Status of the studies in the extension zones of the programme as at 1 September 1979

JOINT COORDINATING COMMITTEE Onchocerciasis Control Programme in the Volta River Basin Area Ofice of the Independent Chairman c/o World Health Organization l2ll Geneva 27, Switzerland TcI.34606t Tcrcx IIES 2782L J.C.C.-C.C.C. COMITE CONJOINT DE COORDTNATION Programme de Lutte Contre I'Onchocercose dans la Rdgion du Bassin de la Volta Bureau du Prisident Indlpendant c/o Organisation Mondialc de la Santd l2l I Gcndve 27, Suisse r.l 346061 rclcxDHt 27821 JOINT COORDINATING COMMITTEE Sixth session Geneva, 3-5 December 1979 JCC6.7 20 November 1979 Provisional agenda item II The Independent Chairman submits for the consideration of the Joint Coordinating Committee, at its siitn session, a document on the status of the studies in the extension zones of the Programme as at I September 1979. This document has been reviewed by the steering conmittee. I I I WORLD HEALTH ORGANIZATION ONCHOCERCIASIS CONTROL PROGRA}4ME IN THE VOLTA RIVER BASIN AREA ocPf 7s.2 September 1979 ORIGINAL: FRENCH STATUS OF THE ST1IDIES IN THE EXTENSION ZONES OF THE PROGRA},I},IE AS AT 1 SEPTM{BER 1979 ocPf7e.2 Page 2 1. INTRODUCTION At the February 1975 meeting of the Joint coordinating Cormnittee (JCC) in Abidjan, Benin,Ghana, Ivory Coast, Mali and Togo expressed the wish that vector control activities shoirld beextended to the adjacent regions south of the progrannne area. This wish was reiterated by all seven participating countries at the December 1976session of the Joint Coordinating Committee in Ouagadougou. In December 1977, in Kuwait, the JCC decided that the extensions should be studied for aperiod of two years starting from 1 January 197g. The extension zones requested cover a total area of 2oo ooo k 2 1rhi"t, does not includeMalil) and are divided by country as follows: Benin 2 "or.ri.rg the upper ou6m6 and okpara river basins north of about Ghana: The extension zone represents a total area of 42 ooo 1.,n2 on both sides ofthe volta Lake and includes the river systems of the Volta and Brong-Ahafo regions. Ivory Coast: LlO OOO km 2 middle Como6 Togo: The extension zone covers 23 ooo km2, including most of the Mono river basin and the rratercourses of the plateaux region. 25 OOO km 8'30'N. This Fis. 1). the area embracing the upper and middle Sassandra, lower Bandama and ri-ver basins. rePort only deals with studies made of the extensions in Benin, Ghana and Togo (cf.The extension studies conducted in Ivory Coast were completed at the end of 197g andinvolved has been incorporated in the regular activities of ocp since March 1g7g. teams loca t ion 2. TIMETABLE OF MISSIONS 2.L Entomological reconnaissance More than 1o aerial missions plus several ground surveys were carried out by thefrom the vector control Unit and by consultants in order to collect information on theof breeding sites in the extension zones during the rainy and dry seasons. The aerial surveys were carried out as follows: from 17 to 26 January 1978: the entire Mono river basin including its main tributaries(Togo) . from 11 to 14 April 1978: Pru river basin (Brong-Ahafo); pra and Ankobra riverbasins (south-western Ghana). from 19 ro 20 July 1979 Okpara, Ou6m6 and Zou river basins and their maintributaries (southern Benin) . from 5 to 7 December 1978: from 14 to 15 June 1979: Ou6m6, Okpara, Zou and T6rou river basins (southern Benin) Mono, Sio and Haho river basins (southern Togo). 1 Studies relating to the extension requested for western Mali l-rave been entrusted unit other than ocP and form part of the extension study in the Senegal river basin report, Mali will only be dealt with incidentally. toa In this from 21 to 22 August 1979: main right-bank tributaries of the Ou6m6: Odola, T6rou and tributaries. Zou, Adj iro, A series of five reconnaissance missions was undertaken in southern Togo, southern Ghana and southern Benin from l"lay to July L979 by consultants responsible for reinvasion studies in the eastern areas of the Programme, working in cooperation with the teams from the Vector Control Unit. The river systems surveyed were: theMono (Togo), the Ou6m6, the Okpara, the Zou (Benin) and the main easEern tributaries of Lake Volta (Ghana-Togo). These tributaries and those situated west of the lake had al-ready been surveyed from 14 to 17 J:uLy L977. These surveys were extended as far south as possible in order to determine the southern- most limit of the breeding sites of onchocerciasis vectors, particularly the savanna species. 2.2 Epidemiolgglqa1 investigetiqns With the excepEion of the Brong-Ahafo region, the OCP epidemiological evaLuation teams carried out investigations in all the extension areas according to the following schedule: - southern Togo: JuLy L977 - Ghana: Volta region: May 1978 - southern Benin: March 1979 2.3 Hydrological missions During missions connected with hydrology contacts were established with the authorities ocPf7e.2 page 3 ar.dforof the various countries in order to deterrrine the progress of work done to install calibrate hydrometric stations. Four missions were carried out, as follows: from 7 to 21 March 1978: (Ghana), installation of stations in the Volta region. from 25 SePtember to 7 October 1978: (Benin, Ghana, Togo), inventory of stations created and calibrated with the authorities from 21 to 22 Jur.e 1979; (Ghana and Togo), new inventory of stations created and calibrated with the authorities. - from 11 ro 12 July 1979: (Benin), participation in a meeting on hydrology in the Benin extension zones. 3 . ESTABLISHI'IENT OF INFRASTRUCTTJRES 3. 1 Sraff traini nq and recruitment Under the responsibility of 1'Institut de Recherches sur l,Onchocercose, Bouak6, twoentomological technicians were given scientific training and then recruited by the progrannne on release by their respective governments (Benin and Togo). 3.2 Opening of subsectors In each of the countri-es where sEudies are being carried out OCp has established one or two sub-sectors to carry out and/or complete the entomological studies. The following sub-sectors have therefore been set up: - Benin: the Parakou sub-sector, opened on 7 April 1979. ocPf7s.2 Page 4 - Ghana: the sub-sector of Hoho6 in the Volta region became operational on 1 June 1978 following the closure of the Yendi sub-sector. In the Brong-Ahafo region entomologi- cal studies have been conducted in the new sub-sector of Kintampo since 5 March 1979, when 8o16 was closed. The same logistic considerations that led to a sub-sector being placed at Hoho6 instead of Jasikan prompted the selection of Kintampo rather than l^lenchi. - Togo: the Atakpam6 sub-sector has been in operation since 12 June 1978. In most of the zones under study, however, entomological surveys had begun before the sub-sectors r^lere opened. In the Brong-Ahafo and Volta regions and in Togo the collection of data started at the beginning of 1978. In Benin entomological activities have been carried out on a regular basis since December 1978, the task of collecting data being entrusted to mobile teams based in the principal tor"ms of the sectors involved. 4. 4.L 4.L.1 ENTOMOLOGICAL KNOWLEDGE ACQUIRED Locating of Simulium damnosum sites (see Figs. 2 and 3) o1o ical s stems In Benin the hydrological systems in the extension zones include four main watercourses, which are, from east to west as foLlows: - the Okpara, much of which marks the frontier with Nigeria and which flows into the Ou6m6. - the Ou6m6 and its many tributaries, the largest of which are the T6rou, the Odola and the Adjiro on the right bank and the Beffa on the left bank. the Zou and its tributary the Agbado, flowing into the ou6m6 at about 7" N. the Kouffo 1 which is entirely separate from the preceding systems and flows into Lake Ah6m6 in south-western Benin Togolese r^/atercourses are mainly represented by the Mono and iE.s tributaries (Ani6, Ogou and Amou) and by the rivers rising in the Plateaux region and flowing into Lake Volta in Ghana. The Sio and the Haho, which are not included in the extension areas, flow into Lake Togo in southern Togo. In Ghana there are hydrological systems on both sides of Lake Volta and the largest of them are the Dayi and the Asukawkaw to the east, and the Pru and the Tain to the west. 4.L.2 Breedins sites in the Okpar ^fzou river basins The 0u6m6 and its tributaries, the Okpara and the Zou, flow on a crystalline subsEratum and all three provide extremely favourable condi-ti-ons for the development of the pre-imaginal stages of the vectors of onchocerciasis. In the dry season, although all three rivers do dry up for about(February and March), they in fact form continuous series of breeding s.1., these sites being found on the Ou6m6 up to 7 23'N. two months of the year sites for S. damnosum Upstream from this latitude, the bed of the Ou6m6 is strer^m with a large number of stony blocks overgro\^7n by vegetation and forming natural breeding sites comparable to those of Grechan on the L6raba or of the Bui on the Black Vo1ta. Below 7'23'N, the Zagnanado and Sagon causeways are the only major breeding grounds observed. On the upper and middle Okpara breeding sites are fewer than on its lower reaches, where they become more dense as the river flows away from the Nigerian border towards the Ou6m6. ocPf 7s.2 Page 5 Ihe Zou river bed has many rock platforms but these are mainly to be found in its middle section. Its lower reaches flow over almost completely flat ground, meandering considerably, and in very sharp bends of the stream breeding sites may appear when the current speeds up. The Kouffo 1 does not on the whole seem to offer a very favourable breeding ground for S. damnosum s.1. except along a 25 lcn stretch between 7'O7' and 7'19'N where rock platforms become potential breeding sites During the rainy season these p1-atforms are submerged to a very large extent, but considerable breeding of the vec.tors is stil1 possible on the main watercourses, on vegetation along Ehe banks. In ttt. ore*e/okpara/zou river basins, the tributaries of these watercourses are swollen towards the end of June and they all contain a large number of breeding sites. 4.1,3 l"lono river basin In the dry season only the stretch downstream from its confluence with the Amou contains breeding sites as far as 6'48'N; the rest of the river and its northern tributaries, with the exception of the Pasa are dry. During this period water is provided to the Mono solely by its right-hand tributary, the Amou, which rises in the Togolese Plateaux region. Ihe Mono has a targe number of breeding sites singly and in series during the rainy season. There are fer^7 of them berween Tchamba and Kpessi, however, where the river flows through a sandy area. From 20 lcrn upstream from Kpessi up to 6"48' N there are a great number of rapids which all become favourable sites for the breeding of S. damnosum s.1. ; the largest of them being located dor,mstream from T6t6tou on the lower reaches of the river. The last natural breeding ground on the Mono is situated 6'48' N by 1'36' E. The upper basin of the river around Sokod6 is divided into many sma1l tributaries flowing from the hill areas and containing numerous breeding sites. One of these tributaries, the @, is perennial and isincluded in the circuit of OCP treatments carried out during the dry season to prevent problems caused by dispersion of vectors from that river towards the upper Mono basin. The Ani6, particularly in its lower reaches, offers very favourable conditions for the development of onchocerciasis vectors. This is not the case of the Ogou (a left-hand tributary of the Mono), which has very few rapids and a sandy bed. The Sio and Haho rivers in southern Togo only have S damnosum s.1. on their upper reaches, vhich flow through a typical forest area. Both rivers go dry during the dry season and are systems independent of that of the Mono. Their lower reaches flow over almost completely flat ground geologically related to the terminal continental sand and clay complex 4.1.4 Eastern tributar ies of Lake Volta These tributaries, the largest of which (the Asukawkaw and the Dayi) are perennial, form the hydrological systems of the Atakora chains in Ghana and Togo. They flow through a typical semi-deciduous forest area, except for the Lower Kpassa and Lower Banoky6 in the north of the Volta region in Ghana, which are part of the Guinean savanna area. The upper reaches of these fast-flowing tributaries are located in hilly areas and accordingly have a large number of rapids that are rarely submerged during the period of high water. In hitly areas the possibility of S. damnosum s.1. breeding often increases during the weE season owing to the large number of waterfalls which last long after the rains have stopped so prolonging the survival of the blackfly populations. 4 .L.5 Wes tern tributaries of Lake Volta Unlike the watercourses east of Lake Volta, rivers to the west of the lake a geomorphologically less hilly area, except around Kintampo. flow through The rivers flowing into the north-western part of the lake: the Bonchi, the Gbongbon; the Bondjari, the Bonya and the Upper Tain, Upper Pru, Upper Sene and the whole of the Afram, do not seem to be of any interest in connexion with the development of onchocerciasis vectors. ocPf7e.2 Page 6 On the Middle and Lower Pru and Tain, however, and on rivers around Kintampo such as the Oyoko and the Pumpum, surveys have revealed the existence of a great many highly productive breeding sites in particular on the Pru and the Pumpum during the dry season. Breeding sites of onchocerciasis vectors seem to be limited in the Brong-Ahafo region to the areas surrounding Asubend6 (Lower Pru) and Kintampo, Wenchi. 4.1.6 Location of breeding sites in south-western Ghana Surveys have been carried out in south-western Ghana on the Pra and Ankobra hydrological systems' wtrich flow through a dense evergreen forest area. Potential breeding sites are tobe found on these rivers dor*rn to the Atlantic, but a rather scanty collection of insectsgathered during the survey in April 1978 only demonstrated the presence of two man-biting species of the S. damnosum s.1, complex on the Pra and its tributary, Ehe Ofin, vLz.S. sanctipauli and S. soubrense. 4.L.7 Linear extent of breeding sites (see Figs. 2 and 3) In brief, the overall length of the stretches containi along rivers in the study areas in Benin, Ghana and Togo is I^ret season and at 1OOO km during the dry season. Account of all the rivers with breeding sites in southern Benin and the southern limit of the extension zones requested. ng S. damnosum s.1. breed ing sites estimated at 5OOO lan during the was taken in making this estimate southern Togo, i.e. well beyond 4.2 Distribution of species of the S. damnosum complex (see Fig. 4) The six West African species of the S. damnosum complex have been identified in the extension study areas. These areas belong from a phytogeographical point of view to theGuinean savanna area, with the exception of the Togolese.high plateaux, which extend intoGhana (vo1ta Region) and where forest vegetation prevails. Sma11 forest areas are also foundin Benin in the middle valIey of the 0u6m6. Both the phytogeogr ca1 characteristics of these areas provide favourable ecological establishment of the six cytological species of the s. damnosum c aphical and the geomorphologi- conditions for the omplex. Cytotaxonomic studies have been concerned not only with wild larvae collected in the various watercourses but also with those reared artificially from biting females. The new methods of morphological study of adults have also been applied to differentiate the savannaspecies frorn the others. Particular attention has been devoted to discovering the southernmost limiE of thebreeding sites of the two savanna species that are of great epidemio logical importance,S. damnosum s.str. and S. sirbanum, which migrate in large populations and cover greatdistances in doing so. S. damnosum s.str., which is widespread throughout the extension areas, has been found in the last breeding sites of the various hydrological basins. Theoverall distribution of cytological species is quite complex. However, the hilly areas separating Ghana and Togo seem to form a reservoir of S. sguamosum, which are to be found ina high percentage in the areas around Kintampo west o f Lake Volta. They have also beendiscovered on the Zou in Benin. The typically forest species, S. soubrense and S sancti au 1i,breed on the Mono, Ou6m6 and Okpara. S. sanctipauli colonizes the watercourses flowing intoLake Volta from the east. 4.3 Vector population nam].c s When the sub-sectors were opened in the study areas, an entomological surveillance net- work was set up for a Eotal of 70 catching points along the various riverine systems in thethree countries concerned. The study methods adopted conform to those currently used in the areas under treatment. Thus captures on human subjects are made at least once a week in important sites and twlce a month in places of lesser entomological interest. Eleven hours a day is the usual catching tirne (7 a.m. - 6 p.*.). Samples of the catches are dissected according to a method appror/edby OCP. ocP/7s.2 Page 7 Data obtained to date are insufficient to enable a comprehensive study of the dynamics of blackfly populations in the extensi.on areas. In some cases not even a full year of data is available. However, it is known that the blackfly popuLations along large watercourses such as the Ou6m6, the Mono and their main tributaries undergo major variations related to thehydrological conditions reaching a peak towards the middle of the rainy season. The rainslast from seven to nine months and are heaviest around Septexober and October, when vectordensity is highest. In the dry season, the percentage of older female flies is of the order of 60%, wirereasduring the rainy season it varies between 20% and 5O%. Experience acquired in L979 in the uPPer 0u6m6 river basin, however, showed that when the wet season starts there is a relativelyhigh rate of parous females sometimes exceeding 9O7.. This may be an indication that black-flies from other areas come to the upper Ou6m6 river basin during this period. As far as the migration of vector insects - especially east of Lakeit would seem that Siven the existence of various natural barriers (such the natural southern boundary of vector breeding sites), the study zones are on the whole not so much arrival places as areas from which invadingbegin their migration towards other zones. Volta - is concerned, as Lake Volta and east of Lake Volta blackfly populations 4.4 Transmission Tables l to 6 give a surrrnary of the data collected from l september with a view to establishing the transmission and biting rate. Forest-type transmission seems to prevail mainly in hi11y areas. r eastern tributaries of Lake Volta and in those of the lower Mono and lowe 1978 to 31 August 1979 n the valleys of the r Ou6m6 there is aheavy load of infective stages of Onchocerca volvulus €rxnong the dissected blackfly populationsTransmission is very intense, for the thresholds estab lished by WHO in L977 of 1OO infectiveO. volvulus larvae for the Annual Transmission potenEial (ATp) and 1OOO S. damnosum s bites1for the Annual Biting Rate (ABR) are far exceeded. In the majority of cases the intensity oftransmission varies with density of blackfly populations. Transmission is nevertheless interrupted for approximately two months (February andMarch) on most river systems; except in the Asukawkaw and lower Mono ri.ver basins and in thelower val1ey of the pru, where it remai.ns heavy the wtrole year round. 5. EPIDEMIOLOGICAI KNOWLEDGE ACQUIRED The epidemiological evaluation teams carried out parasitological and ophthalmologlcalsurveys in the extension zones in Benin, Ghana and Togo. The surveys detelTined the followingcharacteristics of onchocerciasis in those countries: - Benin: These parasitological and ophthalmological surveys covered the whole of the ou6m6 riverbas in. Endemic onchocerciasis exhibits moderate savanna-type features. Hyperendemi.c onchocerciasis prevails in a strip not wider than 15 lon along all the riversystems between 7" and 9'N. Beyond 9'N, along the ou6m6, the okpara and their tributaries,the disease is mesoendemic. Ihe results yielded by clinical examinations of the population made it possible toestablish the various endemic levels by age as indicated in Table 7. ocPf 7s.2 Page 8 - Ghana: The geographical distribution of endemic onchocerciasis in the study areas in Ghana is not the sane on the eastern as on the western side of Lake Volta. In the eastern areas the surveys were mainly carried out in the Dayi and Asukawkaw riverbasins. In the villages along the Dayi the prevalence of the clisease and the rate of ocular onchocerciasis are 1ow, except in the villages in the Hohoe-Wegbe region on the Lower Dayi where transmission is a little heavier. By contrast, the Asukawkaw river basin is a classical hyperendemic area where prevalence rates are as high as 60% or more, with irreversible eyelesions in over 1o% of cases. In these eastern areas the limit of severity of the disease runs along a line dividing the hydrological systems of the Dayi and the Asukawkaw (see Tables8 and 9). In the western areas, i.e. the Brong-Ahafo Region, the medical data have not all been collected yet. However, on the basis of investigations carried out by the Medical Field Unit of the Ministry of Health in Ghana, it would seem that onchocerciasis in those areas forms a mosaic of hyperendemic foci located on the Lower Pru and in the Kintampo-Wenchi areas inparticular. - Togo: The medical surveys covered all the southern areas of the country and showed that endemic onchocerciasis Prevails as far down as 6"30'N. However, hyperendemic onchocerciasis is found mainly in the Mono and Ani6 river basins and along the valleys of the watercourses flowing inthe high plateaux (see Tables 10 and 11). 6. HYDROLOGICAL SITUATION A good knowledge of the hydrological conditions is a prerequisite for drawing up a planfor a larviciding campaign against onchocerciasis vectors, so the beneficiary countries were asked to compliment their existing hydrometric neEworks by setting up and operaEing ne\,r s tat ions . 6.L Existins stations (see Fig. 7) A11 three countries have hydrological almanacs retating to the river basins extension areas. In most cases, however, the information requires updating. in the Tn the Ou6m6 river basin 10 stations are at present ready for operation and are located on the Ou6m6 (3), the Okpara (2), the Zou (2), the Agbado (1), the Klou (1), and the WE-Wa(1). There are also 13 such stations on the Mono. As far as the tributaries of Lake VoLta are concerned, only three stations can supply data of practi-ca1 interest: Dayi (1), Gban-Houo (1), Tain (l). 6.2 Hydrometr ic stations needed (see Fig. 7) A total of 20 additional stations are requi.red in the study areas. Idea11y, they should be located as folLows: Benin: (8) - Afon (Ou6m6) - OuessE (Ou6m6) - Barerou (Yerou Maro) - Gourou (Apouro) - Igbomakoro (Terou) - OdoLa (Odo1a) - Djagbalo (Adjiro) - Vossa (Beffa) ocPf 7 s .2 page 9 Ghana: (8) Kpassa (Bassa) Bonaky6 (Bonaky6) Dodo-Tama16 (Asukawkaw) Ahamansu (Wawa) Menuso (Menu) Asubende (Pru) Yabraso (Oyoko) Tainano or Asantekroum (Tain) Togo: (4) - Tchamba (Mono) - Landa-Mono (Mono) - Goubi (Ogou) - Aoulosso (Aou) Five out of eight new stations planned in Ghana have been set up since March I97g in theVolta Region, but they stil1 require calibration. In the Brong-Ahafo Region i.n Ghana, andin Benin and Togo, however, action is still being taken to create the stations requested. 7. HYDROBIOLOGICAL ST]RVEILLANCE A surveillance network for aquatic ecosystems in the extension zones still has to be esEablished- However, some work has already been undertaken either on the initiative of oCp or by the States themselves. Two sites are currently subject to regular and Asukawkaw-Ferry on the Asukawkaw. surveillance in Ghana: Asubende on the pru Moreover' consultants working on behalf of OCP carried out surveillance activities inin Ghana (volta Region), Togo and Benin on the following watercourses in particular: the 0u6m6 and the Okpara (Benin), the Mono and the Ani6 (Togo); the Dayi, the Menu, the Wawa, Asukawkar.r and the Pru (Ghana). L97 7 the Research by a team of hydrobiologists from the University of Benin is also in progress onthe Sio in southern Togo. They are studying problems of zonation and of qualitative andquantitative seasonal variations of the aquatic fauna as a whole. These studies are concerned with the entire hydrological system and have now been under way for a year and a half. Before beginning treatments on the various hydrological basins in the extension zones,hydrobiological studies are absolutely necessary in order to deterrnine the number of existing species and their seasonal dynamics. ongoing efforts must therefore continue and beintens if ied. 8. POSSIBLE PLAN FOR A LARVICIDI}IG CAI,{PAIGN It is difficult to draw up a plan for a larviciding campaign because of the inadequacy ofthe hydrometric networks. Such a plan can only be established with the accuracy desired whenall the hydrological data have been collected. Another series of questions for which, inline with the terms of reference for the extension study in the senegal Basin, answers shouldbe sought, include the possible impact of treatment on the reduction of costs in the initialProgramme area, the benefits that the extension could have on the reinvasion phenomenon in thePresent Progranrne area, the identification of the constraints imposed by the reinvasion in the areas concerned, and the economic benefits which would result from the removal of these constraints, the possible cost/benefit of such an extension. 8.1 Timing of oper4tions Owing to delay in the collection of data, the launching of campaign operations would befeasible only at the beginning of 1982 at the earliest, starting with the Mono river basin, then extending to the upper Ou6m6 river basin and finally to the rest of the Ou6m6 river basin. These activities would correspond to phases V and VI of the Prograrune respectively. ocP/7e.2 page 10 9. IMPACT OF CONTROL IN THE EXTENSION ARXAS ON THE INITIAL OCP AREA 9. 1 Ivory Coast A means of tackling the problem of reinvasion of studies carried out from L975 to 1978.L the original OCP area was tried out in S. damnosum s. str .andS s irbanum The experimental treatment applied io 1977 in south-western Ivory Coast to various hTater- courses assumed to be potential source areas of reinvasion was remarkably effective in reducing the density of blackflies in the arrival areas. 9.2 Ghana west of Lake Volta These studies showed that reinvasion moves monsoon winds over a distance of 3OO km or more The areas west of la.ke Volta probably do not pLay a the iniEial OCP zone. from south-west to north-east, driven by It mainly involves the savanna cytotypes, significant part in the reinvasion of 9.3 Ghana east of the Vol Lake: Toso and Benin SEudies conducted S. damnosum conp lex (S. findings have extend down t that large mi and Alibori ir in the south in these areas s damnosum s. st a howed that Ehe mig nd S. sirbanum) ar ratory cytological species of e much in evidence.2 More recent shown that these savanna species are extremely widespread and o within 50 km from the Atlantic coast. Studies made in 1979grant blackfly populations reach the valleys of the Mo in Togo n Benin' Most if not all these blackfly populations probably of the countries involved in the OCp. that in Togo they have demonstrated and of the Sota come from areas IO. ADMINISIRATION AND COSTS At the meeting of the Joint Coordinating Connnittee in December L9j7 a total of $ 3 was apProved for Prograrmne extension activiEies in the Ivory Coast and for extension stin Benin, Ghana, Mali and Togo for a period of two years starting from 1 January l97g (OCP/77.2 and the report of the Independent Chairman). The cost of extension activities in the Ivory Coast was estimated at $ Z:+S tOO. net amount earmarked for "Extension studies" is therefore $ 1 182 600 ($ 3 527 7oo -$ 2 345 1oo = $ r 182 600). 5 du 27 700 ies see The Out of this totaL, $ 622 2OO was earmarked for the second year (L979), as follows: the first year (1978) and $ SOO 4OO for Country Year 1 (1978) $ Year 2 (r979) $ Total $ Benin Ghana Togo Mali I41 400 259 600 L23 200 98 000 115 000 207 000 106 000 t32 400 256 400 466 600 229 200 230 400 Tota 1 622 200 560 400 1 182 600 1 - "Studies on the Reinvasion of the onchocerciasis control progranrne in the volta RiverBasin by Simulium darnnosum s.1. with Emphasis on the South-Western Areas,t by Garms et al. 2 See document 'rThe distribution of Simuli um damnosum complex in West Africa wiEh particular reference to the Onchocerciasis Control Area" by Vajime & Qui116v616. ocP/7s.2 Page,11 The breakdonn of expendlture during thc first year (1978) as compared to the estimates ls as follows: Country Estlmatea: Ycer 1 $ Expenditure $ Balance $ Benin Ghana Togo l.tali 141 400 259 600 L23 200 98 000 49 879 96 810 63 7i5 L4 344 9L 52L L62 790 59 475 83 555 Total 622 200 224 758 397 442 The dlfference behreen expendlture and estimates is accounted for by the delay in setting up the sub-gectors for entomologlcal survelllance, by the number of flight hours and by the fact that less recourse to outside consultanta rras needed for epldemiologlcal work than had been expect,ed. Ittls dlfferencc la carrled fonvard to the year L979, givlng a total available amount detalled ac follows: Country Amount $ Benln Gtrana Togo Ma11 206 52L 369 790 L65 475 2L6 056 Total 957 842 EBtlmated e:<pendlture for L979 I Ih" Regional Offlce for Africa assumed responsl-blllty at the beglnnlng of L979 for studlee ro be carrled out ln Ma1l, a8 pert of the rrestern extenglon etudles ln Guinea, Mall and Senegal. Authority has been delegated to Geneva by AFRO to mnnage the funds allotted to Mall for the purchaee of suppliee. Country Est lmates $ Antlclpated expenditure $ Anticlpated balance $ Benin Ghana Togo 206 52L 369 790 L65 475 to7 52L 2L5 290 LOz 975 99 000 154 500 62 500 Subtotal 74L 786 425 786 316 000 I'Ia119 2L6 056 119 571 96 385 Total 957 842 545 457 4L2 385 ocP/7 s.2 Page 12 The breakdown expenditure by ltem is as follows: Category Amount t978 $ L97 9 $ Personnel Consultants Travel Aerial operations Rent and maintenance Supplies Vehicles Equipment 99 9L4 40 644 25 000 4t 5L6 17 684 168 000 55 500 15 000 60 789 42 500 103 500 90 168 Total 224 758 545 457 Sufficient funds should be available at the end of 1979 to finance at least one year of supplementarY studies. SI'MMARY (1) Ihe savanna species of the S. damnosum complex are widespread in the extension zones requested. (2) There is heavy transmission of onchocerciasis in those areas. (3) Epidemiologically onchocerciasis is a severe disease in the Ou6rr6, l'lono and Asukawkaw valleys. (4) Ihe savanna species exist farther south than the southern limit requested. (5) present knowledge of the dynamics of blackfly populations and of the southern limiE of the savanna species is not sufficient to establ-ish a final and detailed surveillance plan. (6) There are not enough hydrological data available for the comprehensive planning of a larvj-ciding carnpatgn and for a precise estimate of costs ' (7) Also requiring clarification is the question of the impact that the extension treatments woulh have on the operational costs in the initial area, the effect of the reduction of the reinvasion phenomenon on the Progranune and alternative methods of vector control. (S) Funds amounting to US$ 316 OOO are available and it is suggested that this amount should be used for gatherin! additional information during the years 1980 and 1981.1 1980. 1 Should additional funds be required for 198I, they will be applied for at the end of ocPhs.2 PsSe 13 A ET 6! o ts o@ NN oo .iN -t+6<' Nts oo c,N6\t d !3, \t oo I -t o @ N @ o o ! o a) NO NNo6NN oo o @ a .l F) @J Oo o o @ N I s a o .l o ab rd $oooso N N N aoN o NoN No 6 o6@NNO @@ o 6€h{' \t 6 @o ts o o o !r Oa €9 €N i .d' €d {,i .$@ oN -f o o!dE @Noa\' N{.@ots rl' 6o o\+ o o F !6 akD o ON o€ o6 N Io @ N{+.o\, o o N 6l dl ! 6 t6 F, 6NN@ ooNc) @o €o@{. N Ns 6l 6l .l H o! o o oo Oa @o -, -,o6tsN N N o @ N -t o 6l & o4 o oz €oOts N $h o aoaN N a $@N o o 6l I o3 o ! 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A N@oo 6{. od {.6 oN oo o@ <,6 o N o N N o F @ ok6E ONQNio oo \+o oo NOts$ o F N o N a o N @ o !6 L ! o Qa ao o-f,QN6@ N Fo 3*NO @6 N o € N N ol o 6l H6) dFl @a rN 6O io66 @d N o N @N tso9S r@ N + N @ oN a 6l 6l dl ! o ! e o o oA OQ @n N@ oo or a N -' N6oooo .+@ o F o ao o qrl !J! E oz 606AFO 6\' €\* -t -, oi o N @o@aQO \to N @ -to o -+a -* o -t o 6l ! op oI o o @dao@+ {.N oo6@ @6 @ F@tso o o -, N @ N a o ! oA E o !A o @ ootso \+e no FQ .So ots dl o a a F dl o oI a F! oko Bqdoii€ 'odoJI aoo Efi6tEo -co o a oE oots!su6o>36 EI d dAJ 6 ts{ oA E6! d * od a oT a o t o >i o t d H o @ ot0a 6 F o o! o!dB B6I B6Jt o a o q d I Id BdB t o E x6o 6 o od ra e ao a a F. =L O. 6F t 6 H ot oa zHq FC HFl9a _-NFlo =dFIU H9 Hil 2<Hr loEr 2d EU o€ r!U!''t aE3 N El aH o !d 6 d 6I6t oz 6l ocP/7e.2 Page 15 ftHn oH $€Nl1llioN tsN66 NO6 N66 9FrN@O N @o .t .$ I a a a d<'d6 No@rNr6 6t\tO6\t @6 -+ )h oho6OFNONi oo.s -, o o 0 c)a €oo6ONr6 i6@N OOa o o a$ -, aE 6Ododrodi@ i ioN o N He s ooo N .+ o ,E o{ :E oooo oo oo hq, a!D o oooo a 6 x!d t a h NoONirNoN 6$ 6l o & o! a o o oA qoNo eaoo oo 6l n a @ ts ! of0 oz @iiN €N6€ I @ .l o o o ! o , ou o OoNNOoh\ti\+ No @ -, x o! al!r oq oo60NOO @6 N oN oo o o o! @ oiEi-odE= :ffiEEgEitsJ< s3i dJ'k q o 3o I a cE o @ l.) o ok o!d - o ot o t o00o a o 5 o Fo ! o a a0 I o N o H o! a0Ur oo zH o EI ilt: H& ozI nE E{ zH q .-1Ll H zoHoq HE6z 1H 3o H o !d 6 6 (! ! dt oz dl oo o a?q E3 !nO'-{N r^\tCiO6l \o o\ (n @\.or-\t$ciroor N\trn 'r rr 6lF{ O\ 6l r.. rn O6l Fl r\ .$ r\ .f, o\ F{ F{\o F{ 6t6l rnNN(')F{ .+ \, .+\tCOOtO Nrnt\(') F{ F{ 6l rno\ o\ o\Or LO .f, N6l\o o\oN (r) \o r\@ >\ F{ h (Y]tn\O\O rn o\ o\ roornoo\ Nr\rnF{ F{ rn \O taocoo rr Fr o\ \O.S @ c7')\o 6l 6l Fl NF\ F{ c) tr) r-) \OrnO-t L) 0O F{ F-O-S\O\O \O.$(7)N .:lN@ .f, o\ r-on-r tYt.S O LN o\\, rn @ rn 6l h rd = .f,@Oro F{(V)O\N6tst@o\ F{ 6l$ rn F{ .s\o@@\oo\o F{ F{ rn 6l\o o\ N i J ..{ t{o o\or^(r) o\ (vt 6t o\\o F* ! OO\t N@J LANF{ o @\t rn F{ o tr(B o.f, Fr ,-{N.$.$ J(f) 6l oao o @\, @ 14 ,o o h \o1/1NN FIOFIF- \O F{ F{ F\ N@C7)(')6lo 6l o @@ c{ F{ td f') 1/)o\No o\61@(\l\t@twrtr.t .SF{d\, N (0l cO\o \,\, \o 6l 16\t\o N o o,o OrO@61@N@\o\O\t@ca \tciOo\ i l.oo\ F\ o\ r0No6l \, o\ N N t oz ooooO\O(fi6l F{O\NF{ 1/].f,rnN F{ oJ(Yl rn (!o o\ rn @ 6l rn @ @ t, o o @N\tr^@@$r{]n.$ O c.) .f,1/1Od F{ F{ cOOr-\o(f)@@O\Gl 6l@ o(n \o F{ F{ N @\t (7) rJo a ooof.)c)N\o@O\ rn rn \t \o 6l o\ F{ F{ cooo F-NF{ @N\t (r) F{ o(7) rn -1 I N F{ C)! .,{ a o .r{E'noroE OJ .r{tro6 (,)"l +Jt (a-c otrou+r(' QrJ O) FllZ<H o th6d OF. d(uGE N b0dd tsF{ha< (! .li t{ .J a o -oo o E o o t{) o(,) I t{ o rJ rd B o F oE 0,) .r{ o b0o ) E ocP/7s.2 PaSe 16 zH U) rc &lc H o1 e eh6aE! tr]9 trb0 z<Hr lco Hs H5 rn -O v6i!ulio;d3 .$ 14 F1 Fq fi o) F{ -o(d F{ .J 6 tU r! rJ dt oz 6l ocPfT e .2 page 17 r!1 uo H< (\ c.) \oHo\o rl0N (\N NO\\O .$ ,i o\ N N o\\o orn N i / o\ @ H o Ni o b0 N@Ln -rN@F\i il@raN Fl _) \o N co i @ rn Fl o o F- N o x F) \tJO\Of] d O,6 \o \t o o-t ca F- ca : o co o t - e{\ooO\\Or)(\o\r) ONcaca cf) N ro co C' ca C' rn o\t Or o o h cd \t co \t oco Fli \o 6 ! o rn @N C' H o o o Fl 'F{lio ooo o c.) o o o o .C o tr G ooo oo o o (nl o o p C) ooo o o I6 o o r! - cf) OcaNN o o d C. o o o AJ a OO\o ri i oooC\ o o @ cn o o o t oz o(dl (dl dl (dl o cl cdl ]J o o co cul (!l -) (nle.l\o (!l (0l (dl o (!l (!l U o. 0.) Cf) co (6l (!l o6l (!l (dl dl o (!l (!l ! .rt U) oii do ol0)lr (i! o_a 0J! oFo o!-pq<E ..i o(d rr)(do ..{ (d Fa}z c.) J) 60 .r{ tr a) o +J o tr I '.1tr(d B d a o c) B o3 o i o cd U) o ta tc) ,0Oli!t ooBU \q) \c.) o c5 ! d o- o o N o tr (.) H rl(H 0) ta OJ 3 0)3 o (! -o o0 o! .,t zH(n 14 & Hil 'E! a .Hil H-i': or, ZP th F-l E1 collxtri o' z ,.o: 6eU) \, !!z^u)+ Z9d H r^ td Fl H a; -o(U - 'rl cd d ! fg ! oz(!l o ocPh s .2 page 18 +o i6s 6AA66N 6+ o tqq N@6 6Ni 6 N 6-t@ 6@ $ o @@6 NNO @@N 6N 6 @io @io !d d6 F] ooo ooo + o Ozo oN@N6N a\ji E o c E Xa 6@N $6i6 N*i ! ! a a oE O^ oi{ o6 .do ! o^ ! ^ o\6o6< o IAC O6 zH H z FI Er J OH Haz nz o4 HOzrJ p, - HJ H !6 .d 6 d 6 6! oz 6I & E d o H N@@ oo$ $-th 6d6 @ os N $ N N $ o @o a o o + { N o @ N N @ 6@6 fi@N NNN {@6O ON NO + N N 6 o @@ 6 @ 66 o a o6@ i@ @N N 6I -1 $N @@ N a+ o N a +o@ o@a N@Q o@$o a o N $ o o + 6 oo o$ 6 ,3SgN@ i$ o@ N o N N N R o a ooo o6 o N a o o c o tsd OoN @ oi o o o dl o o !d H! o ooa 6 ON N o o @ 6l o o 6 2 6 oo@NC N oo6 o NN o o ts o! E o A ON@oo6oo N o$ooFO o No j @ N o N o @$ N ts op E a o z € @N ol ol N dI C dl dl dl ol dl I p o o j$ dl (l N dl N 0 (l (l 6l (l nl ! ! o o o ol ol N@ dlN ol (l 6l @ @o (l dl o o _!? oll tsdq o!!F<E qa 60 o! @ k o o d F ts d3 6 o o 3 o3 ) o 6 6 o d € o ! o I o 6 B I o 6 HdA o a c N a o oF a a B o B oE dp @ o! ! H F d. H& EN\t{ o =io H9H@ z4 I H@ HN@o za o! o o!ZEHOF!HA40 ; Hlj ts ocP/7s.2 page 19 c)]J$ F U' o o .F{ J € 'i(d r!o- '= o.)?E u r,l u(d -. o. !.5sil z zoH(J rdd tr Flo H zH aH U) H Oil E]() (J z tq rd(J z [J]J rI]&A co HJ FA H 6.e N 6{ 6-* N d{(,) o.\ r-t (n \t O e.! .A oF{d\tF{F{F{ b.e 6.e N b=.96tOJLn\O .r{OJtrOO d{NNs{NNN r\ f.. F{ t^ (f) l.\ la ;(')r-{r+OO(f) ! oJi od.93.9oNNcoO.c\to\o.F{t(\tN ! o 'lJ ctrO 1oiH A .f, N \t rrl (n r^ \O O(nN@t\(\t(?)F{6tFlNF{(nd O\ d) F{ F{ Ln \O \O \O C\t -t F{ o 'r{ o 6(H 'rlOoolr 0) oqJ o!Od cdoodE o o FgB,.!NNNB<N ro\NF{Hco@\O\O\O@@Nr\ ;{ o=.9 5{ S< N\t O\ -) F\ O\;J-;;-+N(')\t\O\O o5 .d q, rJtr G 'r'{ o.xo 0.)A 6i\tF\.f,\Otn@o(nd)(?)@ln ct(nNf)-)Nd"l r\Oco(nc\!Oo\\t(nGl('l (O F{ \O \t rn (f) o \t o- (,) ;fr8dYo.J 3U *er -o O\F{oh$OF{\O@OrF\O\O\c.lO -) (7) 6t f) (r) (n \t F{F-Oo\H e{ r--t F- @ @ .7) -t Fl \O .$ o q) @(E F{ H 'r{ xlr oblJ tqC.r{t(0+{BB'+{oE$fio.r{oJJo,zjirJro'oB(,Jttodo ,o$ooEJ OO+JOcd'd|o Itrttlt O\l'\cO\OO\@O(aF\@F\F\N\t(Yl(7)(n(')(n('](n .F{ odt! 'r{do o(d .d -oU -ol] iiJo..{ oFa>,t{N(drodOO.J.n(0Bili'g>16 €doo(0JH..{NJF{B ttrttl\Od)l'\-)Na(') N \o 6l (7t u) 'r{ o(d .o c) .rt ! .r{ ([ a d 6! Er+]ooc .r{ trEo(d -oxEO C(,) ilo(do !g oc)Ho. ocP/7s.2 page 20 TASLE 9. OPHTHALMOLOGICAI EXAMINATIONS IN THE VOLTA REGION (GHANA) a = Proportion of severe and irreversible eye lesions calculated in relation to cases of ocular onchocerciasis and not to the population exami.ned. TABLE 10 PREVALENCE OF ONCHOCERCIASIS BY AGE-GROUPS IN 10 VILLAGES (SOUTHERN TO@) 87 .2 100 oro 94.7 100 100 100 100 100 100 93.4 100 100 93.1 100 100 100 100 100 96.7 B lindness rate 47 .2 83.2 46 .9 56.6 76.3 68 .9 7 5.2 69 .3 77.7 6a.a Vi 1 Iages Number of examinations Preva lence of ocular onchocerc iasis Irreversib 1e lesionsa Rate of vi sua 1 impairment 34O - Asukawkaw 375 - Koto Nkawanta 337 - Alavanyo- Abehenas i L73 - Biakpa 269 2L4 299 27t 5t.8% 34.o% 24.6% 5.3% t2.s% 10.o% 3.4% 4.6% 3.5% 3.6% ) o"/ L.O% t.9% L.9"1 o.67" L.o% Vi I lages o-4 5-9 10 -14 15-19 20-29 30-39 @49 50+ Total L48 L49 300 301 302 303 304 305 306 307 Fazao Alamassou Zoubega Oga Obe Kokote I 1 lougba Onia Kope Kokpli Tetetou Diome L.2 9.1 7.7 7.1 8.0 L5.4 L5.4 7.3 17.5 1.8 17 .6 81.6 28.9 34.7 6t.9 6t.9 60.0 50.9 78.o 4L.5 47 .5 100 36.4 45.8 100 81 .8 94.L 7 5.o 86.2 95.3 83 .3 100 50.o 7 5.O 100 100 100 93 .8 92.9 86.7 82.t 100 81 .8 68 .8 100 100 100 100 92.6 100 88. 1 100 78.6 87 .9 100 100 100 92.3 94.9 100 ocP/7s.2 Page 2L TABLE 11. BLINDNESS AND PRE-BLINDNESS IN 10 VILLAGES (SOUTHERN TOGO) 3 Crude rate. Vi 1 lages Popu 1 at ion examined B lindness Number Percentage Pre -b lindne ss Number Percentage 148 L49 300 301 302 303 304 305 306 307 F azao Alamassou Zoubega Oga Obe Kokote I 1 lougba Onia Kope Kokp 1 i Te t etou Diome 607 262 22t 370 r48 t27 L67 263 257 347 5 4 1 2 5 2 o 1 7 7 L.L"/" r.5% o.4% o.4% L.8% r.3% o% o.8"/" 2.s7"9 2.5%! 31 8 3 7 2 1 4 7 6 6 5.2% 5.6% 3.o% t.4% o.6% L.8% 3.7% 3.3% 3.87"" 2.67"! ocP/7 s .2 page 22 a q o C -oo ., o.o E !3 G o o oo o o oE z lrJ{Jo 9 F z JF oo o o E Ea o o o o G E a o co a a I I I 1t lrJ 9 z lrJ z 5(, ;6 ) a I I) f oa 6 U z 5 aI a< i I a I I i a I i I I a \ t . I\ tt!oi ti' a 'rI I a I l r l t I I I { a t ) o tr, z lrJ t a-----1_ttt-_' It a t{ I It I t I tt I ---+--+ + -. I Y =z E f I U' UJ o co o UJ o UJl o u,E oz o @z UI x u.l lt o z o f U' C) J-G G,(9 o ut o g lt ----A F U' o o TE o z I ak a a a r o a tt It\ , tr tr,l .D J 't I I "f I , I I I I t tI o t , I I \...fi i .o-if: q + t I ocP/|s.2 Page 23 ho oY <(q ll o! o I a ono C o x a a p aI z sq r -+a-++ + a C) o utrn a t II H ono_ + + +,.-t-+- ,-....-.q. l.1 .q *\- ----r"' +/ , , a a a II\ J \ ,, \ aa ,t-_ttt--' , LU:\(q.k s ! 0, ,6 E'I .E!q) o, ! 6 l t!c o .: =qc q, E f o o -ol!o o o. O a a a a a a a t f, rJ =ol-oU IU : q e UU o lr to{q.r al- o .\D a \ o , a y{. 0)5sNO o-N(Jc o.9 GL o '=x .=o bEE 'F_.. !l!(o9!!'EtrC fJ(!OO c.o! .9cc E,P-E EEEiii + -: +iI tn ulF aD(,2 o UJ UJt co z ot/, uJo z a E, N g UJz oN zo tJ)z UJFx UJ z(E uJFln UJ z<l -E *ll- .trd o\ o; I I I o tq :5\ a I I o t It t_ L \ =lUi a \ oa:sH e\ a + I t \ 9 [- \ + ++ , \ o o I t t 5 I I \ I ocP/7 s.2 page 24 a { 'sq ta z 1o_ +..-1 a a a a O a ono a I I tt Y' o, o o a a1 \- ----r utrnr + o , \ r'- s o .Q a Ni I z,t ta a LI EJ J a s a.{J.\ T q J a 96vopo Mon9 t II I rl.. 4/ b Y +++O ! i.-----* <., o ! o \ a I F *^^f, okqq o. a s a -.s. <. .q L o I i o 0, .= g) .E !q) o, -ct E f (o c o .= s c q, E f o (u -o(E -oo o l U e ol- oU tUto I a a t q QUU € o l{\, stI 1a E. o , a a\ {T c (aq 5Y ,+ ++ ., \ L \. a\ o 'ro i =l{i a oE t a\ I t Fa II l oaI *t =\ a , I \. i"' \'" * It 0,TENO LN()c o.9 6L o '=x ,= o, bEE'rL.b€€ tfoooc-o-o .9cc E.E.E oiaE8EiiiiI o ul E u,(, z 6 UI u, E, CO z o aD UJo E o GI g lt ujz oN z o6z UJFx UJ zEt!Ftlt UJ z€ .E *r- .trd t o _! ) ocP f7 s .2 Page 25 tlo_ -+a+++ + no a t{ Tooq q t,') s'1 aa; z oYqq <t{ It I r.t on9 C o Y al o q -./l^> a .E a <t? Sl o o ! o o ! a ui v i++o 4/ \ t oPo 96v o"fI1 ,-------s' 'r. .q t. S* -1 -ll*--- r + \ -" .r t^o e o o rr a a o aaa /.\ 's I\ - O^, I cJ a o a a ,, I ,t-_*t_--t' , J ! tlJ I\q H ,D -ci:ii:c 5f i ;'- i ojvioP' j6to{{l o f, rJ ? l- o(., tU T o q e LJU I to t{ <t s !t -r a a \,1tl o5PxO o,rl(Jc o.9I €l o -X .=o bEEE.. >o6SEE l!oOc-o-o .9ctrEiiBqEEEEiiilo+ill att UT A. oF C) lt o z 9 :)g G 32 o t g lt UIz oN z o -nz UJFx UJ zE UJFt, UI z s *r- .ld c t s ...)Y o a-r T _a\ a I ct': o L a t [. 01 \ II o i Ei, a o o Fr -l',++-., \ It , I at { It -t_ \. i ', \1"** J t .a I "l ocP/7s.2 pa9e 26 v no q 1o_ .ld z C){ -as -++-* i l. II I opo ono o L o Y .lo q' o -3 a q 4/ o q q N a ! o , o 9'tln l ++O ,-+-+-+-q. ,s {q 1 \, + $ o:, a ,\o a,Qit{E I f J t ,I .,0 { \ oY. o a I a.t'*ti++i t^oe \ a f, rJ =o l- o t*, qtUIJ o ttJI o o C o o tN rO a: ooa aol\I o o oo a o o N oo oo oo I o l{ -l s a Bt taqI)Y , L I\ o o a + \ o i i,. I I , o e u a 'a.\i \'r * o o rl It , I It t It -t_ o5ENO GN(Jc o.9 6L .- O, '7x .=o bEE 6€EEccff .EOOc -o -ct .9ctr(Eoo ciE EEEiiiiI a\c GI\I o. F < .oS ci 81E ll-ll J 113ll ur .-il ulz oN z o a.l,z ul x UJ z CE Ll, 1-tn u.l z€ a I I l o I :l ocP/7s.2 Page 27 J t t o Y t \ a 4/ot<tq q a o a II lcEo a a na's q( , .!+- o u'a tn t H aGa i I I q \ q q -.<. r. ! + a I a a It.t.lt IIJ t ,ttt*----i I tA, o \ f,o e al- <tt(, U a IU : a o o c o o ooo ooo E o oo oq oo o to a o lo lRlO ai o-ooO o g E. i L {l IBTNo Or{(Jco.9 GL o '=i .= a, 500 'EII ^LlEaSE? =l888 .9trc EEE EEEiiil!l a 0o o Q e IE !i < (Ds d81 t! llulli .llt UJ zoN z o a.l,z ul x UJ zE lrJF v) lrr z< t <(Ift \ a a-r oi =t{}, \ o i L...\i \ a o o r{ I{ II t --l , I t *++-tt ( i f3 I I ocPf|s.2 Page 28 t , -r- lr--+'- o a a I \ L,A\^i o ' at -a =o a a II op tu l.oa oo a a ( q(/) z t -i,,i ,,rA - ' o gttn r H ana .a oootls I t a +il+++ + , I J stE ! o a ro,I ) t t \ I t \ !l \\ a o 5 o =ol- o(, UJt o <t QUU a cD oicc 660 XXooro0J L € E e,oo LL -t - t.-i- ctl .EPE .= o)!L(!b9o ooa OJz() .rd EE .: .zBB g I sa ao o L t I I {f, tqt5Y a a iat{L I a a o oq. L s _=\ a \ *lj' .\i .\' o o t{ t{ ,t t ,I rs*-*r It o5eNO GN()co.9 .2 .Eb '=x .= o, bEEEl.!.E.E9!tE ff oOOc-o-o '9cc E.EE !r55 =88iiiiI ozI aa 9EF UI =oG o -E ! ; *l=E .NH UJ2 oN z o6z UJ x ul zE LlJ v, UJ z€ I II )_.t ,, I