Sierra Leone has joined other African countries to shift the campaign against river blindness (onchocerciasis) from prevention to elimination, largely due to the excellent work of previous control programmes.
Onchocerciasis is a parasitic infection transmitted by repeated bites of the black fly which breeds in fast-flowing waters. Infection with the parasite can result in blindness, impaired vision and skin disease, all of which can be disabling.
An estimated 198 million people live in areas of three WHO regions where the parasite can be transmitted: the African Region, the Region of the Americas and the Eastern Mediterranean Region.
In 2016, almost 133 million people living in areas at risk of onchocerciasis received treatment as compared with 46 million in 2005.
According to Abdul Conteh, M & E officer at the Neglected Tropical Diseases Programme (NTDP) at the Ministry of Health, one of the main goals of NTDP is to reach all those in need with preventative chemotherapy for NTDs, in particular onchocerciasis.
Referencing the Health Sector Performance Report 2016, it stated that good coverage was attained in 2016. “The NTDP has also integrated the co-administration of ivermectin and albendazole for the control of onchocerciasis. Collaboration with other programmes such as the National Eye Care Programme and the National School Health Programme were crucial in attaining good coverage…” the report adds.
Conteh went on to say that they have made appointments of technical advisor for the oncho teams to guide the program towards elimination. The elimination process is guided by its twice yearly mass drug administration, coupled with an impact assessment survey, entomological surveillance and also adherence to the WHO guidelines on elimination.
WHO says that despite the progress achieved in the region, elimination requires 100% geographical coverage. Barriers to progress include political instability and a lack of political will in some countries to support the onchocerciasis elimination programmes.
“The number of treatments in the Africa region increased from 119 million in 2015 to nearly 133 million in 2016” said Dr. Paul Cantey, medical officer for WHO’s global onchocerciasis elimination programmes.
A statement from WHO says that since 2016, the recently formed Expanded Special Project for the Elimination of Neglected Tropical Diseases (ESPEN) has continued to engage partners, donors and health workers by enhancing the delivery of ivermectin to communities, not only for onchocerciasis elimination but also for combatting the other four neglected tropical diseases amenable to preventive treatment.
ESPEN’s four priority areas are, to achieve full geographical coverage in all endemic districts of Africa; to collect disease-specific data to allows mass treatments to stop; to strengthen information systems to enhance evidence-based decision-making and measure progress towards elimination and to improve distribution of donated medicines, supply chain management and inventory reporting.
WHO’s 2016 guidelines specify that a key step in eliminating onchocerciasis is to establish country-led expert committees that are independent of the national onchocerciasis programme in order to provide external review of programme data and provide advice to the Ministry of Health.
Country programmes and their partners have been working to develop such committees, recognizing the need for their help in transitioning from the goal of control to that of elimination of transmission.
As of October 2017, Sierra Leone is part of the 14 countries in the region that had a committee that had met at least once; a further 5 countries plan to hold their first meeting in 2018. This represents significant progress, despite 11 countries having yet to plan their first meeting.
ZJ/18/11/17
By Zainab Joaque
Monday November 20, 2017.
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