r. The June meeting of National Onchocerciasis Conrnittees in Ouagadougou was also widely covered by regional press, radio and television. INDEPENDENT COWISSION 106. Ihe activities of the Independent Cormnission in connexion with its review of the long-Eerm prospects of the Prograrmne included a series of meetings, visits to the participating counEries to collect information on the health infrastructures, a computer mapping study of the entomological data, and analysis of epidemiological data. LO7. The Vector Control Working Group met in February in London and in September in Baltimore. It reviewed topics ranging from the biology of Simulium to alternative methods of vector control and considered possible strategies for vector control after 1985. Further discussions of strategies took place at a meeting of four Conrmission members in Baltimore in March to consider future overall strategies for vector control and disease surveillance. 1O8. Meetings of the Monitoring and Evaluation and InfrasEructures Working Groups took place in London in June. The InfrastrucCures Group reviewed the information collected through visits to the participating countries and considered requirements for reinforcing these structures. ILre MoniEoring Group gave its aEtention t.o surveillance requirements after 1985, data analysis and research. 1O9. Ad hoc meetings on Cormnunity ParEicipation and Chemotherapy were held in London in late June and in Geneva in early August respectively. 110. The Commission itself met at WIIO Headquarters in JuIy to prepare its interim report which will be discussed by the Chairman with the WHO Regional Office it Brazzaville and health officials in the seven participating countries during visits to be made in October- November 1980. 1 JPC1.6 1 ocef w/ao.+ page 2L MANAGEMENT AND COSTS 111. The closure of accounts for 1979 lndicated total expenditures to be $ 14 296 696 as compared to the figure of $ 12 647 600 lndicated to the JCC ln December 1979. LL2. The real tncrease over earlier estlmates ls $ 784 305, the remalnder being accounted for by a change in reporting proced.rres.l 113. The revised total expenditures for the perlod L974-L979 as follows: $ - Onchocerciasis Fund . 53 783 386 - UNDP I 474 096 - Participating countries . . 650 813 - Miscellaneous income l-7O &4 are thus $ 55 o78 339 financed Total 56 078 339 114. Expendltures for 1980, including Extension Studles, are currently estimated at $ ls 432 483. 1 (a) Until now expendltures for Extenslon Studles ($ 552 459) were presented separately. They are now included ln regular Programne estlmates. (b) The lntegration of expenditures flnanced from sources other than the Onchocerclasls Fund, i.e. contributions from Participating Countrles ($ 2O7 385); miscellaneous lncme from the sale of used vehlcles or equipment, Conference ha1l rental, etc. ($ 1O4 947) has the effect of increaslng the total aEount of expendlture reported. In the past the Progranqre reflected these recelpts by decreasing expenditure reported accordlngly and only the net balance lras shorrn as expenditure. oce/Yx/ao.+ page 22 ANNEX I (France) (Federal Republic of Germany) ONCHOCERCIASIS CONTROL PROGRAMME IN THE VOLTA RIVER BASIN AREA EXPERT ADVISORY COMMITTEE Professor M.G. Camus, Director, Office de 1a Recherche scientifique et technique Outre-Mer, 24 rue Bayard, 75008 Paris Professor H.J. Diesfe1d, Director, Institut fiir Tropenhygiene, Im Neuenheimer Feld 324, 6900 Heidelberg 1 (Switzerland) Professor T.A. Freyvogel, Director, Swiss Tropical Institute, Socinstrasse 57, 4051 Basle (Norway) Dr 0.T. Grande, Technical Adviser for Rural Development, Project Management Department, International Fund for Agricultural Development, 107 Via del1e Serafico, 00142 Rome I taly (UK) Dr Peter Haskel1, Director, Centre for Overseas Pest Research, College House, Wrights Lane, London W8 5SJ (Japan) Dr Shigeo Hayashi, Director, Department of Parasitology, National Institute of Health, 2-10-35 Kamiosaki, Shinagawa-ku, Tokyo 141 (Belgium) Professor Dr P.G. Janssens, Vogelsanck 12, 22321 s Gravenwezel (Netherlands ) Professor Dr J.H. Koeman, Head, Department of Toxicology, Agricultural University, De Dreijen 12, 6703 BC Wageningen (Canada) Dr I.S. Lindsay, Protective Sciences Division, Defence Research Establish- ment Ottar^,a, Shirley Bay, gqlgv/a, Ontario (Kenya) (Ivory Coast) Dr A. Sawadogo, Professeur au D6partement de G6ographie, Universit6 nationale de C6te drlvoire, 01 BP 2553' Abidjan o1 Dr D. Weidhaas, Director, Insects Affecting Man and Animals Research Dr T.R. Odhiambo, Director, and Ecology (ICIPE), P.o. International Centre of Insect Physiology and Box 30772, Nairobi (USA) Laboratory, USDA-SER-AR, P.0 Box 14565, Gainesville, Florida 32604 oce/vt f ao.+ page 23 Annex I ECOLOGICAL GROUP (Canada) Professor H.B.N. Hynes, Department of Biology, University of waterloo' Waterloo, Ontario (usA) Professor K.W. Cumrins, Professor of Fisheries, Department of Fisheries and llildlife, Oregon St.ate University, Corvallis, Oregon 97331 (ux; Mr A.J. Hopson, Fisheries Research Officer, Department of Agriculture, P.0. Box 14, Nukuralofa, Tonga (Netherlands) Professor Dr J.H. Koeman, Head, Department of Toxicology, Agricultural University, De Dreijen 12, 6703 BC Wageningen (USA) Dr Robert E. Lennon, P.O. Box 74, Lincoln, Maine 04457 ocv/w.f ao.+ page 24 ANNEX II Sta 7 Testin (ocP) INSECTICIDE EVALUATION ocPfwc - American Cyanamid Temephos(Abate) Lot 73 (completed) - Chlorphoxim (a) Progranune of Eesting & equipment development reviewed \tith CCC/Viking 18-23 August 19 80(b) Progranme discussed with Bayer (\EC) October 198O to obEain necessary formulaEion - Bacillus thuringiensis israeliensis (Sandoz ) (c) Testing programne Eo begin September 1981 Subject 19 80 1981 Stage 4 Testing (Bouak6) Formulations as follows: - oMs-1356, cfft74 20% EC (CSIRo) - oMs-1806, SAN 1971 20%EC (Sandoz ) - OI'1S-466, Methoxychlor (Chemform) - OMS-1424, Actellic l'1 20%(ICI) formulation JF 6180 + O.5% Waxoline - OMS-1155, Reldan 10% (Dow Chemical) Lot 399 & Lot 406 - OMS-2OOO, Sumicidin 57", mi.cro- capsules (Sumitomo Chemical) - OMS-1424, Actellic 25%, wet- table powder (ICI) - OMS-2OOO, Sumicidin 10% flow- able (Sumitomo Chemical) - Ol4S-1424, Actellic Yt 20%, microcapsules (ICI) formu- lations: JF 6180; JF 7475; JE 7475A; JF 7476; JF 7476A; JF 6180 * Waxoline 1%; JF 6180 + 17" Waxoline OB Formulations as follows: - OMS-1998, K-othrine 1% EC with synergist (Procida) - OMS-1998, K-othrine 17. EC without synergist (Procida) - OMS-18O6, 25% wettable powder (Sandoz) - OMS-18O4, Dimilin (Philips Duphar) forrmrlations: 25% wettable powder, 25% tLottable, 107" flowable - OMS-1697, Altosid PS 10 microcapsules at LO% (Zoecon) - additional formulations resulting from contact with Industry 198O (see below) Stage 5 Testing (Bouak6 ) Formulations as follows - OMS-466 Methoxychlor 20% EC (Chemform) - OYIS-L424, AcEellic 14 20% microcapsules (ICI) formu- lation JF 6180 - OMS-1424, ActeLtic 25% wettable powder (ICI) Formulations as follows Depending on resutts of 1980 and 1981 Stage 4 lesting 6 Testin (ocP) Sta - High priority - Bacillus thuringiensis israeliensis - Forrmrlations successfully passing Stage 5 testing (decision on products to be made in consultation with VBC) (Sandoz ) oce/en /ao. + page 25 Annex II Subj ec t i 980 19 81 OCP will maintain regular contact with IRO, Bouak6 and other insecticide evaluation centres Evalua tion Centres (ocP) Indus try (vBc) General (vBc) Documentation vBC will maintain regular contact with rndustry to promote ner., products - ICI visited - new formulations of pirimiphos-methyl being prepared - Dow contacted - new sEable formulation of chlorpyrifos- methyl possible: one or tr^ro EC formulations requested - Hoescht visited - efforts continuing to encourage de- velopment suitable formulation of Bromophos - Sandoz & Abbott visited regarding development of BTI Tests to proceed with BTI (Sandoz ) - American Companies - to be visited in December Develop or modify methods for chemical and biological moniEoring of Temephos (Abate) and other insecticides Intensify studies on cross-resistance to O.p. compounds - New formulation of Actelyc and Reldan and a Reldan EC to be prepared in 19 81 VBC to finalize document en- titled rrsummary of Laboratory and Field EvaluaEion of Larvi- cides for Simulium Controltr - (done ) VBC to circulate above document to specialists (in process) ocYfflao.+ page 26 ANNEX III BENIN Martln Codjo AKOGBETO + Germein oUSSA + L6onrrd FOURN + Mr T, MEYIZOUN l4r P. TAUZES Mr E. AKoDO Mr P. N'BOUKE GHANA Joseph Somua A}.IAKYE + TRAINING IN PROGRESS OR PROVIDED FOR UNDER THE PROGRAMME, I98O Telcher of blology-geology aE the LycEe Behanzln, Porto-Novo ocP ocP Head of Depertments of Medlcine rnd Predi6tr!cs, Parakou Hospital 0cP Medi.cel Offlcer of the Medlcal Dlstrlct of Alphahoue. Minlstry of Publlc HealEh 0cP Chief, Godomy Flsh Famlng Centre, Porto-Novo 0cP Ch1ef, Flsheries Department, Co tonou ocP Chief, ExploiEatlon Sectlon, Ministry of Rural Development and CooperaElve Actlon, Porto-Novo ocP Head of Post, ContinenEal Fisherles, Mlnistry of Rural Development and Cooperatlve Actlon, Carder Zou, Bohcan ocP Research Offlcer, Sclentlfic and Industrlal Research Council, Am OCP Medical Off!cer, MinisEry of HeaIth, Yendi Hospital, Yendi ocP Medlcal Officer ln charge of comunicable disease control and of the Publlc Health HospiEal, Tamle 0cP Physician, TaMle HospltaI ogP Entomologist, OCP Ouagadougou ocP Prtncipal Medical Officer, Mlnistry of HealEh, Kintampo 0cP Asslstant Research offlcer, Institute of Aquatic Biology, 4$lno:g Medical Officer in Ctrarge of Coumunlcable Diseases Control and Mrternal and Child Health, Minlstry of Health, Accra 2 years of entomology at ORSTOI,!, Parls(12 oct. 1978 - 30 sept. 1980) 3 years of ophthalrclogy at Dakar University (2 Nov. 1978 - 0ct. 1981) 10 monlhs of epidemiology at the InstiEuEe of Pub1lc Health, Cotonou(Sep8.1979 - June I98O) 2 months of ichthyology at the Instltute of Aquatlc Blology, Achlmota and aE ORSTOM, Bouak6 (24 Jar. - lO March; 8-20 Aprl1 1980) 2 months of pisclculture at the Instltute of AquaEic Biology, Achlmota and aE ORSTOM, Bouak6 (24 Jan. - 10 March; 8-2o April 1980) 2 months of hydroblology at ORSTCM,/ Bouak6 (15 June - 15 July; August/ September 198O) II II I I I II II I I 1 I Alexander Y ASARE + 2 monEhs of hydrobio).ogy at oRSToM, Bouak6 (October-November I98O) 3 years' Eraining in hydroblology; first field work in Ghana, Ehen Unlversity of Ghana and University of WaterIoo, Canada (September 1979 - Augusr 1982) I year of ophtha).mology, Royal College of Surgeons, London (Apri1 198O - March 1981) 9 months for a l{ascers degree ln Comunity Health, London School of Hyglene and Troprcal Medicine (October 198o - June 1981) 1 year's Erainrng rn ophthalmology aE the Royal College of Surgeons, London (September 1979 - August 1980) I year's training In Parasltology at Ehe London School of Hygiene and Troplcal Medicine (1 0ctober 1979 - September 198O) 24 months' trainlng in epldemiology aE the University of Michlgan (August. 1978 - July 1980) 3 years' Erainin8 in hydroblology at the University of Salford (United Kingdm) (September 1979 - August 1982) 12 months' trainlng in epidenlology at the London School of Hyglene and and Tropical Mediclne (January 198O - December 198O) I Samuel Zanya BUGRI + Isrrel NaEh NARTEY + **Mlchael OCRAN Wll1im D. OSEI + James SAI.IMAN + I I Country/narne Source offund s PresenE occupation/t1t1e Field of tralning/duratlon Level Victor OKOH + ocP I ocY/w/ao.+ page 27 Annex lI TRAINING IN PROGRESS OR PROVIDED FoR UNDER TnE pROGRA},IME, 1980 (contlnued) ocP UPPER VOLTA Hr W, GUENDA Ur A. NIGNAI,I + ocP Hlar L. K. TRAORX + ocP Mr L. YAHEOGO ocP Ht{r S. LCttPO Mr B. SAWAoOco** Dr D.vld KYELE{ ocP llr Abou Rolend BENON ocP TO@ Ur B. Abrlo SAI.{A ocP Aylta FolIy ABOUSSA 0cP Ur I. BOUMD,IA ocP Ur K, MESSIGA ocP l,tr F. NANYETTE ocP SENEGAL Hr A. BADJI AFRO AsslstrnE Lecturer ln Anuorl Blology, Hlghcr Polytechnlc In6tltute, OuaRadougou Student, Stlte Doctor.te ln Phrrrrccuttc!l Sctences, OurSedougou Doctorrte Student, 3rd level, Outledougou 2 weeke of hydroblology ar the InstituCe of Aquatlc Blology, Achlmota and 2 ueeks at oRSTO}1, Bouakd(2OJanuary-2Februrry; 12-26 May 1980) 2 years of parasttolory at the Anlo.l and Para8ltlc Blologr Laboratory, Parls (1 March 1980 - February 1982) 24 mmthe of parasltology at the Faculty of Phrmacy, Tours (l Aprll 1980 - 31 March 1982) 9 nmths of hydroblology at ORSTOM, Bouek€ (December 1979 - August 1980) 5 months of parasltology at the I0TA, Bamrko (15 Hry - 30 ocrobcr 1980) 2 month8 of nlcroblology !E Ehe IOTA, Brnrko (2O Aprll - 20 June 1980) 1I months of publlc health, Reglonal Hcalth Development Centre, Universlty of Benln (17 Septmber 198O - 31 August 198I) 11 months of publlc hellrh, Reglonal Health Developaent Centre, Unl'rerstty of Benln (17 Septmber I98O - 3I August 1981) 4 months of entomology at the Onchocerci-asls Research Instltute, Bouak6 and 2 months of OCP technlques(5 January 1980 - 5 July 1980) 4 years of speclallzatlon ln ophthalmolory at the Unlverslty of Dakar (Novmbet L976 - October 1980) 2 seeks of hydroblology !t the In8tltute of Aqurtlc 8lology, AchlEotr end 2 weeke rt oRSTO{, Bouak€ (19 J.nurry - 2 February 15-30 August 198O) 4 months of entomology at the Instltute of Onchocerciasis Research, Bouak6 and 2 Eonths of OCP techniqueg(5 January - 5 July 1980) 4 months of cntonology at the Instltute of Onchocerclasls Reeeerch, Bouak6 and 2 months of OCP technlques (5 Janulry - 5 July 198O) 4 mnthe of entmology a! the Instltute of Onchocerciagls Research and 3 Eonthg of OCP technlques (January-August 198O) 4 months of entorclogy at the Institute of Onchocerclaslg Research end 3 months of OCP technlques (January-August 198O) II I Student: ln E tl tu te, Hlgher Polytechnlc 0ueEedougou II II II ocP Nurse, OgP, OuesedouEou ocP Nur8e, oCP, Our8tdou8ou Chlef Medlcrl Offlcer, Sector No, 2, Frde-N'Gourme Strte Certlflc.ted Nur6e, OurSedoulou Herl!h A8slstant, Occupatlonal Physlclan, LomE Chief lledlcr1 Offlcer, Health Subdlvlalon, Aneho Lecturer, Hlgher School of Agrtculture, Unlvcrelty of Benln, Lmt Hcalth A8sl8trnt, HealEh Servlce, Lm6 He.lth Assllt.nt, Herl!h Servlce, Lon6 Medlcrl Technlclen, l,hjor Endanlc Dlaeascs Sector, Tambacounda Medlc.l Technlelan, I*l.Jor Endmlc Dlaeesce Sector, Tambrcounde II I II II, III II, III II, III II, III country/nene Source offunde Fteld of trrtnlngr/dur.tlon FPrescnt occuprtion/tl rle *1 Mr A. BASSENE AFRO I ocP/PP/80.4 PESe 28 Annex III (r) (rt) TRAINING IN PROGRESS OR PROVIDED FoR UNDER THE PROGBAMME, 198O (contlnued) Levels of tralning that the Progrme can offer candidates: speclalized studies for candldates slth a universlEy degree; such studles nomlly last 3 years; more deEalled studies bearing on speciflc aspects and lntended for candldates who have already speclalized; this tratning, lasting from 3 to 12 months, is organlzed by the Programe at sultable centres; tralning ln onchocerclasls deslgned for nurses and laboratory technicians, also lasting from 3 to 12 monEhs and organlzed by the Programe; (III) lnltlation tnto the meEhodology of the Programe, for candldates already familiar trith the Problms of onchocerclasls and havlng speclflc objectlves. Staff mmber. + - Flnanclng required, Septenber 1980 Country/name Sou'rce offunds Present occupatiory'tlEle Fleld of trainlng/duratlon Leve I SUDAN Mr M. H3I&lAD B,lRO Assiscant Director, CBD and Filariasls, Mlnlstry of Health, Khar toum 3 weeks of OCP technlques(July 198o) III octf vt /ao.+ page 29 ANNEX III LEVEL I TRAINEES Year of Award Name Country Speciality Institution t97 6 t978 1979 1980 A. Some* A. Aboussa* +M. Akogbeto +G. Oussa L. Antwi M. Wilson L. Fourn+ + W. Osei J. Amakye I. Nartey + +J. Sanman M. Ocran* + +S. Bugri V + Okoh A. Asare+ A +Nignan +L. Traore Upper Volta Togo Benin Benin Ghana Ghana Benin Ghana Ghana Ghana Ghana Upper Volta Ghana Ghana Ghana Ghana Upper Volta Entomology Ophthalmology Entomology Ophthalmology Pesticides Parasitology Epldemiology Hydrobiology Ophthalmology Hydrobiology Parasitology Parasltology Epidemlology Public health Ophthalmology Ophthalmology Paras ltology ORSTOM, Paris, France University of Dakar, Senegal ORSTOM, Paris, France University of Dakar, Senegal University of Miami, Unlted States of America London School of Hygiene and Tropical Medicine, United Klngdom Institut Sup6rieur Poly- technique, Cotonou, Benin Unlversity of Waterloo, Canada Royal College of Surgeons, London, United Kingdom Salford Unirrersityr United Klngdom London School of Hygiene and Tropical Medicine, United Kingdom University of Michigan, United States of Amerlca London School of Hygiene and Tropical Medlclne, Unlted Kingdom Royal College of Surgeons, London, United Klngdom Royal College of Surgeons, London, United Kingdon Laboratoire de Btologle animale et parasltalre, Parls, France Unlversity of Tours, France * + OCP Staff member Requlring funding during 198O 31.7.80 ocP/ylf}o.4 page 30 Annex lII oIro !!i oa, H6H o oo rl> ohJ ottsdo t, op! EO o, o Fdo k ooqdko ok ooo oota!o !p(! o la .iQdd H oo .c, a o oU iBIt dtsko HSHtr o.r otsJ! !H OH 5oi;Q OQqJ >t o!po to o@!d6 iE HH HH oo oo FIJ ** H H H H o oFl d o H Eid6 EO o! n@s NNN a6$o 0tsd Tco ca Iooc zoo d 6NO6 o ! ! a o toa o rq z; NNNI N o Naao o$ H H o J d o H @ @ oH6 o!!I lata Iood zoo **** oo90 o .e H d o &ao IHzz ** q H o oJ d oH 6{N6N66 @ o!€ Yco da I ooc zoo r6 @ o a o q oo :E z; o $ 6jN606N @ H o o l] o oH o$ OF6 -i ca c) | ooEzoa d o h a o AO o Zu. os 6 N d o +6@N@6ONNNT66006660iiiiJd 6 oF oE tsz d o& = o2 H2 H4&a I H E z c )r € &: E oz H H dts I I @ I I I