Progress report of the World Health Organisation for 1978

JOINT COORDINATING COMMITTEE Onchocerciasis Control Programme in the Volta River Basin Area Ofice of the Independent Chairman c/o World Health Organization l2l I Geneva 27, Switzcrland rct. 346061 Tctcx 2DtIi 2782L JOINT COORDINATING COMMITTEE Fifth session Lom6, 5-8 December 1978 COMITE CONJOINT DE COORDINATION Programme de Lutte Contre l'Onchocercose dans la Rdgion du Bassin de la Volta Bureau du PrCsident Indlpendant c/o Organisation Mondiale de la Sant6 l2ll Gendve 27, Suisse Tcl 346051 T6lcxtrtr(il 2782L JCCs.2 19 October 1978 J.C.C.-C.C.C. 1 Provisional agenda item 4 The Independent Chairman submits for the consideration of the Joint Coordinating Committee, at its fifth session, the progress report of the Wortd Health Organization for 1978. This report has been reviewed by the Steering Committee. @ WORLD HEALTH ORGANIZATIONORGANISATION MONDIALE DE LA SANTE ocPfPRfTB.4ORIGINAL: ENGLISH ONCHOCERCIASIS CONTROL PROGRAMME IN THE VOLTA RIVER BASIN AREA PROGRESS REPORT OF IHE WORLD HEALTH ORGANIZATION FOR 1978 CONTM{TS SUMI',IARY VECTOR CONTROL EPIDElIOLOG ICAL EVALUAT ION ECONOMIC DEVELOPMENT APPLIED RESEARCH ENVIRONMENTAL PROTECTION TRAINING LIAISON ACTIVITIES With Ehe participating countries With the statutory organisms . . With the general public MANAGEMENT AND COSTS The issue of thrs document does not constitute formal publrcation. lt should not be reviewed. abstracted or quoted without the agreement of the World Health Organrzation. Authors alone are responsrble for vtews exprossed tn srgned art,cles. Ce document ne constttue pas une publrcatron. ll ne doit farre I'objet d'aucun compte rendu ou rdsumC nr d'aucune cltatlon sans l'autorrsatton de I'Organrsatron Mondiale de la Sant6. Les oprnions exprimdes dans les artrcles srgn€s n'engagent que leurs auteurs. Page 2 3 5 6 7 8 8 lo 10 10 IO L2 ocPfPRfTB.4 Page 2 SI]MMARY (1) The peak of the dry season was reached in March when the aerial fleet was reduced from elght to six machines. On the other hand, the rai.ns started six weeks early and as rivers started to flow treatment recomoenced over the whole Programme area. By July most of the rivers were being treated together with the Marahou6 and Sassandra complex to the south. A11 eight helicopters and the two fixed-wing aircraft were fully utilized. (ii) The epidemiological evaluati-on teams started their second passage in the phase I zorle. (iii) In close cooperation with the National Onchocerciasis Cormnittees (NOCs;, 11r" Economic Development Unit prepared its reporE on some aspects of the socioeconomic development of the zone. (iv) In research, there was important acEivity in many fields including helminthology, transmission of onchocerciasis, testing of larvicides, the identification of the different species of the S. damnosum complex and their vectorial potential. (v) In environmental protection, a group of hydrobiologists engaged in the aquatic monitoring activit.ies met in Ouagadougou in January. (vi) As to training, considerable progress has been made and more than 25 candidates have been awarded fellowships during the year. (vii) Very close contact has continued t.o be maintained with the participating countries, mainly through the annual meeting of the National Onchocerciasis Conmittees which was heldthis year in Benin, with Ehe statutory organismsr through various meetings and also with thepublic at large through an increased effort in the field of general information. (viii) Another major activity has been the preparation of the report evaluating the firstfive years of operations and out.lining the Plan of Action and Budget for the next phase1980-1985. The draft report was reviewed initially by a smalI group of Scienrific andTechnical Advisory Comrittee (STAC) members who meE in Ouagadougou in early May, and subsequently by rePresentaEives of National Onchocerciasis Corunittees (NOC) and the Steer{ng Cornmittee in June, and the full STAC at its August meeting in Brazzaville. a (ix) Expenditure for 1978 is expected to be in rhe order of g 12 too OOo, reflecting saving of about $ f 7OO OOO in relation to the budget approved in December L971. INFRASTRUCTURE DEVELOPMENT, INSECTICIDE CONSUMPTION, FLIGHT HOURS AND EPIDEMI0LOGICAL EVALUATIONS: Lg74-L977 L974 t97 5 L97 6 L97 7 Tota I No. sectors No. subsectors Li tres/in sect ic ide Helicopter hours Fixed-wing hours No. villages examined (EEU) No. persons examined (EEU) 3 : 1 6 90 000 2 783 54L 74 L9 623 3 IO 130 000 4 265 6L4 L29 30 960 155 6 15 5 358 L O25 1ll 25 98L 7 24 375 6L5 9 623 1 639 240 56 94L ocY/Yxfta page 3 VECTOR CONTROL l. For the first four months of L978, the helicopter requirement of the aerial fleet was reduced from eight to six machines and the two fixed-wing aircraft were converted from treatment to passenger configuration. 2. With the onset of the dry season, which reached its peak at the end of March, riversgradually dried up. The fixed-wing and helicopter hours flown, and quantities of Abate dispensed during the first six months of the year, reflect this pattern: He licopter Fixed-wing AbaEe January Eebruary Mar ch April May June Ju ly Augus E September 339 .9 280. O 290.r 264. L 590.7 458.6 s67.7 597.7 462.9 8.2 31.0 27 .5 L2.6 57 .O L20.9 L22.4 L7 8.L L62.7 4 0t4.3 2 059.5 L 822.7 2 482.3 L2 957.4 L9 748.5 22 L96.L 35 547.3 37 854.6 Iotals 3 8s1.7 720.4 L38 682.7 3' As the dry season progressed and low fly catches were recorded it was possible to suspendtreatment in a number of areas: in Mali on the Farako and Lotio rivers, and also on thePlandi, Guenako, Diendoa and comoe basins. However, due to poor flow of certain rivers, theinsecticide r^Ias not effectively distributed and difficult brelding sites became hard tocontrol. The "restrictorl system was then put into use. 4' The rains started almost six weeks early and as rivers started to flow treatment recommenced over the whole Programme area. The Sota river in Benin, left untreated lastyear' was treated by helicopter for the first time in March during the 14ch cycle. TheMekrou and Alibori came under treatment in l,Iay, initially by helicopter. rn the Ehird weekof June this circuit was extended to incrude the Tapoa river in Niger. 5' rn the western part of the Programme area increase in river discharge Lras srow, and evenin July both the Baou16 and Bag'cie rivers, normally treated by fixed-wing, were still.underhelicopter treatment. In the Programme extension area of Ivory coast, treatment of theMarahou6 and Banoroni rivers started during the 17th treatment cycle in Aprir; this wasfollowed by treatment of the sassandra complex starting in the first week of June. 6' rn May the helicopter conEractual requirement reverted to eight machines, and sixhelicopters were employed weekly on treatmenE missions, leaving two for prospection flying,one at each base' Both fixed-wing aircraft were put back into treatment confi-guration by thebeginning of June. By Jury most of the ri-vers in the prograrnme area r^7ere being treatedtogether with the Marahou6 and sassandra complexes to Ehe south. A11 eight helicopters andthe two fixed-wing aircraft were fuIly utilized. 7 ' raking into accounE the need to extend activities to the south in lvory coast and undertakestudies in Ghana, Togo and Benin, the entomological evaluation network \ras reorganized. Theouagadougou sector headquarters, and the Leo, Banfora, Dabakala and yendi subsector officeswere closed' All Phase rr Ghana and upper Vorta evaluation activities are now managed fromTamale sector headquarters. The Korhogo sector was transferred to Bouak6, and additionarsubsectors were opened in Hohoe (Ghana), Bouak6 (rvory coast), seguela (rvory coast),Arakpam6 (Togo) and parakou (Benin). ocP fPRf 78.4 Page 4 8. Altogether an everage of 23O catching stations have been visited on a daily or r^reekly schedule. The results show that the criteria established for resettlement are already being met over 75% of the original Programne area. The situation is particularly encouraging in the Phase II area, and the northern part of the Phase I area where at most sites only occasional flies are caught. 9. Ihe peripheral area of the Programme, particularly the south-r{resE, continues to be affected seasonally by the natural redistribution of flies from untreated rivers. While counts can be high at riverine catching sites in the long-recognized reinvasion areas, the flv highly effective control operations prevent these flies from becoming established and subsequently spreading to the interior of the programme area. Consequently, the programrneis moving towards an intensive barrier of control operations effectively protecting a large central core of the original OCP area as envisaged in the PAG Mission Report. 10. During the first three months of 1978 fly populations were reduced to very low levels everlnvhere with virtually no transmission. Excellent results rrere noted especially on theL{hite Volta, Red Volta, the Oti/fend5ari, rhe Black Volta (except berween Chache and Bui), andthe Niger tributaries in Mali, Niger and Upper Volta. In all these areas, the vector was Practically nonexistent. However, as a result of heavy rainfall experienced in ApriI over most of the area, there was an early build-up of fly populations, particularly in the south- west. This reinvasion was first observed on 1O April and the plan prepared for its study immsd1.6.1y set in motion. Initially, events followed a similar pattern to previous years with a high parous rate amongst the captured flies. 11. The reinvasion research was conducEed from a base at Seguela (Ivory Coast) by a team ofthree consultants and two Programe entomologists. The Programe research scientisEs also ParticiPated. Ihirty-eight vector collectors and nine vehicles were assigned to these studies. Six catching points were established in the "departurettzone and nine in thet'arrivalrr zone; three Johnson suction traps were installed as weIl as tTro meteorological stations on the rivers L6raba and Marahou6. L2. The combined treatment of the Marahou6 and Sassandra had a pronounced effect on the traditional reinvaded rivers of the south-west. The experimental treatments in 1977 markedly improved the situation on the L6raba, Bandama and Bou rivers during August and September. In 1978 the Upper l'1arahou6 was treated from the time flow starred and this prevented the development of a serious reinvasion problem on all Ehree rivers. With the extension of control to the Upper Sassandra that reinvasion almiist ceased. 13. 1978 was also marked by detailed discussions with the Canadian Comercial Corporation and Viking Helicopters Limited to review the first year of operations. one important out,come of these discussions has been the adoption by Viking of the WHO definiEion of "flying rimer'.As a result, tachometers were installed in all contractual helicopters to record t'Iift off" to "touch downt'. Following the installation of tachometers, it was calculated that of the 1174 helicopter hours flown in the first four months of the year, 70 of those hours were "ground running" on the o1d definition of flying time. These extra hours will be credited to I'rIHO at the end of the year. Other interesting developments included the issuance of new radio procedures for Viking aircraft and the implernentation of a standardized method of completing flight reports. L4. A mission visited Benin, Ghana and Togo at the beginning of the year for discussions with the national authorities on Ehe organization of the operations and on the entomological, medical and hydrological studies to be carried out in the proposed extension areas. Eight hydrological stations are being installed on the Ouem6 river system in Benin, and three stations on the Mono river in Togo. By the end of l"larch, five new stations had been installed by the authorities in Ghana on the Bassa, Bonakye, Asukawkaw, Wawa and Mono rivers. In each country the Government is expected to provide buildings to house the new subsectors. 15. At the end of February a new technical officer was appointed to assist the aeriaL operations officer, and following a period of training in Bobo-Dioulasso, he assumed his duties at the Tamale base. ocPfPRfTB.4 Page 5 COIIPARISON OF FLY CATCHES - L975-I978 EP IDN,IIOLOG ICAL EVALUAT ION 16. The Epidemiological Evaluation Unit has been re-examining villages in Phase I to assess the evolution of the disease following a period of vector conErol, completing its collection of baseline data in the Programme area and examining villages in the proposed extension areas. L7. Altogether, 18 villages in Upper Volta and trro in Ghana were evaluated for the second time. Results from the second passage revealed Ehat, in villages close to rivers where control had been carried out and transmission interrupted, the disease \{as no longer recorded in children under five-years-of-age. In the next, younger, age-groups the severity of the disease had not increased as was normal in pre-control siEuations. In the older, serious cases no significant change was observed, which is understandable after such a short period of control. The exception to this encouraging pattern was the village of Dangouadougou, which is situated in the reinvasion zone of Upper Volta, where no improvement was observed and, where, in fact, if anything the severity of the disease had slightly increased. 18. In Benin, baseline data was collected froa 24 villages. Similar examinaE.ions were undertaken in 10 villages in MaIi, and lO in Upper Volta. A further 12 villages were surveyed in Ghana. 19. In collaboration with the Bernhard-Nocht Institute, the Epidemiological Evaluation Unit has experimented with a new method of parasitological exami,nation based on collagenase. The method proved no more effective than that previously followed and, in facE, is more suited to use in laboratory rather than field conditions. 20. Also with the Bernhard-Nocht InstituEe, the nodulectomy experimenE in Upper Volta was followed up. Preliminary results show that the removal of head nodules from the younger age- group had a favourable impact on Ehe ocular lesions. 2L. The chemotherapy trials with levamisole together with diethylcarbarnazine, as well as with metrifonate, have continued in association with OCCGE (Centre Muraz). In the first case the results do not seem significantly betEer than wiE.h DEC alone. In the second case, the results are less encouraging in view of the toxicity of the product. L6raba River - Pont Routier L97 5 L97 6 197 7 L97 I I"lay June Ju 1y Augus t September 92 141 26 50 I15 L29 134 39 151 I05 60 33 114 86 6 2 69 54 I I Bandama River - Bema L97 5 L97 6 L97 7 L97 8 57 56 6 33 94 68 82 18 t82 40 L2 7 116 34 3 2 35 L4 2 I Bou River - Gite 3 L97 5 197 6 L97 7 L97 I 153 2L9 48 108 270 170 256 33 344 103 58 2l LL2 15 l1 66 L7 32 ocPfPRf78.4 Page 6 22. The village of Mou16, Upper Volta, was re-examined in detail three years after a treatment with suramin used at the classic dose of 5.2 g administered over six weeks. The parasite load was found to be greatly diminished, but an increased incidence of optic atrophy was found in the treated groups when compared to untreated control groups. 23. Research on dermal microfilaria of T. streptocerca has been carried out in the Volta Region in Ghana. Several carriers of this filaria were detected of whom all except one were also suffering from onchocerciasis. In four villages aI1 ages were affected, suggesting local transmission, while in other villages the infection was probably imported. 24. The in utero transmission studies at Pa hospital were completed and show that 2% of babies born to mothers with onchocerciasis are carrying microfilariae. 25. For the three-year period 1975-L978, the evaluation part of the activity of the Epidemiological Evaluation Unit can be surunarized as follows: 4 662 4 442 4 885 89 674 Tota I sarnp 1e ECONOMIC DEVELOPMXNT 26. Ihe main activity of the Unit has been the preparation of the annual report on the socioeconomic development of the oncho zone. In the process, verv close cooperation was maintained with National Onchocerciasis Conunittees and national authorities responsible for health, planning and rural development and also with multinational and bilateral aid agencies. Contact was made with TAMS-EARTHSAT, the contractors for the earth satellite studv of the oncho zones of Benin, Ghana and Upper Volta. Country Compos it ion of sample Population examined at least once by EPI Number of examinations in Number of peop 1e S iurp le eva lua t ion Deta i led eva Iua t ion L97 5 L97 6 L97 7 L97 8(ro 1. lo) Niger Togo Ivory Coast Benin Ma 1i Upper Volta Ghana 3 578 LO 764 14 186 8 931 t6 440 32 562 L8 972 L 246 7 43L 7 637 5 929 11 480 23 743 13 084 794 L 797 3 168 L 436 L 256 4 L77 3 336 4 L74 LL 260 560 3 966 3 480 5 444 9 223 8 t7s L 469 5 L97 2 375 2 68L 7 99L 6 268 Tota 1 105 433 70 550 Ls 964 r8 856 30 848 25 98L 13 989 86 5L4 Programme area Areas outside present OCP boundaries Number of villages Popu la t ion concerned ?1? 28 96 625 8 808 Tota 1 361 lo5 433 ocYfer.fta.,. page 7 27. In March a Pub1ic Health Adviser was recruited. His initlal tasks included missions to each of the participating countri.es to investigate public health problems in the oncho zone. Topics discussed included integration of the blind people into the corununity as well as appropriate health structures for newly established settlements in areas made safe from onchocerciasis. APPLIED RESEARCH 28. As a result of the establishment of criteria for resettlement of the populations in the river valleys, and the need to ensure a correct interpretation of the Annual Transmission Potentials, the Prograrune convened a meeting in February on the coordination of research in the field of helminthology and transmission of onchocerciasis. The parEicipants recomnended that further studies be undertaken on animal onchocerciasis transmitted by different species of the S. damnosum complex, on the veclorfparasite association and its relation to the a:.ttureiE$G-of the disease, and on the influence of human and vector migrations on Programme strategy. Two consultants were subsequently engaged for eight months to pursue specific studies in this respect. 29. In order to assess what had already been achieved, and to stimulate activity towardsthe develoPment and testing of larvicides and formulations potentially suitable as alternatives to AbaEe, a Scientific Advisory Panel (SAP) Working Group met in Geneva in July as ProPosed by STAC at its meeting in November L977. Representatives of 10 chemical companies atEended. Recormnendations were made on the testing facilities that would be required to screen ne\^I products. The type of cooperation expecEed by indust.ry to stimulateinterest and promote a flow of larvicides in different formulations was defined. The needfor products selective against Simulium larvae and as i-nnocuous as possible against non-target organisms was recognized. It was noted, however, that the quantities required wereinsufficient to justify special research into a new technical ingredient. Varieties offormulations courd be developed for testing and it was emphasized that some products may be more suiEed to formulaEions other than emulsifiable concentrates, in which form Abate is used. 30. Canadian scientisEs under conEract to the progranrme have made encouraging progress indeveloping a key for the identification of the different species of the s. damnosum cmplexusing a series of morphological characters. This key has been tested in the field witha measure of success. rn order to determine how it could be rnodified and adapted for generalfield use, a SAP working Group of taxonomists and scientists from Canada, France, Germany andEhe unlted Kingdom met with staff frorn the vector control unit in the programme area from16 to 20 Ocrober. 31' Supported by oCP, research has continued at the Institut de Recherches sur 1'Onchocercose,Bouak6' on the vector Potential of the different species of the s. damnosum complexr,the restingsites of the adurts and new insecticides. As a result of the "GE-io., of the controloperations in rvory coast a new site had to be found on an untreated river where differentformulations of larvicide could be tested. 32' i^Iith the assistance of a consultant, a large-scare trial was undertaken with chlorphoxinto determine its efficacy for operational use. while it is effective against s. damnos,m1arvaeatconcentrationSIowerthanarerequiredwithAbate,ch1orpho"i..i"-.Io,,ffio.. toxic against the non-target organisms. A modification of the formulation would possiblyimprove its selectivity against S. damnosum. 33' A contract was established with the l-lniversity of Tiibingen, Federal Republic of Germany,for a continuation of longitudinal studies on s. damnosum and o. volvurus in Northern cameroonrt is anEicipaEed that this work will be "o.plffiEiry rsffitrr..-.r."-."""i.""ii,,. o"used in the development of a mathematical model on onchocerciasis. 34' rn July' suPPort Eo the Tamale chemotherapeutic Research centre was transferred Eo thewHo speciar programrne for Research and Training in Tropicar Diseases (TDR). ocp, however,will continue to maintain a close link with the centre, particularly in the larger-scaIevillage trials of drugs cleared by the cenEre. rn this respect, discussions have taken place ocP/PRf78.4 Page 8 with the health authorities in Upper Volta regarding the possibility of undertaking onchocerciasis medical treatment and drug trials. A protocol is in preparation. 35. To strengthen the medical research component, an epidemiologist was recruited in ttay. ENVIRONMEMAL PROTECTION 36. The annual meeting of hydrobiologists engaged in the aquatic monitoring activities vras held in Ouagadougou in January. The group reviewed the 1977 results and the prograrune for 1978, and discussed the analysis and storage of data as weIl as matters concerning reports and publications. Reconrmendations were made regarding: (a) ttre timing, methods, sites and frequency for the surveillance of invertebrates, in rivers both in the present programtre area and the proposed extension areas; (b) the intensification of chemical moniEoring of Abate in fish, mud and larger molluscs; and (c) the timing of first treatment of new rivers. 37. A consultant was recruited to collect baseline data from a number of rivers in the eastern part of the Prograrmue area, not covered by the routine monitoring prograurme. TRAINING 38. The numerous contacts made during the year by visits to the countries, by correspondence or in the course of the annual meeting of the National Onchocerciasis Comrittees, have led to a betEer,underst.anding of the objectives of the Progra"rme and the means available in respect of training. Also, the countries have defined their needs. A tinetable of action has been drawn up. Already, for the year 1978, more than 25 candidates have been presented for training suPPort and the situation to date is shown in the following table. TRAINING PROVIDED BY OCP IN 1978 BY NATIONALITY, FUNCTION AND FIELD OF TRAINING Ben in I Gilbert MB{SAH Germain OUSSA Djokodjo Cl6ment GLELE Martin CODJO AKOGBETO Ghana James SAMI,IAN Hydrobiologiste Charg6 de Recherche MinistEre de la Sant6 Publique Cotonou Chef des Services de M6decine et de P6diatrie HOpital Parakou M6dec in-Che f C irconscription m6dica 1e Dj ougou Professeur de Biologie- G6olog ie b Porto-Novo au Lyc6e Behanzin Assistant Research 0fficer Instit-dte of Aquatic Biology Achimota Research Officer aE Council for Scientific and Industrial Research, Accra 6 monthsr training in hydrobiology at ORSTOM.ftolo^ue, started August 1978 3 years' specialization in ophthalmology at Dakar University, starting 2 November 1978 Training in epidemiology requested by government. OCP exploring possibilities with institutions Training in entomology at ORSTOM/Paris - 15 months, starting 12 October 1978 3-year course in hydrobiology at Salford University (UK) with field work in Ghana initially 3-year course in hydrobiology, field work in Ghana initiallv Country/Name Current occupation /ritt" FieId of training Joseph Somra AI.'IAKYE Country/Name CurrenE occupation ft*t. FieId of training Ghana (continued) L6onard Abraham Kwame ANTWI Samuel Zanya BUGRI Michael D. WILSON Guinea Ars6ne SAGNO Roger Topko 1,AI'1A Kabine KABA Mamadou Sarifou BALDE Raymond Koho KONE Souleymane KOUROUNA Theoue OUI,ARE S6kou Yalani CAUARA Research Officer at Council for Scientific and Industrial Research, Accra Medical Of ficer i.n charge of Communicable Disease Control and Public Health Hospital Tama 1e Entomologist Biologiste charg6 des enqudtes paludom6triques au Service de Pr 6ven t ion Projet Paludisme Conakry Professeur de Biologie Facult6 des Sciences de la Nature, I.P.K. Conakry Assistant auprEs de lrExpert Entomologiste OMS pour projet pilote Oncho-Guin6e Chef drEquipe Entomologie Projet pilote Oncho-Guin6e Chef drEquipe Parasitologie Service de Pr6vention Projet Paludisme Chef d rEquipe Parasitologie Projet p ilote Oncho-Guin6e Assistant auprds Expert Entomologiste. OMS Projet pilote Oncho-Guin6e M6decin i lrlnspection M6dicale des Ecoles Conakry M6decin 0pEhalmologiste et Directeur du Projet Oncho- cercose, Kankan ocP/PRf 78.4 page 9 0n-the-job training in pesticide residue analysis at UniversiEy of Miami, Florida(USa), srarting Sept. 1978, 6 months Miami, and 1 month At lanta Postgraduate public health training course with special emphasis on parasitology in Teheran, Iran 1-year course medical parasitology aE London School of Hygiene and Tropical Medicine, starEed 25 September 1978 4 monE.hsr trainin entomoloBy at IRO I /z in ouak6 Reported 20 September 1978. Subsequently 1 month training with OCP 4 monthsr t.raining in entomology at IRO/Bouak6. Reported 20 Seprember 1978. Subsequently I monEh with OCP do do- 4 monEhst training in entornology at IRO/Bouak6 starting January 1979. Subsequently I month training with ocP do do Prior to atEending IRO/Bouak6 will undergo 6 weeks' training in parasitology ar OCp (EpI), scarting October 1978 12 roonthsr training at IOTA Bamako, ReporEed 13 September 1978. Subsequently 2 months with OCp Yaya KASSE a Country/Name Current occupation ftitt" Field of training Guinea (continued) Rahiou LABO N iger ia Candidaters name not yet known Ianzania Nicholas John MASAOE Dr Ayit6 Fol1y ABOUSSA Lah DORE Amadou DIALIO Hamadi ADAI'IOU Togo KEECVi KOUMOUVI Siba GBAMOU Niger Chef dr Equipe d6pistage L6sions oculaires, projet pilote Onchocercose Chef Section Parasitologie Laboratoire national Projet Paludisme Technicien Parasitologie Projet pilote Onchocercose Laborant in Direction de ltHygiEne et de la M6decine Niamey Adjoint Chef Section Para s ito logie-Labora toire drElevage, Niamey District HeaIth Officer at Regional Development Director, Arusha AssisEant d rEntomologie auprEs du Service Grandes End6mies et Paludisme. Lom6 Ophtha lmologist M6decin Chef Subdiv. Sanit. Aneho 12 monthsr trai.ning at I0TA Bamako. Reported 13 September 1978. Subsequently 2 months with OCP 8 weeksr training in parasitology with OCP (EPI), starting October 1978 Practical field training in entomology within Programme area prior to his attending IRO/Bouak6. Reported Bouak6 18 September 1978 Ophtha lmologica I rra ini_ng with OCP 4 monthst training in entomology at IRO/Bouak6 starting January 1979 4 mont.hsr training rn entomology at IRO/Bouak6. Reported 2 October 1978 3 yearsr specialization in ophthalmology at University of Dakar. Started November 1976 do do- ocPfPRfl8.4 page 10 LIAISON ACTIVITIES With the partic ipating countries 39. The second meeting of National Onchocerciasis Conunittees was held at Cotonou, Benin,from 6 to 8 June and was presided over by H.E. Issifou Bouraima, Minister of public Health andSocial Affairs. Delegates reported on activities in their countries si-nce the last meeting of NOCs in June 1977. A report \^7as made on the progress of the Programme. participants then reviewed and commented on the draft evaluation report of the entomological and medical aspects of the Prograrmne as well as on the draft report for 1978 on socioeconomic development in the Programme area, Discussions also took place regarding overflight and landing rights. At theinvitation of the Government of Ma1i, the next meeting of the NoCs will take place in Bamako inJune 1979. a aocP fPRf78.t, Page l1 40. On behalf of the World Bank, the Programrne organi,zed a two-day meeting of representatives of the participating countries in Ouagadougou on 7-8 September, to review the dtaft report on the economic development aspecEs of the Programme. Eighteen country representatives attended. The meeting \^7as opened by H.E. Dr Tinga Douamba, Minister of Public Health and Social Affairs of Upper Volta, in the presence of the Minister of Planning and Cooperation and other Government officials. 4L. The Programme also participated in the Annual General Assembly of the Union des Radios et T6l6visions Nationales d'Afrique (URTNA) which took place this year at Lom6, Togo, in early February. The Eheme discussed at this Assembly was the role of radio in mass campaigns, on which the Programme had organized a seminar for Rural Radios of the participating countries in May 1977. OCP reported Eo the General Assembly on this seminar, and the representative of Mali reviewed the activities undertaken subsequentty by the rural radios of the seven countries 42. The PrograrTrme also informed the Institute of the Sahel that it wished to follow closely the work of the Cornmission on "Mass conrnunication in development", established during the meering of the CILSS Human Resources Team at Niamey in March. with the statuEory o nisms 43. The Steerins Corrnitt ee for Onchocerciasis Control in the Volta River Basin area held its Er"/enty-second session in June and its September and 0cEober respectively. twenty-third and Ewenty-fourth sessions in 44- A sma1l group of Scientific and Technical Advisory Committee members meE with progranme staff in Ouagadougou in early May to review the first draft of ttre evaluation report.A meeting of the full comtrittee subsequently took place at the WHO Regional Office for Africain Brazzaville from 2l to 25 August. This meeting, which was opened by the i,rrHO RegionalDirector, was attended by the Independent Chairman of the JCC and by a representative of theWorld Bank. 45. A meeting of the Ecological Panel took place on 29 and 30 May, to review the results of Ehe aquatic monitoring programe with particular emphasis on the fish populaEion of thetreated rivers. While recognizing that weekly treatment was resulting in a certain reductionin the number of invertebrate organisms, the Panel considered that this was not important aslong as the overall productivity of the rivers was unaffected. 46. From 1l to 13 September the Economic Development Adv isory Panel met to review the draft report of the economic review mission. 47. In line with the reconrnendation made bv STAC at a Scientific Advisor deve lopment of insecticides. who indicated the readiness formulations for testing, y Panel working group was called its sixth meeting in November 'L977, in Geneva in early July to consider theParticipants included representatives of the chemical industry of their companies to cooperate in submicting new compounds and 48. A second SAP workinq qrouD held from 16 to 20 0ctober brought together five cytotaxono-mists and Progranrme personnel to review the progress made in the study of the mor phology ofthe species of the S. damnosum complex conmon to West Africa. The aim of the group, which undertook actual examination of specimens' was to devise a practical method of identifying e field.adults of S, damnosum s.1. in th i,Iith the qenera I public 49' Information on the Progranme was disseminated through the presentation of films,arEicles, fact sheets and radio and television interviews. 50. on a number of occasions, oCP staff have presented the work of the programe atinformation sessions or seminars organized in ouagadougou. rn collaborati.on with the Ministryof Health of upper Volta and the AutoriE6 des Am6nagements des vall6es des Vorta (Avv), aninformation meeting was organized on 20 April. This included a presentation of both the ocP /PRf78.4 Page 12 activities of the Programme and those of AW, the projection of films, and a "questi.on andanswert' session- During the same period, films on onchocerciasis were shown daily in theloca1 ci-nenas; interviews with Prograrune and AW personnel were broadcast, and a round-tablediscuss i,on was televised. 52. Programme oPerations were described and films on onchocerciasis were shown at seminars organized by the Secretariat drEtat aux Affaires Sociales of upper Volta for participants fromNigeria, Upper Volta, Senegal and Mali. A similar presentation was arranged for some30 radio specialists from different countries of Africa within the framework of a serninar organized by the Voi-ce of Germany as well as at a seminar held by the Institute forInternational Cooperation and the University of Ottawa. 53. Apart from fact sheets, the Prograrme provided background material for articles which appeared in t'WorId Health", t'France Outremer", and the new CIDA magazine, r'Directi-ons du D 6ve loppementrr . 51. Similar information sessions other Ouagadougou schools, as well America visiting Ouagadougou under group of 23 American professors on were held for the Ecole Nationale de Sant6 publique, and as for 18 university professors from the United States of the auspices of the Fulbright Foundation and another a study tour under the auspices of the phelps Stokes Fund centre in Februarv and May this year, Generai activities are 54. Assistance was given to the Canadian NaEional Film Office in the making of an educational film in the t'Sant6-Afrique, series, as well as to the I'lali National Cinema which prepared a film on onchocerciasis and other ocurar di-seases. 55. In collaboration with the Division of Information, WHo, Geneva, the programe hasincreased its library of information material. Also, a series of radio recordings wasprepared including interviews with the Programe staff as well as with several participants at the 1978 meeting of National onchocerciasis Cormittees. In addition to these recordings,the Progralme now has at its disposal six filns on onchocerciasis and a number of photographs and slides. 56. Amongst the manY visitors received by the Programme during the course of the year wereMr Vernon Johnson, Assistant to the Under-Secretary of State for Foreign Affairs, UnitedStates of America, Mr D. Conroy, Director of Regional Prograrmnes for the Africa Bureau, USAID,iniashington, Dr Kern and Dr Pu1st of the Ministry of Cooperation of the Federal Republic of Germany, and Mr Moise Mensah, Vice-President of the International Fund for the Development of Agriculture. 57. The information bulletin 'rOncho Flasht', which appeared reports matters of special interest concerning the programre. regularly reported in the monthly and quarterly reports. MANAGEMENT AND COSTS 58. Ihe Administrative Services Unit was involved in the reorganization of the entomological evaluation network in Phases I, II and III, the extension of Programrne activities in IvoryCoast and the initiation of extension studies in Benin, Ghana and Togo. The physical infra- structure of the Prograrnme has evolved from six sectors and 24 subsectors in 1977 to five sectors and 25 subsectors. 59. The total personnel complement now stands at 50 professional posts and 73I general service Postsl compared to 47 ar,d 756 as originally anticipated at 31 December 1977. 1 - Including liaison and WHO headquarters. .fsupport services from the hr{O Regional office for Africa, BrazzavrLle, I ocPfPRfTs Page 13 60. Salary revisions for general service staff were implemented in Ivory Coast, Ghana and Togo. These revisions represented annual increases of 24-47% (Ivory Coast),2O-Ll3% (Ghana) and 3-8% (Togo), depending on the grade. 61. The building Eo house Programme headquarters in Ouagadougou, which includes a Conference Room, has been completed. 62. In addition to modifications to the physical infrastrucEure associated with the opening and closing of various subsectors, in Mali a garage was constructed at Bougouni and modifica- tions were effected to the Bamako sector office. In Ouagadougou, the garage complex was modified and work started on a body and paint shop for vehicle repairs. Also, a warehouse was constructed. 63. The radio conununications network was slightly modified and new units were installed at Seguela (Ivory Coasr), Hohoe (Ghana), Bandiagara (lta1i) and Atakpame (Togo), bringing the number of stations to 24. 64. The closing of accounts for L977 revealed that the savings for the year in fact totalled US$ 2 428 729, i.e.US$ 269 729 more than the figure announced at the Kuwait session of the Joint Coordinating Cornmittee. 65. In 1978, weekly expenditure reporEing was instituted. Expenditures for 1978 are expected Eo be in the order of US$ 12 lOO OOO reflecting a further saving of about US$ I 700 O0O. The 1979 Budget was prepared on the basis of this revised 1978 expenditure. t- t a