Central African Republic

Home , Republic of the Congo

Central African Republic (the) 2010 CENTRAL AFRICAN REPUBLIC The control of neglected tropical diseases represents a major challenge to those providing health- care services in the endemic countries. The purpose of this country profile is to provide public health professionals with the most recently available epidemiological information on diseases for which a PREVENTIVE CHEMOTHERAPY AND TRANSMISSION CONTROL strategy and tools to implement large-scale preventive chemotherapy exist. C

This summary outlines the burden of targeted diseases and program implementation outcomes in the Central African Republic. OUNTRY BASIC COUNTRY DATA AFRICAN REGION Total population 4,505,945 Population 1–4 years (Pre-SAC) 524,495 Population 5–14 years (SAC) 1,155,261 Population female 15–49 years 1,098,445 Population requiring preventive chemotherapy (PC) Lymphatic filariasis (LF) * 3,300,000 Schistosomiasis (SCH) * 3,830,053 Soil-transmitted helminthiasis (STH) - Pre-SAC 524,495 DEPARTMENT OF CONTROL OF NEGLECTED TROPICAL DISEASES

- SAC 1,155,261 P Onchocerciasis (Oncho) 1,409,395 Trachoma * 1,914,091

Development status1 LDC 2

Income status LIC ROFILE The boundaries and names shown and the designations used on this map School enrolment data do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, Gross enrolment rate territory, city or area or of its authorities, or concerning the delimitation Girls enrolment ratio (gross) of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. * Provisional estimates, to be refined © WHO 2010. All rights reserved

Sources: Population data - United Nations, Population Division, The World Population Prospects - the 2008 revision, New York, 2009; Population requiring PC for STH - STH: estimates of the number of children needing preventive chemotherapy and number treated, 2009. WER, N°25, 2011, 86:257–268. Population requiring PC for LF - PELF; Population requiring PC for SCH - estimates based on L.Chitsulo et al. / Acta Tropica 77(2000)41-51; Population requiring PC for Oncho - APOC; Population requiring PC for Trachoma - GET2020; School enrolment data - UNESCO Institute of Statistics, 2000 Assessment. 1 United Nations classification; 2 World Bank classification.

SITUATION ANALYSIS OF PREVENTIVE CHEMOTHERAPY DISEASES

PCT disease Endemicity Disease Mapping status Implementation status distribution (Complete/in status (endemic/non- (Nationwide/ progress/not (Complete/in- endemic) partial) started) progress/not started)

Lymphatic filariasis Endemic - In progress Not started Schistosomiasis Endemic Partial In progress In progress Soil-transmitted Endemic Partial In progress In progress helminthiasis Onchocerciasis Endemic Partial Complete In progress Trachoma Endemic Partial In progress In progress 1 Loa-loa Endemic 2010 Maps of infection/disease endemicity CENTRAL AFRICAN REPUBLIC

Lymphatic filariasis Onchocerciasis

Endemicity of LF Endemicity of Oncho Non-endemic Hypo-endemic Nigeria Endemic Nigeria Endemic Uncertain

Chad Chad Sudan Sudan

Cameroon Cameroon

Democratic Republic of the Congo Democratic Republic of the Congo Congo Congo

The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, 4 or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which 4 or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which 060 120 240 360 480 there may not yet be full agreement. 060 120 240 360 480 there may not yet be full agreement. ' WHO 2008. All rights reserved ' WHO 2006. All rights reserved Kilometers Kilometers ROFILE

Schistosomiasis, S. mansoni

Prevalence of SCH.m No data Nigeria Less than 10% >=10% and <50% P 50% and above DEPARTMENT OF CONTROL OF NEGLECTED TROPICAL DISEASES OF NEGLECTED TROPICAL OF CONTROL DEPARTMENT

Chad Sudan Schistosomiasis, S. haematobium No data available

Cameroon

Democratic Republic of the Congo Congo

The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, 4 or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which 060 120 240 360 480 there may not yet be full agreement. ' WHO 2006. All rights reserved Kilometers OUNTRY

Soil-transmitted helminthiasis Active trachoma (TF, 1-9 years old)

Prevalence of STH TF No data Non-endemic Nigeria <5% C AND TRANSMISSION CONTROL PREVENTIVE CHEMOTHERAPY Less than 20% >=20% and <50% >=5% and <10% 50% and above >=10% Chad No data Chad Sudan Sudan

Cameroon

Democratic Republic of the Congo Democratic Republic of the Congo Congo Congo

The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which 4 4 or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. 060 120 240 360 480 there may not yet be full agreement. ' WHO 2006. All rights reserved 060 120 240 360 480 Kilometers ' WHO 2010. All rights reserved Kilometers 2 Maps of preventive chemotherapy strategy required 2010 CENTRAL AFRICAN REPUBLIC

PC strategy required - ROUND 1

ROUND 1 No impl./No data Nigeria MDA1 PREVENTIVE CHEMOTHERAPY AND TRANSMISSION CONTROL MDA3 C

Chad Sudan OUNTRY

Cameroon

Democratic Republic of the Congo Congo

The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever

on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, DEPARTMENT OF CONTROL OF NEGLECTED TROPICAL DISEASES

4 or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which P 060 120 240 360 480 there may not yet be full agreement. ' WHO 2008. All rights reserved Kilometers ROFILE PC strategy required - ROUND 2

ROUND 2 No impl./No data Nigeria T1 T2 once in two years T3

Chad Sudan

Cameroon

Democratic Republic of the Congo Congo

MDA1 (IVM+ALB), MDA2 (DEC+ALB), MDA3 (IVM), T1 (ALB or MBD + PZQ), T2 (PZQ), T3 (ALB or MBD) 3 2010 Preventive chemotherapy implementation CENTRAL AFRICAN REPUBLIC PREVENTIVE CHEMOTHERAPY IMPLEMENTATION

2006 2007 2008 2009 2010

MDA1 (IVM + ALB) Population targeted Population treated Geographical coverage Programme coverage

MDA2 (DEC + ALB) Population targeted Population treated Geographical coverage Programme coverage

MDA3 (IVM) Population targeted 1,601,059 1,603,599 1,626,049 1,409,395 Population treated 763,715 724,791 870,516 1,088,053 Geographical coverage 62.6% 63.7% 61.7% 82.4% ROFILE Programme coverage 47.7% 45.2% 53.5% 77.2%

T1 (ALB or MBD + PZQ) Population targeted

ROUND 1 Population treated Geographical coverage P

DEPARTMENT OF CONTROL OF NEGLECTED TROPICAL DISEASES OF NEGLECTED TROPICAL OF CONTROL DEPARTMENT Programme coverage

T2 (PZQ) Population targeted Population treated Geographical coverage Programme coverage

T3 (ALB or MBD) PreSAC SAC Population targeted 504,026 Population treated 255,630 Geographical coverage Programme coverage

A (AZI) Population targeted 265,000 790,000 Population treated 45,500 230,000 OUNTRY Geographical coverage Programme coverage 17.2% 29.1%

C AND TRANSMISSION CONTROL PREVENTIVE CHEMOTHERAPY T1 (ALB or MBD + PZQ) Population targeted Population treated Geographical coverage Programme coverage

T2 (PZQ) SAC SAC

ROUND 2 Population targeted Population treated 167,181 222,981 Geographical coverage Programme coverage

T3 (ALB or MBD) Population targeted Population treated Geographical coverage 4 Programme coverage Geographical coverage - proportion (%) of endemic districts covered with preventive chemotherapy; Programme coverage - proportion (%) of individuals who were treated as per the programme target. National disease-specific coverage 2010 CENTRAL AFRICAN REPUBLIC LYMPHATIC FILARIASIS SCHISTOSOMIASIS *

1.2 30% 1.0 PREVENTIVE CHEMOTHERAPY AND TRANSMISSION CONTROL C 0.8 20% Millions MDA not started 0.6

0.4 10% OUNTRY 0.2 0.0 0% 2004 2009 2010 Requiring PC Treated National coverage

* SAC

SOIL-TRANSMITTED HELMINTHIASIS

Pre-SAC SAC

0.6 100% 1.4 30% DEPARTMENT OF CONTROL OF NEGLECTED TROPICAL DISEASES 1.2 P 0.5 80% 1.0 0.4 20% Millions 60% Millions 0.8 0.3 40% 0.6 0.2 10% 0.4

20% ROFILE 0.1 0.2 0.0 0% 0.0 0% 2005 2006 2007 2008 2009 2010 2005 2006 2007 2008 2009 2010 Requiring PC Requiring PC Treated Treated National coverage National coverage

ONCHOCERCIASIS TRACHOMA

2.0 100% 2.5 30% 80% 1.5 2.0 20% Millions 60% Millions 1.5 1.0 40% 1.0 10% 0.5 20% 0.5

0.0 0% 0.0 0% 2005 2006 2007 2008 2009 2009 2010 Requiring PC Requiring PC Treated Treated National coverage National coverage 5 National disease-specific coverage - proportion (%) of individuals in the population requiring preventive chemotherapy for the specific disease (see Basic country data on page 1) that have been treated. Monitoring decline of disease endemicity 2010 (in sentinel sites or periodic surveys)

CENTRAL AFRICAN Data source: REPUBLIC LYMPHATIC FILARIASIS

Years ->

Cumulative number of SS with base line mf>1% identified (of total) Percent of the SS (with a baseline of >1%) which have Mf prev <1% in year No. of IUs where MDA discontinued after meeting epidemiological criteria

Data source:

SOIL-TRANSMITTED HELMINTHIASIS

Years ->

STH prevalence in pre-SAC (range) STH prevalence in SAC (range)

ROFILE Data source:

SCHISTOSOMIASIS

Years ->

P S. haematobium prevalence (range) DEPARTMENT OF CONTROL OF NEGLECTED TROPICAL DISEASES OF NEGLECTED TROPICAL OF CONTROL DEPARTMENT S. mansoni prevalence (range)

Data source:

ONCHOCERCIASIS

Years ->

Number of endemic communities Number of endemic communities with baseline >1% Number of endemic communities discontinued after meeting epidemiological criteria

Data source:

TRACHOMA OUNTRY

Years ->

TF/TI ratio in 1-9 years old C AND TRANSMISSION CONTROL PREVENTIVE CHEMOTHERAPY Trachomatous trichiasis males & females > 30 years old Districts achieving Ultimate Intervention Goals, % “CHANCE” at least 80%

For more detailed information, please contact:

Preventive Chemotherapy and Transmission Control, Department of Control of Neglected Tropical Diseases World Health Organization, 20, avenue Appia, 1211 Geneva 27, Switzerland We would also like to be informed as soon as possible if we have made any errors in detailing your activities or if you have any other comments. Thank you for your collaboration. Our contact e-mail is [email protected]

© World Health Organization 2010. All rights reserved. This document is not a formal publication of WHO and does not necessarily represent the decisions or the stated policy of the Organization. The presentation of maps contained herein does not imply the expression of any opinion whatwoever on the part of WHO 6 concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delineation of its frontiers or boundaries.