CBM Presents Four Studies at American Society of Tropical Medicine and Hygiene

CBM NTD Programme Manager Julia Amanyi-Enegela will present the results of a study: The Impact of Mass Drug Administration to Eliminate Lymphatic Filariasis in Abuja, Nigeria.

Lymphatic filariasis (LF), caused by Wuchereria bancrofti (a parasitic worm), is highly endemic in Nigeria. An estimated 134 million people are at risk of infection.

The results of this study show that the Federal Capital Territory is making steady progress towards elimination. Two regions that reported high coverage were assessed and the results showed that the criteria for MDA elimination have been achieved. As a result, 225,661 people in these two regions no longer require MDA, although monitoring is continuing.

Julia recommends that MDA strategies need to be fine-tuned in the final phase of elimination of LF to ensure that all challenges in achieving effective treatment coverage are addressed, especially in urban areas.

Michel Mandro-Ndahura, CBM NTD Programme Manager for West and Central Africa, presents in a poster session the findings of DR Congo: High Onchocerciasis-Associated Morbidity Despite 9 Years of MDA in an Isolated Village in North Ubangi Province, DR Congo.

Gboko health area in Bili health zone is located in an onchocerciasis (river blindness) endemic area in North Ubangi province, Congo. Many blind people are known to live there and the simulium fly (a black fly that transmits river blindness) is very common.

A high prevalence and incidence of epilepsy and recent onchocerciasis-related morbidity indicate that transmission of onchocerciasis continues despite high treatment rates. This is probably one of the most onchocerciasis-affected areas in the DRC and shows that active infection can persist despite years of mass treatment with Mectizan. Michel's work shows that strengthening integrated, regular and effective MDA campaigns in northern Ubangi is strongly recommended. There is also a need to improve awareness and community participation in efforts to eliminate onchocerciasis.

Geoffrey Muchiri- CBM's Regional NTD Coordinator in Africa- is presenting a poster on: 

Socio-Cultural and Mobility Factors Affecting Uptake and Increase of MDA Coverage Among Nomadic Pastoralists in South Sudan. 

Consistent treatment coverage during Mass Drug Administration (MDA) campaigns contributes to effective control and elimination of Neglected Tropical Diseases (NTDs) in endemic communities. Increasing the participation of pastoralist communities is critical to achieve the NTD elimination targets in South Sudan. Previous MDA data has indicated lower participation of pastoralist communities since they generally live in isolated and remote areas. These areas are often conflict prone, food insecure and associated with high levels of vulnerability to disease. Service provision in pastoral areas is usually less well developed than in other areas, with lower health and education indicators than national-level figures. 

Nomadic and pastoralist communities’ mobility patterns in South Sudan are motivated by search for water, pastures, and livestock disease outbreaks, which in turn influence the access and uptake of MDA.  Decision making on health is largely male dominated, affecting women’s participation in MDA and other health interventions.

Community members have specific notions on the causes and treatment of NTDs. For example, that lymphatic filariasis is caused when one steps on elephants’ faeces, trachoma is caused by dust or theft of property, or that soil transmitted worm infections are caused by overconsumption of food. Similarly, community members also shared their experiences with remedies such as washing eyes with cows’ urine to treat trachoma. The study also revealed community member concerns around inadequate information about MDA campaigns, drug expiry, general lack of trust in drug distributors, and concerns around side effects. Perceptions that strong men do not need medicines also affected participation in MDA. 

These findings reveal that NTD interventions such as MDA require a nuanced approach. This includes community sensitisation that addresses structural factors such as seasonal mobility, gender norms, traditional leadership structures, and social concepts on disease and remedy. 

Girija Sankar, Head of NTDs at CBM, presents the results of a study: Evaluating the Effectiveness of Global Health Partnerships for Disease Elimination. 

Global health partnerships have been addressing public health challenges in low- to middle-income countries (LMICs) for 30 years. There is a need to understand the different types of global health partnerships and to identify the factors that contribute to the efficiency and effectiveness of partnerships.
 
Girija's study findings identified communication, transparency, governance, inclusion and representation as five process measures. Greater participation of civil society organisations and NGOs from the global South in global health policy and advocacy can address the challenges of transparency, inclusion and diversity in global health partnerships.

The discussion points to consider are: Just as non-governmental organisations adhere to global standards such as the Global Standard for Accountability of Civil Society Organisations (CSOs), global health partnerships could adhere to global standards for building global health coalitions. Global health partnerships could develop partnership metrics that (a) measure progress against performance targets and (b) provide the necessary information to advance research on global health partnerships.