REMO EXERCISE AND RAPLOA STUDY IN ANGOLA, NOVEMBER 9 - DECEMBER 16, 2003
MISSION REPORT FOR WORLD HEALTH ORGANIZATION, AFRICAN PROGRAMME FOR ONCHOCERCTASTS CONTROL (APOC) OUAGADOUDOU, BURI(NA FASO
BY WHOiAPOC TEMPORARY ADVISORS
Prof. B.E.B.Nwoke Department of Animal & Environmental Biology Imo State University Nigeria PMB 2000 Owerri, Nigeria Tel: (234) 83 230 698 E-mail: [email protected]
Dr Peter ENYONG Tropical Medicine Research Station, Kumba P.O Box 55 Kumba, Cameroon. TelelFax +(237) 33 54 231; +(237) 77 54 l0l E-mail [email protected]
Dr Innocent TAKOUGANG Department of Public Health Faculty of Medicine & Biomedical Sciences University of Yaound6 1 P.O Box 1364 Yaound6 Cameroon Tel: (237) 231 87 s31' (237) 96s 28 08 Fax: (237) 23 I 5l 81 E-mail : [email protected] TABLE OF CONTENT
1.0 SUMMARY
2.0 MISSION OBJECTIVES
3.0 MATERIALS AND METHODS
4.0 RESULTS AND DISCUSSION
5.0 REFERENCES
ACKNOWLEDGEMENTS
7.0 APPENDIX 7.1 List of GTNO and Provincial staff members trained on RAPLOA 7.2 REMO data 7.3 RAPLOA data 7.4 UN Certificates of Basic Security in the Field-Staff safety, Health and Welfare 7.5 UN Security Clearances I.O SUMMARY
Rapid Epidemiological Mapping of Onchocerciasis (REMO) reJinement and Rapid Assessment Procedure for Loiasis (RAPLOA) were carried out in some Procvinces of Angola, November 9 - December 16, 2003 supported by WHO African Programme for Onchocerciasis Control (APOC)
A total of 23 persons were trained in the RAPLOA Jield procedure and techniques during the mission viz: 9 nationals, 14 Provincial staff members, 7 each from Cabinda und Lunda Sul.
With the avaliabe REMO results and topographical maps of Angola, on-the-spot analysis of the data was done to jine tune the deJinite CDTI , no CDTI arefls, and areas that require REMO reJinement as well as un-inhabited areas.
REMO reJinement was carried out in accessible selected villages in Cunene, Huila, Cuando Cubango and Moxico Provinces during the mission. The results are going to be integrated with the existing REMO data of Angola into Atlus GIS/IIealth Mapper by APOC to deJine the CDTI areas. However, it not was possible to conduct REMO rejinement/validation in Bengo Province becuuse the Temporary Advisors had no security clearance to work in the selected villages while in Lunda Norte no field work coald be done as a result of logistical limitions
RAPLOA study was conducted in Csbinda und Lunda Sul. Of the 24 selected RAPLOA villages in Cabinda, 4 were inaccessible at the time of the study. Out of the 20 villages that were studied, only the village of Fubo had percentage history of eye worm lower thun the threshold of 40% for possible severe adverse effect (SAE). Four villages had a prevulence of history of eye worm above 40% and below 60%, Fifteen villages had prevalence of history of eye worm sbove 60%. AU these 19 villages have percentage history of eye worm >40% threshold for SAEs following CDTI In the province of Lunda Sul, 65 villages were selected for the RAPLOA study, out of which, 28 were studied. 37 were inacessible at the time of the study. Of these , there was no history of eye worm (0.0%o) in 8 villages while in the remaining 27 villuges studied, <20% (1 - 16.8%0) of the respondents reported history of eye worm. No village studied in lunda Sul had up to the 40% threshold. The present result on RAPLOA in the coatry is instructive 2.0 MISSION OBJECTIVES
The objectives of the present mission were :
2.1To train and supervise Angolan Nationals to execute Rapid Assessment Procedure for Loiasis (RAPLOA) in the Provinces of Cabinda, Lunda Norte and Lunda Sul.
Z.2Workwith APOC Management to facilitate the spatial presentation of REMO communities and "to conduct on-the-site analysis of the data."
2.3 Support the NOTF Angola to refine the Rapid Epidemiological Mapping of Onchocerciasis (REMO) Map.
3.0 MATERIALS AND METHODS
The geography of Angola, and the study area of the present exercise, were presented in otlr 2002 mission report
3.1 RAPLOA TRAINING
During the present mission, a two-day intensive RAPLOA traning course was organized in Luanda for the Nationals (NOCP, NGDO and the Provincial Staff from Cabinda, Lunda Norte and Lunda Sul). During this training, the participants were exposed to the basic clinical aspects and epidemiology of Loiasis as well as the biology and ecology of the vector flies, Chrysaps. The main components of the training were the objectives, procedures and techniques of the Rapid Assessment
Procedure for Loiasis (RAPLOA). The following support documents were used : - WHO(2001) Rapid Assessment Procedurefor Loiasis - WHO(2002) Guidelines for Rapid Assessment of Loa loa With the use of the photograph of the eye worTn and the RAPLOA forms, participants were taught how to successfully conduct a RAPLOA interview in the selected villages, as well as filling out the RAPLOA forms. Training at the Provincial level involved interviewers who were all from the Provincial Directorate of Public Health. At the end of the training, the trained team executed RAPLOA in the field.
A full description of the methods of executing RAPLOA was presented in previous study reports (Takougang,2003 a, b). The selection of study villages gave priority to the villages selected for the REMO exercise as they were sufficiently representative and took into account topographical data. After the training, a plan of execution of coverage of selected villages was designed, discussed with the provincial team and amended as necessary.
3.2 ON.THE.SITE ANALYSIS OF THE REMO DATA AND REVISION OF THE REMO MAP
Working together with HonoratZoure (BIM/APOC) and with the help of the topographical maps of Angola, we were able to identify other parks and uninhabited areas which hitherto were classified as outstanding REMO areas. These included areas in Bie, Cuando Cuando, Cunene, Huila and Moxico Provinces. This also helped to refine the initial REMO map of the country. The actual areas or zones where REMO was pending or to be refined were identified risee Appedix 7.5). Additional villages where REMO refinement was needed were selected, together with those in which it was necessary to conduct RAPLOA. Because Mr. Zoure left for Ouag:rdougou in the middle of the mission, the on-the-site integration and analysis of the data generated during the present mission was not possible.
3.3 REMO REFINEMENT
With the refinement of the REMO map, it became clear that there were areas in Lunda Norte, Moxico, Huila, Cunene, Bengo and Cuando Cuabango Provinces that required REMO refinement. The REMO villages were selected for these areas and their Latitudes and Longitudes calculated ( in the absence of enough GPS). Finally, REMO was conducted in all the accessible villages in these Provinces. 3.4 REMO/ RAPLOA FIELD EXERCISE
Before the field exercise, we had to attend a UN Security briefing as well as a IIN mandatory computer-interactive security training session (with certificate given at the end as a prerequisite for security clearance)(see Appendix 7.6). In addition we had to submit our itinerary before any clearance was given. Some of the areas were not accessible becauso of landmines and thus security clearance was limited (see Appendix 7.7). Furthermore, the immigration policy of Angola affected our plans. On arrival, we were given only 15 days in the first instmce- up to November 25. This meant that we could not stay in the field beyond November 24 . lt also meant that after the first l5 days we had to apply for an extension of our visas to cover the last period of our stay in Angola.
Against this backdrop, we planned our REMO/RAPLOA field exercise in two phases ( as listed under) believing that the renewal of the visas, according to our host was going to take us at most 2-4 days:
Phase I. REMO in Huila, Cunene, Cuando Cubango and Moxico and RAPLOA in Cabinda.
Phase II. nnUO in Bengo, RAPLOA in Lunda Sul and REMO/.RAPLOA in Lunda Norte.
The phase I was planned for November 18 - 24, but we did not travel until November 20 because of logistical problems. Because of the renewal of our visas we traveled to Luanda on November 24 while the National team remained behind in Cunene/Hiula to cornplete the exercise. We did not supervise the REMO field work in Moxico because we had no security clearance for this Province. Two NOTF members, were, therefore, sent to Moxico for 10 days (November 20-30) to work with the Provincial and District staff.
Phase II was planned for November 28- December 9 but we never got our visas renewed until December 2,2003. We left for the phase II field work on December 3/4.
At the end of the phase I we realized that the National team left be:hind to complete the outstanding REMO refinement in Hiula and Cunene Provinces (when the faciUtating consultant went to Luanda to re-apply for his visa), the refinement in Cunene was not carried out. One of the consultants had to lead a team back to Cunene to clear the gray area. It was planned that Drs. Hortentia and Cani (both NOCP members) were to lead the teams for the RAPLOA field work in Lunda Sul while Mr Marcello (the Provincial staff from Lunda Norte trained in REMO and RAPLOA) who conducted REMO exercise in the Province was to lead the team for REMO refinement/ RAPLOA in Lunda Norte.
Unfortunately, we were given security clearance only for Saurimo (the capital of Lunda Sul) in the first instance and further clearances were to be given by the UN Field Security Officer in Saurimo (see attached). Against this background, our flights were booked for Saurimo.
To our greatest surprise Dr Cani did not turn-up for the exercise. In fact it was at the airport (on departure to Saurimo) that we learnt of his absence from the team. It is important to note that Dr. Cani worked with us in our previous REMO exercises in Cabinda, and also led the RAPLOA team in Cabinda. No reason was given for his absence for the second phase of the mission.
Before we left for Saurimo, WHO Luanda informed the WHO Coordinators for Lunda Sul and Lunda Norte of our arrival date and time; and directed them to provide us with WHO field vehicles as we were given security clearance to travel in vehicles with radio facilities. By this arrangement, also, the WHO/Coordinator in Dundo (the capital of Lunda Norte) was directed to send the WHO vehicle to Saurimo to pick the consultants for the study in Lunda Norte. Dundo to Saurimo is about 300 km. Mr Marcello, the team leader for Lunda Norte opted to travel in advance to enable him facilitate the mission.
On arrival in the evening of Thursday December 4 in Saurimo, we did not see anybody from Lunda Norte nor their WHO vehicle. There was no message left behind for us as to their plan. Efforts to reach them that day failed. On Friday December 5, we were able to speak with the Coordinator. We expressed surprise why the WHO vehicle was not in Saurimo to pick the consultants as directed by WHO Luanda; and requested that the vehicle be sent. He told us that he needed an authorization from the Provincial Directorof Public Health to enable him send the vehicle to Saurimo. He further said that the Director would want to see the consultants before the authority to use the vehicle. But we told him that it was the WHO vehicle (with radio facilities) that is expected (by security clearance) to pick the consultants to see him. At this point he told us that he was going to discuss with the Director and he was going to reach us later. He further told us that our facilitator, Mr Marcello was not in Dundo that Friday. Efforts to inform WHO Luanda of our experience were not fruitful. Our facilitators were in the WHO/AFRO meeting in Luanda. We were scheduled to train and supervise the teams, Thursday December 4 - Monday December 9. We never heard from the WHO Coodinator nor Marcello. We were time bound and we therefore directed our efforts to conduct the RAPLOA in Lunda Sul. Our hosts here, in Lunda Sul, facilitated our field work and gave us tremendous support.
4.0 RESULTS AND DISCUSSION
4.1 RAPLOA training ln all, 23 persons were trained on RAPLOA at both National and Provincial level. At the National level there were 9 participants (all members of the National Disease Control Programmes. At the provincial level , 7 workers each from Cabinda and Lunda Sul were trained. It was a successful training.
4.2The on-the- spot analysis of REMO data On-the-spot analysis of REMO data with the help of Mr Zotre was very valuable. It identified the actual zones that required REMO refinement. In fact, it helped to fine tune the definite CDTI and non-CDTI areas as well as un-inhabited zones which hitherto were grouped as areas that required REMO refinement.
4.3 REMO refinement REMO refinement was planned for Huila, Cunene, Cuando Cubango, Moxico, Bengo, and Lunda Norte and the results are shown in table I
Tablel: Summary of the results of REMO refinement in Angola, November 9 - December 16, 2003.
PROVINCE Number of Number of villages Number of villages villages refined inaccessible or selected for non-existence refinement TIUILA 24 t6 t2 CI.iI[ENE 10 6 4 CUANDO CUBANGO 24 t9 5 MOXICO 89 29 60 BENGO 5 * LT]NDA NORTE 34 18 t6 * W" h"d no security ctearance to work in the five setected REMO vitlages in Bengo Province
Huila A total of 24 villages were selected for REMO refinement in this Province and 8 of them were either inaccessible ( due to the presence of land mines or broken bridges) or the villages were non- exsitent- as the population has migrated to other areas due to the civil war. Of the 15 villages examined, onchocerciasis was absent in 10 villages and the other 5 villages positive for onchocerciasis are hypoendemic.
Cunene Ten villages were selected for this exercise, 4 of them were inaccessible/non-existent at the time of the study. Onchocercisis was absent in all the 6 villages examined.
Cuando Cubango. Of the 24 villages selected for REMO refinement in this Province, 19 of them were examined. Onchocerciasis was absent in 10 of the examined villages, six villages were hypoendemic while the remaining three were mesoendemic.
Moxico Moxico is a large Province; and before the present mission, only a limited REMO exercise was carried out by the national team. As a result of this, 89 villages were selected for the REMO refinement. The Temporary Advisors had no security claerance to supervise any field work in the Province Two national teams were therefore sent for ten days to implement the REMO refinement in Moxico. Unfortunately they were able to carry out the exercise in only 29 villages(32.6oh). Most of the roads according to the teams were not yet open because of land mines and/ or broken bridges. The results from the present work showed that of the 29 villages examined, the disease was absent in one village, 25 villages were hypoendemic while three of the them were mesoendemic for onchocerciasis.
Bengo For obvious epidemiological reasons, 5 villages were selected to be personally refined/validated the Temporary Advisors in Bengo Province. We thought that results from these villages would have helped to create a better understanding of the CDTl-mapped area in some parts of Bengo and Kuanza Norte Provinces. All the logistic arrangements were put in place by WHO Luanda for this study for December 12,2003. At the last count, on December 11,2003, we were told that we had no security clearance to work in those villages. The 5 selected villages were therefore not examined.
Lunda Norte A total of 34 villages were initially selected for REMO refinement in Lunda Norte. In course of the study, we were given REMO results of 18 villages conducted by the national team early in the year. Of these villages, onchocerciasis was absent in 4, ll villages were hypondemic while 3 of them were mesoendemic for onchocerciasis. REMO refinement was not conducted in the 16 outstanding villages in Lunda Norte because of the logistic limitations earlier presented in section 3.4 of this report.
4.4 RAPLOA RESULTS 4.4.1,. The Province of Cabinda RAPLOA study was planned for Cabinda, Lunda Norte and Lunda Sul, but we were unable to carry out the study in Lunda Norte.The results for the Cabinda and Lunda Sul Provinces are shown in Tables 2 and 3.ln all,25 villages were selected for the RAPLOA study. Two of the villages were inacessible (Necuto, Quissoki) and two did not exist (Chimbuade, Viede). Out of the 20 villages that were studied, only the village of Fubo in the Cabinda Municipio was at low risk of SAE following mass treatment with ivermectin (Table 3.1). Four villages of the Municipio of Cabinda and Cacongo had a prevalence of history of eye worrn (RD) above 40oh and below 60%o and are at high risk of SAE following CDTI (Table 3.2.).
Fifteen villages, covering all Municipios of Cabinda, Cacongo, Buco Zau and Miconje had prevalence of history of eye worrn (RD) above 60Yo and are at very high risk of SAE following CDTI (Table 3.3). From the results above, it is clear that the Province of Cabinda is largely hyperendemic for loiasis and the distribution is not focalised.
4.4.2. The Province of Lunda Sul In the province of Lunda Sul, 65 villages were selected for the RAPLOA study, out of which, 28 were studied. 37 were inacessible at the time of the study because of broken bridges. In all villages studied, <20oh of respondents reported a history of eye worrn (range 0%-16.8%). In eight of the villages, the prevalence of history of eye worrn was nil. The area is at "no risk of SAE" and standard CDTI can be safely applied there (Table 4).
5.0 REFERENCES
WHO (2001) Rapid Assessment Procedurefor Loiasis.Result of Multi-Centre Study. Wanji, S(Ed.) TDR/IDE/RP/ RAPL /01 .1 WHO Geneva TDR/WHO (2002) Guidelines for Rapid Assessment of Loa Loa TDN IDE/ RAPLON}Z.I. TDR WHO Geneva
Takougang I.(2003 a). Rapid Assessment Procedures for Loiusis (RAPLOA): Mapping of Loa loa in the North lYest Province CDTI Project Area - Cameroon. WHO/APOC Report.
Takougang I. b. 2003. Rapid Assessment Procedures for Loiasis (RAPLOA): Mapping of Loa loa in the Nanga Ebok Health District CDTI Project Areu - Cameroon. WHO/APOC Report.
6.0 ACKNOWNEDGEMENTS
We are most grateful to APOC Management for the opportunity given to us to serve and contribute in this study and to WRs of Angola, Cameroon and Nigeria for facilitating this mission. The assistance and understanding of the Ministry of Health and NOCP Angola throughout this study are highly appreciated. We enjoyed tremendous support and assistance from the staff of WHO Angola. The Provincial WHO Coordinators, the various Provincial onchocerciasis teams and the Districts gave us the much needed field assistance and support. To all who contributed to the success of the mission we say thank you. T.OAPPENDIX
RAPLOATRAINING AT THE CENTRAL AND PROVINCIAL LEVELS
(9 NOVEMBER - 16 DECEMBER 2003)
A. GTNO Angola Luanda l. Pedro Jos6 Antonio 2. Autur Luciano 3. Marcelo Uaiba Casseche, Lunda Norte 4. Ermelinda Domingos 5. Cani Pedro Jorge 6. Gongales Jotu Cetosa 7 . Dr. Olga Fernande de Fontes Pereine 8. Dr. Hortencia do Santos J. Miguel 9. Jo6o Jos6 Muguema
B. Cabinda Province l. Cris6stomo Macanda Mabiala 2. Dr Madalena de Fftima Muila 3. Paulo Chiuima 4. Dam6sio Macaia 5. Angelina Nunes 6. Rog6rio Vicente Filipe 7. Domingos Casimiro
C. Lunda Sul Province 1. Jos6 Lucas Calengulu 2. Domingos Alfredo Jos6 Barros 3. Jo6o Mutaleno Satxambanga 4. Jolo Baptista Muquinda 5. David Muangongo 6. Salvador Viaqueur 7. Jos6 Luis A. Tchicaho Table 2 Summary of results of the RAPLOA exercise in Cabinda Province
Village lD Village name Number of Number with 'f' with Lower Upper respondents history of eye history of value value Limit Limit RD RD (n) worm RD eye worm RD 1 Ganzi 99 32 33 24 42 2 Chinzazi 128 99 78 71 85 3 Mau-Lelo 90 70 78 70 87 4 Chimbuade NE 5 Matondo 97 73 76 67 84
6 Chiadede 100 65 65 56 75 7 Fubo 120 28 24 16 31 8 Sassa Zau 97 75 78 69 B6
I Limano 81 31 39 28 49 10 Lucula 93 45 49 39 59 11 Lico 94 53 57 47 67 12 Mongo Tando 80 36 45 35 56 13 Chicamba 107 71 67 5B 76
14 Beira-a-Nova 119 73 62 53 71
15 Dinge 91 63 70 60 79 16 Chivoyo 92 71 7B 69 86 17 lnhuca 60 42 70 59 82 18 Necuto NA 19 Viede NE 20 Quissamano 92 58 64 54 73 21 Sanga Mongo 70 52 75 65 85 22 Quissoqui NA 23 Caio Guembo 94 69 74 65 83 24 Miconje 89 58 ob 56 76
NE : Village not accessible NA : Village does not exist TABLE 3 : LOCATION OF THE STTJDY VILLAGE BY ON THE PROVINCIAL HEALTH MAP (CABINDA PROVINCE)
Village ID Village name LATITUDE LONGITUDE Municipio Communa
1 Ganzi -5,705,209 12,200,615 Cabinda Cabinda 2 Chinzazi -5,668,542 12,437,276 Cabinda Cabinda 3 Mau-Lelo -5,583,109 12,368,949 Cabinda Cabinda 4 Chimbuade -5,575,369 12,418,554 5 Matondo -5,459,483 12,427,209 Cacongo Dinge
6 Chiadede -5,385,914 12,310,979 Cabinda Malumbo 7 Fubo -5,332,721 12,654,433 Cabinda TandoZinze 8 Sassa Zau -5,310,997 12,208,702 Cabinda Tando Zinze
9 Limano -5,192,061 12,301,875 Cabinda TandoZinze 10 Lucula -5,170,358 12,442,024 Cabinda TandoZinze 11 Lico -5,083,692 12,217,026 Cacongo Dinge 12 Mongo Tando -5,135,425 12,133,692 Cacongo Cacongo 13 Chicamba -4,993,125 12,125,188 Cacongo Massabi
14 Beira-a-Nova -5,075,359 12,449,311 Cacongo Massabi?
15 Dinge -5,025,374 12,350,908 Cacongo Cacongo 16 Chivoyo -4,942,024 12,297,762 Cacongo Massabi 17 lnhuca -4,820,258 12,401,875 ND ND 18 Necuto -4,792,109 12,608,702 NA 19 Viede -4,851,875 12,771,609 NA 20 Quissamano -4,761,642 12,608,520 Buco ND Zau 21 Sanga Mongo -4,624,312 12,625,187 Bugo ND Zau 22 Quissoqui -4,575,191 12,807,649 Belize 23 Caio Guembo -4,587,024 12,351 ,609 Belize Miconge 24 Miconje -4,458,524 12,832,044 Miconje Miconje TABLE 3.I : LOCATION OF THE STUDY VILLAGE BY ON THE PROVINCIAL HEALTH MAP BY LEVEL OF RISK OF SAE (CABINDA PROVINCE) - Villages at low risk of SAE2I% Village Village name LATITUDE LONGITUDE Municipio Communa ID 7 Fubo -5,332,721 12,654,433 Cabinda TandoZinze TABLE 3.2: LOCATION OF THE STTJDY VILLAGE BY ON THE PROVINCIAL IIEALTH MAP BY LEVEL OF RISK OF SAE (CABINDA PROVINCE) - Villages at high risk 40% Village lD Village name LATITUDE LONGITUDE Municipio Communa 1 Ganzi -5,705,209 12,200,615 Cabinda Cabinda I Limano -5,192,061 12,301,875 Cabinda fando Zinze 10 Lucula -5,170,358 12,442,024 Cabinda Tando Zinze 12 Mongo Tando -5,135,425 12,133,692 Cacongo Cacongo TABLE 3.3 : LOCATION OF THE STIIDY VILLAGE BY ON THE PROYINCIAL HEALTH MAP BY LEVEL OF RISK OF SAE (CABINDA PROVINCE) * Villages at very high risk of SAE RD>60% Village Village name LATITUDE LONGITUDE Municipio Communa ID 2 Chinzazi -5,668,542 12,437,276 Cabinda Cabinda 3 Mau-Lelo -5,583,109 12,368,949 Cabinda Cabinda 5 Matondo -5,459,483 12,427,209 Cacongo Dinge 6 Chiadede -5,385,914 12,310,979 Cabinda Malumbo I Sassa Zau -5,310,997 12,208,702 Cabinda Tando Zinze 13 Chicamba -4,993,125 12,125,188 Cacongo Massabi 14 Beira-a-Nova -5,075,359 12,449,311 ND ND 15 Dinge -5,025,374 12,350,908 Cacongo Cacongo 16 Chivoyo -4,942,024 12,297,762 Cacongo Massabi 17 lnhuca -4,820,258 12,401,875 ND ND 20 Quissamano -4,761,642 12,608,520 Buco ND Zau 21 Sanga -4,624,312 12,625,187 Bugo ND Monqo Zau 23 Caio Guembo -4,587,024 12,351,609 Belize Miconge 24 Miconje -4,458,524 12,832,044 Miconje Miconje TABLE 3.4 : LOCATION OF THE STUDY VILLAGE BY ON THE PROVINCIAL HEALTH MAP BY LEVEL OF RISK OF SAE (CABINDA PROVINCE) _ Villages selected but not covered Village lD Village name LATITUDE LONGITUDE Municipio Communa Reason 4 Chimbuade -5,575,369 12,418,554 NE 1B Necuto -4,792,109 12,608,702 NA 19 Viede -4,851,875 12,771,609 NA 22 Quissoqui -4,575,191 12,807,649 Belize NE Table 4: SUMMARY RESULTS OF THE RAPLOA EXERCISE IN THE PROVINCE OF LUNDA SUL Village Village Name Number of Number % Upper 95o/o Lower ID respondents reporting reporting Confidence 95% history history Limit RD Confidence of eye ofeye Limit RD WOITN WOITN 257 Satela (S) 90 1 2 -2 4 258 Muachivanvua 90 1 2 -2 4 261 Nandonge (H) 87 3 4 -1 8 263 Taria 101 0 Cambachi 0 0 0 (H) 264 Chombo 81 0 0 0 0 266 Musseque (H) 51 4 I 1 16 267 Camanhinga 104 6 (H) b 2 11 (H) 268 Cacolo 121 6 5 2 9 272 (H) Dala 131 7 b 2 10 273 Sazambi(H) 129 6 5 2 I 274 Samugimo (H) 95 6 7 2 12 (H) 277 Sachula 79 0 0 0 0 Lunjata (H) 279 77 3 4 -1 9 280 Mona 86 6 Quimbundo 7 2 13 281 Samuquimba 79 6 (H) I 2 14 (H) 282 Gambo 80 1 2 -2 4 283 Luachimo (H) 118 4 4 1 7 284 Muamungo (H) 72 4 6 1 11 (H) 285 Catoca 126 0 0 0 0 (H) 286 Camacola 79 10 13 6 20 290 Muene Choco 99 7 I 3 13 (H) 300 Chicundo 111 6 6 2 10 303 Muazaza (H) 120 5 5 1 8 308 Puege (H) 22 0 0 0 0 312 Chilunga 67 6 I 3 16 Table 5: SUMMARY RESULTS OF THE RAPLOA EXERCISE IN THE PROVINCE OF LUNDA SUL : Villages not accessible Village Village Name ID 246 Cangoane (H) 247 Saluiz (H) 248 Muungo (H) 249 Gunge (H) 250 Satechifunga 251 Sesse (H) 252 Xassengue (M) 253 Aculo (s) 254 Missao (H) 255 Zumbi(S) 256 Samu Chima (H) 259 Cazoa (S) 260 Mucuamuilo 262 Muacuango (S) 265 Samucamba (H) 269 Chizanda (H) 270 Cangolo (H) 271 Sassulo (H) 275 Peso (H) 276 Luachimo (H) 278 Chepapala (H) 287 Capagi(H) 288 Chiangui(H) 289 Sacamuena (S) 291 Muconda (H) 292 Sacaluila (H) 293 Sacufa (H) 294 Culovua (H) 295 Machingo (H) 296 Tambue (S) 297 Cabo Catanda 298 Muaximbundo 299 Muacaueu6 (H) 301 Muriege (H) 3A2 Muacauene (H) 304 Cuita (S) 305 Mucuamba 306 Dala (H) 307 Bige (H) 309 Xirige (S) 310 Antigo Luia (S) APPENDIXT.2 Result of Rapid Epidemiological Mapping of Onchocerciasis (REMO) Refinement in Angola, November 9 - December 16,2003. a U (, g s 5 A ! 5 I I 5 5 (, (, g u (, N N N N N N N z N @ Or (r N o @ o) (r (, N q 6) o ! 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