Restarting Neglected Tropical Diseases Programs in West Africa during the COVID-19 Pandemic: Lessons Learned and Best Practices

Abstract

Countries across West Africa began reporting COVID-19 cases in February 2020. By March, the pandemic began disrupting activities to control and eliminate neglected tropical diseases (NTDs) as health ministries ramped up COVID-19–related policies and prevention measures. This was followed by interim guidance from the WHO in April 2020 to temporarily pause mass drug administration (MDA) and community-based surveys for NTDs. While the pandemic was quickly evolving worldwide, in most of West Africa, governments and health ministries took quick action to implement mitigation measures to slow the spread. The U.S. Agency for International Development (USAID) Act to End NTDs | West program (Act | West) began liaising with national NTD programs in April 2020 to pave a path toward the eventual resumption of activities. This process consisted of first collecting and analyzing COVID-19 epidemiological data, policies, and standard operating procedures across the program’s 11 countries. The program then developed an NTD activity restart matrix that compiled essential considerations to restart activities. By December 2020, all 11 countries in Act | West safely restarted MDA and certain surveys to monitor NTD prevalence or intervention impact. Preliminary results show satisfactory MDA program coverage, meaning that enough people are taking the medicine to keep countries on track toward achieving their NTD disease control and elimination goals, and community perceptions have remained positive. The purpose of this article is to share the lessons and best practices that have emerged from the adoption of strategies to limit the spread of the novel coronavirus during MDA and other program activities.

The impact of COVID-19 on communicable and non-communicable diseases in Africa: a narrative review

“…Moreover, the proportion of countries reporting severe disruptions of NTD activities was the highest among all health services (19%) [42]. However, by December 2020, 11 West African countries (Benin, Burkina Faso, Cameroon, Cote d'Ivoire, Ghana, Guinea, Mali, Niger, Senegal, Sierra Leone, and Togo) had restarted the MDA and the community-based surveys to monitor NTD prevalence [48]. Among all NTDs, Strongyloides stercoralis infection deserves a special mention due to clinical implications in COVID-19 patients.…”

Tropical Infectious Diseases: Still Here, Still Raging, Still Killing

“…6 Two new papers in the American Journal of Tropical Medicine and Hygiene (AJTMH) examine the consequences of the COVID-19 pandemic and its adverse impact on global efforts to control tropical infectious diseases in Africa. 7,8 In Kabore et al, an NTD consortium of U.S. government contractors and NGDOs, led by FHI360, examined the impact of the pandemic on programs of NTD control in 11 West African countries. 7 In spring 2020, the WHO issued guidelines to postpone or delay mass treatment campaigns, only to reissue guidance in the summer for cautiously restarting these programs when feasible.…”

“…7,8 In Kabore et al, an NTD consortium of U.S. government contractors and NGDOs, led by FHI360, examined the impact of the pandemic on programs of NTD control in 11 West African countries. 7 In spring 2020, the WHO issued guidelines to postpone or delay mass treatment campaigns, only to reissue guidance in the summer for cautiously restarting these programs when feasible. 7 In response, the NTD consortium created a tool or matrix to monitor situation reports on COVID-19 and shifting epidemiologic patterns, while modifying NTD programs to restart them safely.…”

“…7 In spring 2020, the WHO issued guidelines to postpone or delay mass treatment campaigns, only to reissue guidance in the summer for cautiously restarting these programs when feasible. 7 In response, the NTD consortium created a tool or matrix to monitor situation reports on COVID-19 and shifting epidemiologic patterns, while modifying NTD programs to restart them safely. There was emphasis on adjusting mass drug administration approaches to minimize COVID-19 transmission.…”

“…They included extra resources for programmatic staff to maintain social distancing during drug administration, often going door-to-door rather than conducting large public gatherings, and ensuring an adequate supply of personal protective equipment. 7 Still another element included efforts to combat healthcare disinformation.…”