Monitoring community-directed treatment programmes for sustainability: lessons from the African Programme for Onchocerciasis Control (APOC)

Amazigo, Uche; Obono, Oka; Dadzie, K. Y.; Remme, J.; Jiya, Jonathan; Ndyomugyenyi, Richard; Roungou, Jean Baptiste; Noma, Mounkaïla; Sékétéli, A.

doi:10.1179/000349802125000664

Cited by 73 publications

(64 citation statements)

References 7 publications

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“…So far, ComDT has been very effective (Katabarwa et al 1999;Amazigo et al 2002). Ivermectin treatment is popular and communities have responded enthusiastically to the concept of 'community-directorship' in which they are responsible for planning and implementation.…”

Section: How To Treatmentioning

confidence: 99%

Research for control: the onchocerciasis experience*

Remme

2004

Tropical Med Int Health

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SummaryOnchocerciasis control has been very successful in Africa and research has played a critical role. An overview of the main epidemiological and implementation research activities undertaken over the last 20 years in collaboration with the African onchocerciasis control programmes and of the impact this research had on control is given. The research included the development of epidemiological modelling and its application in programme evaluation and operational planning, research on disease patterns and disease burden in different bioclimatic zones to justify and guide control operations, community trials of ivermectin to determine its safety for large-scale use and its impact on transmission, rapid assessment methods to identify target communities for treatment and community-directed treatment for sustained drug delivery. Lessons learned during this unique collaboration between research and control are discussed.

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Section: How To Treatmentioning

confidence: 99%

Research for control: the onchocerciasis experience*

Remme

2004

Tropical Med Int Health

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“…5). In general, the results of using the CDTI approach have been very encouraging, although some challenges, such as the need for constant training of the CDD, the issues of incentives and longterm sustainability and compliance, remain (Amazigo et al, 2002b;Burnham and Mebrahtu, 2004).…”

Section: Ivermectin and Its Applicationmentioning

confidence: 96%

Towards the elimination of onchocerciasis

Thylefors¹,

Alleman²

2006

Annals of Tropical Medicine & Parasitology

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Human onchocerciasis is a severely disabling filarial disease that is endemic in 28 African countries, six Latin American countries and Yemen. The disease causes a high burden of blindness and visual loss, along with itching and other severe dermal manifestations. It constitutes a significant obstacle to socio-economic development in highly endemic riverine areas, where the Simulium blackflies that act as vectors breed. Onchocerciasis has been subject to control efforts for more than 50 years, initially mainly through vector control but since 1988, with free access to ivermectin (Mectizan), also through large-scale chemotherapy. The Onchocerciasis Control Programme in West Africa operated successfully from 1974 to 2002 in 11 countries, covering the worst savannah foci of the disease through vector control and, in its later stages, also through ivermectin distribution. The African Programme for Onchocerciasis Control was established in 1995, to cover the remaining endemic areas in Africa, with the sustainable annual distribution of ivermectin by 2010 its main goal. Meanwhile, the Onchocerciasis Elimination Program for the Americas is making rapid progress in the virtual regional elimination of the disease through ivermectin distribution, which is achievable primarily because the vectors in the western hemisphere are less efficient than those elsewhere. The global elimination of onchocerciasis as a public-health problem is now within reach but this will require long-term strategies to secure the great gains made so far, through ivermectin treatment and local vector control. Research is needed to define the optimal approaches with the existing tools and to intensify the development of alternative strategies, such as macrofilaricidal drugs for wide-scale use.

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“…15,16 Projects are visited and judged on a series of criteria based on interviews with health staff at all levels and also the community. The government's financial contribution is also assessed as well as the community participation in the programme.…”

Section: Is the Problem Of Onchocerciasis Solved?mentioning

confidence: 99%

Ivermectin and onchocerciasis: is it all solved?

Hopkins¹

2005

Eye

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The donation of ivermectin by Merck and Co. Inc. has led to one of the most effective private-public partnerships controlling a disease of major public health importance particularly in Africa. The up scaling of ivermectin distribution during the last 15 years has been remarkable with almost 40 million people treated in 2003, many already on their regular annual dose. The tools that have been developed particularly by the APOC programme have been instrumental in this increase. However, ivermectin is a microfilaricide and does not kill the adult worms. Distribution will be needed for at least 25 years and latest estimates indicate that 90 million people need annual treatment if onchocerciasis is to be eliminated as a public health problem. In spite of this incredible progress it is difficult to see how the programme will be sustained, especially after the closure of APOC in 2010. A macrofilaricide destroying adult worms and safe for mass distribution would solve the problem of onchocerciasis.

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Monitoring community-directed treatment programmes for sustainability: lessons from the African Programme for Onchocerciasis Control (APOC)

Cited by 73 publications

References 7 publications

Research for control: the onchocerciasis experience*

Research for control: the onchocerciasis experience*

Towards the elimination of onchocerciasis

Ivermectin and onchocerciasis: is it all solved?

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