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African Programme for Onchocerciasis Control (Apoc)

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African Programme for Onchocerciasis Control (Apoc) AFRICAN PROGRAMME FOR ONCHOCERCIASIS CONTROL (APOC) Six-Month Report for Community Dirccted Treahent with Ivermectin CDTI Dambatta Bichi basawa Bagwai Shanono Ajingi Gwarzo Kabo Gaya Wudil Kiru Bebeji Karaye Rano Takai Sumaila t -t, \ I -tr _,t_l- i I J I Tcct loa.nrtf =*n s/rrpouf Doguwa I , L-Sls : I u"Il i I { , A/rr'i' i 4 5 f .Llll .,r I Kano State I I Nigeria I RE9ll ,. September 1998 to February 1999 t 0 MAI 1999 fPoc / Ptvt EXECUTIVE SUMMARY Kano State is situated in the northern part of Nigeria. The State has 44 local government areas out of which 18 are Meso endemic with few hyper-endemic foci. The State falls in the Sudan Savannah and Sahel zones. However, the endemic areas are generally located in the sudan savannah. The terrain is flat or some major rivers such as River Kano, River Zungur and Challawa and their tribulaties drain slightly undulating, with sandy soil; the region. There is obtained a large irrigation scheme in the project area (the Kadawa Scheme) which covers a large area and is marked by an extensive network of irrigation channels. These provide suitable breeding places for the blackfly. Ivermectin Distribution Program (lDP) started in 1996 with CBM assigned by NOCP to assist Kano State in the control of onchocerciasis in all the endemic area of the State. Below are the treatment figures for the period of 1996 to 1998 before the new approach (CDTI). 1996 108,837 t997 209,135 1 998 241,518 The CDTI approach began fully in January, 1999 with the arrival of APOC funds after formal approval in September, 1998. The main goal of the CDTI project in the State is to treat a total number of 390,000 rural population who are known to be infected with onchocerciasis or are at-risk of the diseaie through the annual dosing with Mectizan. The goal hoped to be achieved by establishing an effective and sustainable community directed treatment program in all the endemic areas of Kano State by the year 2003. This program is being fully integrated into the existing PHC system of the State. SECTION I BACKGROUND INFORMATION 1.1 ComnutuitiesimplementingCDTI There are approximately 100 endemic communities identified in the 18 target Local Government Areas in Kano State. These communities are determined by cluster of households under the leadership of a recognized village head. A community may have an average of four to give (4-5) satellite areas with an estimated average population of 500 to 1,000 persons in a settlement. The households in these communities contain an average of 5-10 persons per each household but with some as having up to 20 - 30 members. 1.2 Endemic LGAs witlt treatment round The following are the treatment rounds for each endemic Local Government Area:- I Doguwa J 2 Tudun Wada 3 3 Bebeii 3 4 Kura J 5 Garun Mallam J 6 Gaya 3 a 7 Aiinei J a 8 Takai J 9 Sumaila Ja l0 Gwarzo 2 ll Karaye 2 t2 Rogo 2 13 Kiru 2 t4 Madobi 2 l5 Dawakin Tofa 2 t6 Danbatta 2 l7 Kabo 2 l8 Makoda 2 ,L SECTION II CDTI IMP ATION ( Septemberl998 to December 1999) TABLE 1 s/N I)islricULGA No. of No. of No. of No. of No. of No. o[ No. of Comm Communitics Communities Comm Comm Comm Comm /Yilhgcs lYillegcs /Villeges thet /Villrgcs lVilleges /Yilleges Yilhgcs Thrt sclected thrt collcctcd dccided on thrt dccidcd with prying CDDs Drugs Month(s) of on lhc trrincd CDDs in distribution. month(s) of CDDs clsh or TrcrtmcnL I Doguwa t2 t2 t2 l2 t2 l2 2 Tudun Wada t0 l0 l0 l0 l0 l0 3 Kura il il ll ll ll ll 4 Garun Malam t0 l0 l0 l0 l0 l0 5 Bebeii 7 7 7 7 7 7 6 Gaya 3 3 J 3 3 1 7 Aiinei 4 4 4 4 4 4 8 'l'akai 4 4 4 4 4 4 9 Sumaila 4 4 4 4 4 4 l0 (lwarm 5 u Kabo 4 l2 Karaye 3 l3 Kiru 4 l4 Madobt 4 15 Dawakin'l'ofa 9 l6 Danbatta 3 t7 Roeo I l8 Makoda I TO'IAL 99 65 65 65 65 65 I TRAINING OF DIFFERENT LEVELS OF STAFF INVOL IN CDTI IMPLEMENTATION. 2.1 Training obiectives/achievement The annual training objective was to train 386 Health Workers and 600 Community Directed Distributors. Out of these , a total of 354 Healthworkers and 298 Community Directed Distributed (CDDs) were trained on the Ivermectin Distribution Program (IDP) using CDTI approach. 2.2 Developed training materiol used The lraterialused during the training was the training manual for CDTI, CDD Guide, brochure, Oncho flipchart, posters and forms that were provided by APOC funds. t 2,3 Performance of CDDs The performance of CDDs in their respective communities indicated a good level of understanding, of their roles in the program. Coverage rate, correct registration, drug accountability, and good drug management were the main indicators of accessing their performance. 2.4 Imorovins the qualitv of training. The quality of training needs to be improved upon, with more emphasis on the new 3mg tablets. LOCTmembers should be encouraged to assume the roles of trainers in their LGAs. Though the literacy level is very low, different approaches should be employed to get CDDs to comprehend the recording forms. (See table 2 for training) MOBILIZATION AND EDUCATION OF TARGET COMMUNITIES 2.2.1 The use of media in Mobilization The services of modern mass media were utilized to some extent during the on-going activities in the communities and LGAs. In the LGAs, advocacy visits were conducted to the LGA officials and distriot heads. 2.2.2 Result of Mobiliujioacllbtt!, Communities were fully mobilized using the following media:- Traditional and religious leaders Face-to-face discussion with the community members 'fown criers mobilizing community members 2.2.3 Response of the communities Mobilization activities have been quite satisfactory resulting in successful acceptance of responsibility by community members and understanding the problem from the right point. 'l'his is expected to make CDTI a sustainable project. The reactions of the communities were favorable and positive to the CDTI strategies. This was noticed by the level of involvement of communities in CDD selection, deciding of time and method of distribution. 3 oU' (o @ @ o) N o r.- o @ I I I I I I I I t o) 86 (f) @ (f, +z (9 ro ro N $l 3E tro z. l- l l! C) Ll- -fE- =oo<j-z $ urqrO (o @ ro co r.- o, (f) o @ (o $ r r.- o o o o r{) = (f) o -L)^ N N N (9 r r N N N a4, ^U LU lt=uJoYz z2Eot< J uJ l- o o lt- lLF F(J<o =lJ. z (o ie (f) r o o 9o $ $ $ {- N N N C9 N N c{ N N $ N rf J IIJ U' tr ot11 Z. J oE IIJ zF IJJ tu tr J O o t I F lrJ Fn J I I = rLz od i z J o< F (f) (f) (f) (o IJI o- oE O (o (o (o lr) C9 (f, $ (f, s cr) co N N t z.' ao lIJ (o lJ. = ]L 0z o zw o : -o o I t I od F i I t I I t *iLF : o , IJ. '.E F_ o o bts oC) N N N N N N N N J r r r zJoz J r (,z N E (tr (I, E rF E G o o (u z G (I, := '6) '6 o o E F u ro 3 G o o s N o f o o { L o .Y o o (Il L o c c, o (, (,= o (E .g E o o E -o o x, =c = C o G 3 (E v (I, o tr o j o .lf,f Y m (, F :f \z = (u t E, L) U) o V 3 o o = (o o F= (9 o = F N TU J m N (f, $ rf, (o r.- @ z N (9 $ rri (o f.- @ o) o r r r r F a \ I U' tJl E r r z r r r r r :f ;*=s e22 = o= r=6 N N 00 o EICE rf) lr) tr) tr) N N N N N N N N N N N N l'- lU l'r2E (, I t. s-d 6o lr. F {u 'o 8k.tP= o lr $ s $ $ $ $ $ $ $ N N N N N N N N N tlo <ootJuieb6pd o LFulutr ovEE z O@z= o orl I FI I o t () 3 N o r o f.- ce $ s \r I I I I I I I I @ o r r r UJ EEEHE zo Jo .- JUI rO z .{- I I I I I t I I I N O o cr) \t (o :=I r r r f= $ o =l l-- =EEo= (g N (, rts E o (u (u E o (U o J (t, := '(r, 'o o 0) 5 F- o E o (D o o o B B N (I, N (g Lf o c (,l o = { L E _o tz (o -o E _o F 6 o (r)= c f (g ,E (s E (U t- (I, C o -v j o Y )C C) o F Y G =(U o t o o != L m = o= \z = F o (') o (U a o o = = LrJ t-- o o J = CO F O r N (f) -t rO (o r- cj z c.i cf) $ lri (o f.- d o) r r r r r r U' - 5 2.2.4 Suggestion to improve mobilization.
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