Neglected tropical disease control in post-war Sierra Leone using the Onchocerciasis Control Programme as a platform

Abstract

Strategic investments in the control of neglected tropical diseases (NTD) spearheaded by the US Government, the British Government and other bilateral donors such as foundations and key pharmaceutical partners have enabled the treatment of millions of people for the five targeted debilitating diseases (lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiasis and trachoma), paving the way for the potential elimination as public health problems of some of these diseases. Like many other countries, Sierra Leone has a high burden of these major NTDs. Despite the fragile infrastructure of a health system emerging from a devastating 10-year civil war, the country has successfully implemented the National NTD Control Programme, reaching national coverage in 2010. The NTD Control Programme uses the existing Onchocerciasis Control Programme as a platform and involves primary health workers. The programme has provided extensive training opportunities to health workers at national, district and community levels. The country currently has 31 161 trained community volunteers treating a population of five million people. It is shown that the investments in NTD control are not only to control NTDs but also to strengthen health systems, particularly at the primary level, through extensive capacity building of frontline health workers and community-directed distributors.

Community Acceptance of Tsetse Control Baits: A Qualitative Study in Arua District, North West Uganda

“…Evidence of the feasibility, cost-effectiveness and effective scaling up of control measures in community-driven interventions is mounting [43], [44]. However, community misunderstanding of disease control tools still poses a challenge to the success of such interventions.…”

Mass drug administration significantly reduces infection of Schistosoma mansoni and hookworm in school children in the national control program in Sierra Leone

“…It was based upon the existing Community Directed Treatment with Ivermectin (CDTI) platform developed for onchocerciasis control [23]. As part of the integrated effort for NTD control, national mapping of schistosomaisis and STH was conducted in 2008 [15] and a complementary survey in 6 highly endemic districts in 2009 [16].…”

“…Supplies of anti-histamines and paracetamol were donated to the NTDCP by the St Andrews Clinic for Children-SL a local NGO, for distribution by health staff to children if any mild side-effects might occur. A total of 562,980 school children were treated with praziquantel and 549,701 were also treated with mebendazole with reported coverage of 94% and 92% respectively in this first round of MDA [23]. …”

Integrated Implementation of Programs Targeting Neglected Tropical Diseases through Preventive Chemotherapy: Identifying Best Practices to Roll Out Programs at National Scale

“…There are many instances that could be cited where failure to attend to one or more of these essential elements early in the roll-out process—i.e., having a lack of sufficient government commitment, a poor understanding of disease distribution, an inadequate assessment of funding needs, poorly engaged stakeholders, an imprecise work plan, and the like—have caused programs to falter initially. The details of some of these failures and the remedies applied have been previously recorded,15,18–21 and other accounts will follow from subsequent country reports. The purpose of this work, however, has been to summarize the key lessons learned from these early experiences and to define what appears today to be the most effective roadmap to successful program development.…”