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ONCHOCERCIASIS CONTROL PROGRAMME IN WEST AFRICA
Expert Advisory Committee OCPIEACZ2 Twenty-second session OzuGINAL: FRENCH Ouagadougou. 4-8 June 2001
REPORT OF THE MEETING ON GROUND LARVICIDING OF BLACKFLIES DURING THE POST-OCP PERIOD
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REPORT OF THE MEETING ON GROUND LARVICIDING OF BLACKFLIES DURING THE POST-OCP PERIOD
1. INTRODUCTION
The meeting on ground larviciding was held at OCP/Ouagadougou on 22123 March 2001. Participants at the meeting included key technicians of the Programme involved in ground Iarviciding activities, representatives of hydrobiologists, the interim CPET and independent specialists (cf. List of participants in Annex 1 of this report).
The objectives of this meeting, which was to ensure the application of recommendations made by EAC 21, were as follows:
a) To discuss the efficacy of ground larviciding of blackflies in the post-OCP context;
b) To address possible ecological problems relating to such activities;
c) To ascertain progress made with respect to feasibility studies on ground treatment in target basins;
d) To make concrete proposals for actions, which could re-state the protocols of on- going studies.
Discussions centred mainly on the 5 river basins (tributaries of the Oti, Tinkisso, Niger, Mafou and Pru), on which transmission might not have been completely interrupted by 2OO2, but where larviciding will automatically cease due to the end of the Programme.
2. OPENING OF THE MEETING
The Director of the Programme, Dr. Boakye A. Boatin, in his welcome address, called on participants to be open-minded during discussions, and to make relevant recommendations for the ground activities to be undertaken.
Dr. L. Yameogo, chief of VCU, on his part, thanked participants for honouring the invitation of the Programme. He was full of praise for the presence of Dr. B Philippon and Dr. A. Yebakima at the meeting, which he hoped, would be an opportunity for sharing experiences in the area of ground larviciding.
The proposed agenda (Annex 2) was adopted by participants, without any major amendments.
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3. GROUND BLACKFY LARVICIDING FOR CONTROLLING TRANSMTSSION IN THE OCP CONTEXT
The chief of VCU, after presenting the larviciding coverage map for the OCP area, showed the results obtained on the Dienkoa and on the mid Niger, due partly to the ground larviciding. The excellent results obtained in these 2 basins, which have different characteristics, go to prove the fact that ground larviciding that is properly carried out could bring about a cessation in onchocerciasis transmission in a context where aerial treatment would continue in other basins.
4. GROUND BLACKFLY LARVICIDING FOR CONTROLLING TRANSMISSION IN THE POST.OCP CONTEXT
Papers were presented by the national entomologist of Guinea on the activities undertaken or on-going ones on the Tinkisso, the upper Niger and the ft/afou. Additionally, the CAT of the Eastern Zone presented ground treatment activities that have been carried out on the Oti and its tributaries since 1997, as well as the on-going investigation on these rivers and on the Pru in Ghana. The national entomologist of tt/ali presented the outcome of ground treatment activities and those by boat on the mid Niger, in the vicinity of Bamako.
Results on blackfly densities, as well as figures on annual transmission potential were presented by the ATO on the various basins that are mentioned.
Entomo-epidemiological results show that the number of years during which transmission will have been controlled on these basins, before the end of the programme in 2002, will not be sufficient to bring down the risk of recrudescence to an insignificant level.
It will therefore be necessary to continue with CDTI, entomological surveillance and ground larviciding activities for some time in these basins.
Since ground larviciding is neither feasible nor efficacious in all cases, it was decided to choose a single criterion on the basis of which all the basins selected for ground larviciding (the Pru, tributaries of the Oti, the mid Niger in the vicinity of Bamako, the Tinkisso and Upper Niger-Mafou) will be examined. lt is to be noted, however, that in the post-OCP context, the surrounding basins will no longer be under larviciding, and may therefore be sources of contamination. . .
The workshop addressed 9 items as follows
1. Characteristics of the basin. 2. Epidemiological situation and distribution of ivermectin. 3. Entomological data 4. Larvicides used and sensitivity of larvae to chemical insecticides 5. Evaluation of needs (human and material resources). 6. Points of capture, accessible points for prospecting and ground treatment; 7. Entomological evaluation of treatment 8. lVonitoring of level of sensitivity of vectors to the larvicides used; 9. Post-OCP larvicide supply channels, and possible coordination of ground treatment in the various countries.
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5. WORKSHOP ON FEASIBILITY STUDIES ON GROUND TREATMENT IN THE SELECTED BASINS
5.1. Background
Two working groups were formed, and it was agreed to focus discussions on the five basins presented under item 4. The Chief of VCU recalled that it was actually a brainstorming exercise. Participants were to put emphasis on the efficacy of ground treatment and the various strategies used, based on their knowledge and field experience.
The first group worked on the feasibility studies of ground treatment on the Oti and its tributaries, the Keran, Kara and the Mo in Togo, and the Pru in Ghana. The second group reviewed the ground treatment options on the Tinkisso and on the Upper Niger/Mafou in Guinea, and on the mid Niger in the vicinity of Bamako, in Mali.
Presentation of outcomes of the discussions and views on the various basins were annexed as follows:
Annex 3: Ground treatment after 2002 on the tributaries of the Oti in Togo
Annex 4: Ground treatment after 2002 on the Pru basin in Ghana.
Annex 5: Ground treatment after 2OO2 in the basin of the Mid Niger in Mali.
Annex 6: Ground treatment after 2002 in the Tinkisso basin in Guinea.
Annex 7: Ground treatment after 2002 in the Niger-Mafou basin in Guinea
5.2. Summary of reports on workshops and plenary discussions
The need to form and train teams that are able to carry out ground treatment activities was specially emphasised. The training will have to be carried out in the field by OCP technicians before the end of the Programme.
Relevant information on the bio-ecology of vectors, their sensibility to the various larvicides, as well as characteristics of larvicides used under the Programme, will have to be included in the data to be transferred to the teams. lt was deemed appropriate to prioritise 8.f. H-14 and temephos for ground treatment, in order to minimise the impact on non-target fauna.
Some surveillance of the aquatic environment will have to be carried out during the ground treatment period.
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As much as possible, the VCU teams should try to write down figures for each of the foci, especially with respect to the intensity of bites and of transmission, the increment value that may be expected, with effect from the cessation of OCp activities, and CDTI coupled with manual larviciding, as compared to the CDTI strategy only. The prospects for keeping OCP entomological results at a level at least equal to the current one, must also be assessed.
For the evaluation of treatment, captures/dissections must be parallel to the evaluation of the prevalence of infection with blackflies, using the molecular biology technique.
Discussions centred also on the supply channels of larvicides after the OCP Programme. National structures should organise themselves, with the assistance of the Multi-Disease Surveillance Centre, which is being set up on OCP/Ouagadougou premises.
Participants brought to the fore the need for coordination of actions and the sharing of experiences among teams of the various countries. Setting up a network of national entomologists will enhance the exchange of fruitful experiences. ln a bid to guarantee OCP gains and dynamics, participants wished mechanisms could be put in place so the various teams complement one another in the entomological, epidemiological and chemotherapy areas.
The observations and suggestions made by participants on the various basins are summed up as follows:
a. The Tinkisso: efforts will have to be concentrated on the Fifa stretch which constitutes the focus where transmission is not well controlled, and where access to breeding sites is possible in all seasons.
b. The Upper Niger/Mafou: investigations carried out to date indicate that ground treatment for bringing transmission under control is not very feasible given the inaccessible nature of breeding sites on most parts of the river during the rainy season. It was suggested that investigations continue on access to important breeding sites, and that ivermectin distribution should be enhanced in this basin.
c. The tributaries of the Oti: tests carried out on the Keran, Kara and the tVo show that ground treatment is efficacious during the dry season. ln the rainy season, however, it is practically impossible to carry out ground treatment due to the large number of breeding sites that are inaccessible, and the high risks of re-contamination by blackflies from adjacent rivers.
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d. The Pru: The outcome of investigations conducted to date show that this river is navigable downstream at Asubende, during the dry season. Studies to be conducted during the rainy season will help to confirm the navigability of the upstream part of the river for the control of breeding sites on this stretch by boat. This will enable the mapping of breeding sites to be completed, and also the identification of spraying points for effective treatment.
The teams should take into account the suggestions made, and write up a final report on the feasibility of this activity by November 2001. A general framework of the exercise (cf. Annex 8) for specifying or completing the 9 points chosen in the previous outline was proposed to participants.
6. ECOLOGICAL PROBLEMS PERTAINING TO GROUND TREATMENT
Generally, the breeding sites of the blackfly are at the same time habitats of species that are sensitive to pesticides. The follow-up on recommendations of the ecological group in the use of larvicides for controlling blackfly larvae was instrumental in avoiding the irreversible negative effects of these chemicals on aquatic invertebrates and fish species. The most critical problem has to do with the handling of the various pesticides, which calls for the exercise of some precaution, both for the handlers and the surrounding populations.
With respect to ground larviciding, which might be carried outside the OCP context, one of the major challenges would be to abide by the judicious use of larvicides that might not harm the non-target fauna and man. To guarantee this, consideration must be given to the following:
- the kind of insecticides to be used. To this end, the choice should be mainly Bt H- 14 or temephos, which are less toxic for non{arget fauna.
The flow rates which must be measured very well in order to determine the right quantity of insecticides, the distance between the spraying point and the breeding site of blackfly larvae, and the spacing of treatment points.
The profile and drainage status of the river, in order to avoid a high concentration of larvides in the stagnant water basins.
During the discussions that followed, participants underscored the large-scale use of pesticides/insecticides in agriculture, without any supervision, with the obvious attendant consequences on the environment. They, however recommended timely surveillance of aquatic fauna during ground larviciding periods by national Hydrobiologists.
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7. RECOMMENDATIONS
After two days of deliberations on blackfly ground larviciding during the post-OCP period, 4 recommendations were made as follows:
A. The participants expressed their gratitude to the Regional Director of WHO/AFRO for creating a multi-disease centre (AFRO-MDSC). However:
a) given the importance of the role the Centre will play in the control and surveillance of diseases in general, and of onchocerciasis in particular, after the end of OCP;
b) recognising the role of this Centre in initiating certain research actions at the sub- regional level;
c) conscious of the resurgence of some diseases transmitted by vectors such as the Trypanosomiasis, the Dingue and Yellow fever in the sub-region, participants at the workshop strongly advocate the creation of the post of General Medical Entomologist as one of the first posts at the Centre. This specialist will be of invaluable assistance to the various national teams (DlR).
B. Participants at the workshop recommend that from now till the end of the Programme, the various activities that are already on-going in the Mafou basin should be intensified: i.e. vector control, CDTI, epidemiological and social/anthropological surveys. The lt/afou basin will also need to undergo a special entomological surveillance, given its potential role as the "barometer" for monitoring the movements of the S. damnosum (Nat. Ento./Nat. Coord).
C. lt is recommended that national entomological teams, which will be responsible for surveillance activities and those of vector control in the four states concerned, be formed and trained as early as possible by VCU teams, in order to benefit from the field experience of the latter before the end of activities of the Programme (CVCU/Nat. Coord.).
D. The meeting suggests that on the basis of a common outline, a well-argued project document, supported with figures, be drawn up for each of the foci identified by the EAC to be proposed, as soon as possible to the officers in charge of the countries concerned, after validation by the EAC and the JPC (Nat. Ent/Nat. CoordtuCU).
8. CLOSURE OF MEETING
The Director congratulated participants for their availability and the seriousness with which they participated in deliberations. He expressed his gratitude to Drs. Philippon and Yebakima for their active contribution to the discussions. Before giving the closing speech, he expressed the wish that the outline drawn up be implemented, and wished participants a safe trip back to their countries.
A6 ANNEX 1
LIST OF PARTICIPANTS
1) Country representatives
[/r. IM. Asante, National Entomologist, Ghana (Gl) Dr. E. Diop, Hydrobiologist, Guinea Conakry (G1) lVr. R. T. Lama, National Entomologist, Guinea Conakry (G2) Mr. tt/. Sow, National Entomologist, tt/lali (G2) tt/r. A. D'Almeida, National Entomologist, Togo (G1)
2l OCP participants
Dr. E. W. Soumbey-Alley, CBIS/CPET a.i. Ouagadougou Dr. H. Agoua, CATiEastetnZone, Kara (G1) tVlr. S. Bileou, A/RRE, Kara (Gl) Mr. tVl. Sarr, CATA//estern Zone Odienne (G2) Dr. Y. Bissan, CRE, Odienne (Gl) lMr. T. Barro, A/CRE, Odienne (G2) Dr. L.K.B. Akpoboua, ATO , Ouagadougou (G2) Mr. V. Kere, CHYDRO, Ouagadougou (G2) Dr. L. Toe, RLA, Ouagadougou (G2) Dr. L. Yameogo, CVCU, Ouagadougou Mr. L.J.R. Bakone, A/CSH, Ouagadougou (G2) Mr. J. lV. Tapsoba, A/ATO-CSH, Ouagadougou (G1)
3) lnvited Experts
Dr. B. Philippon, lRD, Paris, France (G1) Dr. A. Yebakima, Centre Demoustication, Fort de France, Martinique (G2)
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ANNEX 2
AGENDA
Thursday 22-03-2001
Bh0o-Bh 15 Welcome address by the Programme Director lntroduction by CVCU
8h 15-8h35 Ground treatment of blackflies for transmission control in OCP context (20 min). - study by example (CVCU) - Discussion (efficacy and monitoring)
Bh35-10h10 Ground treatment for transmission control in the post-OCP context.
Presentation of the two basins of Guinea: Tinkisso and Upper Niger/Mafou (Entomo. Guinea, CAT West Zone, CRE) - 20 min Presentation of the Niger basin in the vicinity of Bamako (Entomo. t\Iali, CAT West Zone, A/RRE) - 1Omn Presentation of the Pru basin (CAT East Zone, A"/RRE, Entomo. Ghana) -10 min Presentation of the Oti basin and its tributaries (CAT East Zone, A/RRE, Entomo. Togo) - 15 min Entomological situation in the 5 selected basins (ATO) - 20mn Discussions (efficacy and monitoring)
10h'10-10h25 Coffee break
10h25-12h00 Workshop on feasibility studies on ground treatment in identified basins.
lntroduction Formation of working groups Deliberations start - progress of studies - drawing up of protocols with implementation timetable
1 2h00-1 5h00 Lunch break
15h00-18h00 Group work (cont'd.)
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Friday 23-03-2001
Bh00-1 0h00 Plenary sessions
Presentation of deliberations Discussions
1 0h00-1 0h1 5 Coffee break
1 0h1 5-1 0h35 Nuisance control issues Ecological issues relating to ground treatment - Presentation (Hydrobiology. Guinea, CSH & A/CSH) - Discussions
1 0h35-1 2h00 Group work contd. For finalising protocols and recommendations
12h00-1 5h00 Lunch break
1 5h00-1 6h30 Summary of reports, protocols and Group recommendations.
1 6h30-1 7h00 Adoption of report, protocol and recommendations
1 7h00-1 8h00 Closure
NB: - The indication (Gl etc.) in from of the names of participants shows the working groups in which participants deliberated.
ATO will be the main rapporteur of the meeting. He will be assisted by the two CATs, who will be the main rapporteurs for the working groups. CATs may appoint a participant in each group to assist them.
A9 ANNEX 3 Ground treatment after 2002 Tributaries of the Oti in Togo
Objective: Feasibility study of ground treatment of blackflies for sustaining the control of onchocerciasis transmission in the foci after December 2002.
1. Characteristics of the basin
[Vountainous area with several rivers and breeding sites in all seasons on the Keran, Kara and the t\Io.
The hydrological situation is properly monitored from about ten stations. Flow rates at Titira fluctuated between 1m3/sec and 126m3/sec (2000), and 550m3/sec in 1 998-99.
2. Epidemiological situation and ivermectin distribution
With regard to epidemiological parameters, the results obtained in 2000 show high prevalence rates, especially on the Upper Keran (Titira, Tapounde) and on Lower Kara (Sikan, Tougel and Kadjol). CN/lFLs are generally low.
lvermectin distribution has been regular since 1996-97
3. Entomological data
The transmission trend has been good: ATP<100 at all points in 2000 (max=77 at Titira in 2000).
4. Larvicides used and sensitivity of larvae to chemical insecticides
B.t (Vectobac and Teknar) is the main larvicide used. Long-range chemical insecticides (temephos, pyraclofos) are used mainly during spate periods. lntermediate sensitivity, as compared to the Temophos, is normal for the Pyraclofos and Phoxim.
5. Evaluation of needs
Human resources and training. Two entomological evaluation teams of 5 persons each (1 entomo technician; 1 auxiliary worker; 1 driver-captor; 1 captor and 1 boatman). Teams to be trained.
Equipment: Dissection tools (1 binoculars, etc..) prospecting and ground treatment (2 boats and2 outboard motors).
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6. Capture points, accessible points for prospecting and treatment (cf . 2 maps and 1 table hereto appended.)
4 CPs, with 2 (Titira and Tapounde) on the Upper Keran and 2 (Sikan and Tougel?) on Lower Kara.
Prospecting and treatment are feasible on 28 points during the dry season (November-March) and on 23 points in the rainy season (April-october).
Ground treatment is feasible all seasons only on Upper Keran (6 accessible points), and on Lower Kara (8 accessible points).
7. Entomological evaluation of treatment
Capture-dissection of blackflies, and pool screening of crushed blackflies
8. Monitoring the level of sensitivity of vectors to larvicides used
Not absolutely necessary Be careful however with OP (do not exceed 3 consecutive cycles)
9. Larvicide supply channel after OCP, and potential for coordinating ground treatment in the country
Suggest the creation of a multi-disciplinary entomologist position at the multi-disease surveilla nce centre for manag ing resid ual entomolog ical activities.
All ANNET 3 Fie. 1 : GITES SIMITLIDBNS / BREEDING SITES
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I ?.^l t- t6r l?r.?t't^:.a.rl tqoo( -f vi, z rir Jreaarrr 15 2 icrr .r;atoite., catlgrc^a O. 5" lo.ta + .arN. r(i ocF L i Atz ANNEX 3 Pig. pOrN:rS 2 - KARA - I*RAN - MO : OU GITES ACCESSTBLES ACCESSIBLE POINTS OR BRBBDING SITES r !O BOUl(OM8E N --:\\\ r45 KAN . + Nra ta T AIIT.KOUXA 6) rJi ARA g + + o ! @ ,( 4 rl :t{ i!c- : I ,l- LEGENO/LEGENOE )E E. dea / FoEt l-a @ t6r Al.)o(t tairooort ! \ t sol A13 ANNEX 3 TABLE 1 KARA - KERAN - MO : ACCESSIBLE POINTS OR BREEDING SITES Coordinates Accessibility Water Dry Wet Breeding sites River Latitude Longitude gauge season season 1 Naboulgou K6ran Yes 10'16'N 00" 47'E Yes Yes 2 Titira K6ran Yes 09'59'N 01" 07'E Yes Yes 3 Sola K6ran No 10'00'N 01" 08'E Yes No 4 Tapounde Keran No 10" 03'N 01'15'E Yes No 5 Pouda Binah Yes 09" 52',N 01' 14'E Yes Yes 6 Djabrgnon Kara Yes 09'53'N 00' 34'E Yes Yes 7 Koutrere Kara No 09" 51',N 00" 45' E Yes No 8 Sikan Kara No 09" 46' N 00'51'E Yes Yes I Tamene Niankpe No 09'29'N 00" 52'E Yes Yes 10 Ouakad6 Kara No 09" 29'N 00" 59'E Yes Yes 11 Conf.KawalKara Kara No 09" 36'N 01" 01'E Yes No 12 Sarakawa-Kara Kara Yes 09" 38'N I 00" sg',E Yes No 13 Sarakawa-Kpelo Kpelou Yes 09"39'NI00'57'E Yes Yes 14 Pont Niantougou Kp6lou No 09" 42',N i 01'07',E Yes Yes 15 /dchankpad6 Kpaya Yes 09" 29'N 01" 10' E Yes Yes 16 Landa-Pozanda Kara No 09" 31' N I 01' 16'E Yes Yes I l 17 Kpayando Kpaya No 09" 21'N I 01" 12',E Yes Yes I I 18 Djogma Djogma No 09" 21'N 1 01" 10' E Yes Yes 19 Kadjoukada Gningba No 09" 28'N I 01" 06'E Yes Yes 20 Aleheride Bouale No 09" 13'N 01' 13'E Yes Yes 21 Am ar'd6 Boual6 No 09'10'N 01' 10',E Yes Yes 22 Mo a N40 MO Yes 09" 06'N 01'03',E Yes Yes 23 Pont Kama Kama Yes 09" 14'N 00'48'E Yes Yes 24 Tcharchaminad Kama No 09" '17' N 00' 54', E Yes Yes 25 Bouzalo Bouzalo lNo 09" 17'N 10'02'E Yes Yes 26 Bagan Mo Yes 09" 00'-N 00" 40' E Yes Yes 27 Tipaoti Kiatiko No 10" 07'N 01' 17',E Yes Yes A14 ANNEX 4 Ground treatment after 2002 The Pru basin (Ghana) Objective: Feasibility study of ground treatment of blackflies in order to prolong the control of transmission of onchocerciasis after the end of OCP activities. This study is exclusively on foci identified by the EAC. lt has to do with those foci where OCP will not have totally achieved its objectives by December 2002. Operations will be carried out by specialised national teams from the countries concerned, and operating also under national structures. The said operations must be designed and conducted in close collaboration with CDTI chemotherapy control, and the results of the monitoring of the epidemiological situation. 1. Characteristics of the basin The Pru, tributary of the Volta Lake in Ghana, takes its source from the hills of Kumasi. lt is a perennial river in the Brong Ahafo region and constitutes the southern limit of the OCP area in Ghana. lt is a guinea savanna forest zone. The treated breeding sites span about 80 kilometres upstream of the Prang Bridge. The only hydrological station used is that of Asubende. Flow rates fluctuate between 1 and 120m3/sec. 2. Epidemiologicalsituationandivermectindistribution The trends atAsubende from 1987 to 1997 are as follows: Prevalence rates from 95.9 to 49%; CMFL from 70.3 to 1.47) The trends at Fawomang, from 1987 to 1997 are as follows: Prevalence rates from 100% to 14.3%; CMFL from 80.51 to 0.12). lvermectin has been combined with larvicides since 1988. CDTI started in 1997 3. Entomological data The transmission trend atAsubende is good: from 1978 to 2000, the gross ATP went from 3.330 to 174. Corrected ATP=91 in 2000. A15 -2- 4. Larvicides used and sensitivity of larvae to chemical insecticides B.f (Vectobac and Teknar) is the main larvicide used. Temephos (Abate@) is sometimes used when river is in spate. lntermediate sensitivity, as compared to temephos, and normal for pyraclofos and phoxim. 5. Evaluation of needs Human resources and training: One (1) entomological evaluation team of 5 persons (1 entomo. technician, 1 auxiliary worker, 1 driver-captor, 1 captor and 1 boatman). The team has already been formed and is operational. Equipment: vehicular means (1 4x4 vehicle), 1 binoculars etc.. for dissection; prospecting and ground treatment (2 boats and Hudson pumps, 2 HB motors) 6 Capture points, accessible for prospecting and treatment (cf. 3 maps and table hereto appended) Capture point: Asubende Prospecting and treatment are feasible at 18 points, during the dry season (November- March) and at 4 points during the rainy season (April-October). Three (3) spraying points could have a good irrsecticide coverage during periods of spate. These 3 points will be identified after on-going studies for navigability in the upstream portion of Asubende. 7. Entomological evaluation of treatment Capture/dissection of blackflies, and pool screening; 8. Monitoring of the level of sensibility of vectors to the larvicides used. Not absolutely necessary. Be careful, however with O.P. (do not exceed 3 consecutive cycles) I Larvicide supply channel after OGP, and feasibility of coordinating ground treatment in the countries. The group suggests that a post of General Entomologist be created within the AFRO Centre for supporl to surveillance and multi-disease control in West Africa (Afro IVDSC) for the management and coordination of entomological activities in the countries concerned. aL6 ANNEK 4 Fig. 1- LAPRU GiteS SimUlidienS /simuri,n breeding sires ,,-- A L /,.G .i, 4.. o As ubende c rrD .o q (/{ n rOnO ATE E NCHI URU ( J c So ct, j I EJURA ( t +-* -'l- -<- .^ -< - - _+_*_+ 4f- Ab o >\- (\ 0(' /-J-\ \\ at7 ) .'2, ANNEX 4 TIGURE o a) € o 00 E c o E 0) o- o Ftr @ o E tr I ..J o po 6 I, D OJ o n - tr ( e CJ 2 I q, t lt l o o +J A t FT e IU u 0 o a (J x s- 2 -z r H. l c () o t! H o ll @ F] ) o N _L o o o z U o z o o o s 9 q r o o ! ) c ,@ U D () (, : o o l' .: a oc @ r fr o D- a q td @ @ ts at-t o c t D z J 4 A Irl a (/ / lll p 4? // d 89 -o' / : SE ,/l cn EA Ff o -/F= , 9c E =Y (/}i J { : F 3 H, 7 I (J t- o (J e EO o .\. E ,.\ ) o \. oFll E) 9\ a, a F ',l o o al8 ANNEX 4 Frc.3. LAPRIJ B ief tra ite a u x la rv icid es STRECM UNDER T.ARVICTDBS TRBATHENT ( q\ \ SAL AGA a I A A/ ,4. l P o Unr[-,urICnO \ \ kro m lt Asubende 7e KINIA[rPO Odum Anolo S U Dr n s0 ) Tcnirono I \ i -io I nl r A'I'E 8 UB U ) CHI C tA ((. -te 5/r A,,-"roo" ,/ Se ne so --JFvqotf- -rE'+h, \ '\\ a-->J ( ) I q \ . $\ Sum, \ t) fi t'r, o a 9,n o \ Otrt"l' \ ( $ l -\ I A19 ANNEX 4 Tablel PRU: ACGESSIBLE BREEDING SITES FOR GROUND LARVICIDING Coordinates Accessibility Accessible villages and Water Dry Wet River Latitude Longitude Breeding sites gauge season season 1 Prang Pru Yes 07" 55' N 0" 53'W Yes Yes 2 Nujua Pru No 07'57' N 0" 57'W Yes No 3 Boumbondini Pru No 07" 59' N 0" 57',W Yes No 4 Bachimburu Pru No 07" 59' N 0' 57'W Yes No 5 Bachumbakura Pru No 07'57' N 0" 58'W Yes No 6 Beposo/Adjaradja Pru No 07'59' N 0' 58'W Yes Yes 7 Asubende Pru Yes 08' 01' N 0" 57'W Yes No 8 Baaya Pru No 08" 01'N 0' 58'W Yes No 9 Mantuka Pru No 08" 01'N 0" 59'W Yes No 10 Fawoman Nwasan No 08" 01'N 01' 00' w Yes No 11 Ohiampe Pru No 08" 01'N 01' 01' w Yes No 12 Trohwe Pru No 08" 00' N 01" 03'w Yes No 13 Kutupe Pru No 07'57' N 01" 01'w Yes No 14 Dama Nkwanta Pru No 07" 58' N 01' 04' w Yes No 15 Dama Nkwanta Nwasan No 07" 59' N 01" 05'w Yes No 16 Buipe Pru No 07'56' N 01" 07'w Yes No 17 Kofi Basare Plakese No 08'03' N 0' 52',W Yes Yes 18 Kutund6 Labokese No 07" 59' N 01' 05' w Yes Yes A20 ANNEX 5 GROUND TREATMENT AFTER 2OO2IN THE MID.NIGER BASIN IN MALI Obiective: Feasibility study of ground larviciding of blackflies in order to sustain the control of onchocerciasis transmission THE MID-NIGE BASIN IN MALI 1. lntroduction Following the presentation on current control activities in Mali, the group realised that since the training of the national team by OCP in 1995, ground treatment activities have continually been carried out by this team since 1996. These treatment activities have enabled transmission to be kept at an acceptable level, with satisfactory results that are comparable with those of aerial treatment. The technique has therefore been proved to be feasible, and the points that are currently being monitored could be in the post-OCP context. However, a number of prior conditions may have to be satisfied. These include the availability of qualified personnel, adequate logistics and equipment, data pertaining to the entomological, epidemiological and hydrological situation, CDTI, areas and the population concerned. This information, which might be available either at OCP or at the national team level, will serve as the basis for drawing up a project, which the country concerned could submit to her bilateral partners for funding. 2. Epidemiologicalsituationandivermectindistribution The results obtained during the last evaluation carried out in 1999 show a general downward trend, especially in the monitoring villages of Tienfala and [t/ananbougou. CMFLs are generally low (figure 1, 1b and 2). Several ivermectin distribution strategies were implemented beginning 1988 (the year the drug was introduced), namely: treatment by mobile teams, community-based treatment, then CDTI since 1997 (table 2). lvermectin has been combined with larviciding since 1 9BB. ln drawing up the protocol for a better analysis of the situation, all the information relating to treatment with ivermectin in the basin (start-up, geographical and therapeutic coverage) will have to be complied by the national team and OCP/PET. 3. Entomological data The first larviciding activities started in 1976, but it was only in 1990 that the basin undenrruent regular treatment, combined with ivermectin distribution, which helped to bring about a significant drop in the trends of entomological parameters, with corrected ATPs that were everywhere below 100 (cf. Figure 3). The gross ATPs recorded on the Niger and its tributaries are recorded in figure 4. A21. -2- 4. Larvicides used and sensitivity of larvae to insecticides Given that the post-OCP activities will aim at transmission control in the basin of the Niger and its tributaries, the same type of insecticides will have to be used, while respecting treatment cycles and the rotation principle, so as to avoid resistance. However, considering parameters such as the flow rate of the Niger (Figure 5) and the role of the tributaries in re-colonising the basin, a strategy wlll have to be put in place to reduce the number of treatment cycles, and thus bring down cost. NATU RE AND COST OF INSECTICIDES a 2001-2002 PRICE/LIT. IN 2OOO COST PRODUCT QTY $us(rF) Temophos 17.14 Permethrin 3215.5 10.98 35306 Carbosulfan* 806.1 20.82 16783 Etofenprox 246 24.15 5941 B.t. H14 : Vectobac 643.5 5.74 3694 Teknar '139.5 5.92 826 TOTAL 5065 62550 US$ 62550 = 43 785 000 CFA ($1=700FCFA) " Thls is residual stock; the insecticide must no longer be used after available stock is depleted. a Post-OCP MAIN BASIN TRIBUTARIES lnsecticide to be determined B.t. H14 After feasibil studies Treating the tributaries of the main Niger River right from the very first flows, and ensuring a good coverage of all the breeding sites up to the end of these flows could have an impact on the colonisation of the main basin. The implementation of this strategy could only allow the main Niger River to be treated from week 1 1o29. Treatment will then be suspended until week 52. A longer suspension period during periods of high flow rates will have an impact on the overall cost of treatment. It will, however, be necessary to undertake an analysis of entomological, epidemiological, hydrological and meteorological data right from 2001, so as to verify the efficacy of such a sirategy-. The outcomes of this analysis should enable reliable scenarios to be proposed for controlling the basin, while bringing down costs. A22 -3- 5. Evaluation of needs r Human resources and training: Personnel is available and trained at national level for ground treatment and entomological evaluation at points monitored by the B.O. of Bamako. State public servants: 1 medical entomologist; 2 entomologist technicians Staff on contract: 1 boatman 6 captors 1 laboratory assistant The group wished a second laboratory assistant could be trained to beef up the capacity of the team. t Equipment: With regard to the equipment needed to carry out activities, the standard OCP list could be considered by putting figures to the items in order to determine the cost of one kit (see table l). 6. Capture points; accessible points for prospecting and treatment. Five capture points were identified on the Niger and its tributaries (Fig. 6), as well as all the points of access for prospecting and treatment (Figs. 7, B, 9, 10). All the breeding sites are accessible, but it is worth noting that in the case of River Fi6, they are inaccessible when the river is in spate (September to December). Ground treatment is therefore suspended during this period. OCP/Odienne takes over, with aerial treatment during this period for between 5 and 10 weeks. This alternative will, however, not be possible during the post-OCP period. Given this situation, the group is of the view that: a) emphasis will have to be placed on CDTI, prior to the rainy season, so that increases in blackfly densities may not have an impact on transmission; b) it will be necessary to enhance ground treatment during the dry season, in order to have a good entomological situation, before the rainy season sets in. 7. Entomological evaluation of treatment. Since activities are aimed at controlling transmission through ground larviciding and evaluation of its impact, it will be necessary to plan carrying out capture and dissecting activities, which, alone, could furnish rapid information for decision-making relating to larviciding. This, however, does not imply the exclusion of the technique of alcoholising blackflies for identification by the DNA laboratory. A23 -4- 8. Monitoring the level of sensitivity of vectors to Iarvicides used First of all, it is necessary to take stock of the situation on the entire basin, in order to help in choosing and establishing a baseline situation, the trend of which could longitudinally be monitored. This monitoring may be carried out at the national level, if qualified personnel could be identified, trained and adequately equipped. Another alternative would be to do this through the tVlulti-Disease Surveillance Centre, which is to be set up after OCP and which will have the necessary resources and competence. 9 Channels of larvicide supply after OCP and feasibility of coordinating ground treatment in the countries. a Supply Contacts made with the lVlalian chemical company failed to ensure the supply to the interested structures. lt is therefore up to the national coordination, with the assistance of and in collaboration with OCP: to directly contact the firms that could supply the identified insecticides, in order to provide them with all the indicators that will enable them to determine Mali's needs for all activities (interrupting transmission and nuisance control); to involve the highest national authorities, with the information furnished by firms and wlth well-argumented/costed protocols to be taken into account in the health development plan in the post-OCP context. a Coordination of treatment and exchange of experience By the end of the Programme in 2002, OCP could encourage the exchange of expertise among nationals, in the entomological, epidemiological and hydrological areas. This will ensure a concerted effort in managing problems inherent in the basins (human and blackfly populations), which they have in common (eg: the Fie River, tributaries of the Niger). The meetings initiated in Ouagadougou by OCP, between entomologists and national coordinators aim at promoting these exchanges. Entomologists should formalise the idea of their network in order to put in place this chain of competence for managing entomological problems that will surely come up during the post-OCP period. a24 ANNEX 5 Tablel EQUIPMENT A/ Larvicidinq Boat zodiac (lVark ll) 2 Outboard motor (1 ot25 HP andl of 40 HP) 2 R6servoir/Tank 2 Prospection boats 6 pairs Stopwatch 1 x2 5 cm rope 1 ball Calibrated jauge 1 x2 Calculator 1 x2 Calibrated bucket 1 x2 1 litre test tube 1 x2=2 2lltre test tube 1 x2=2 Funnel 2 lnsecticide Engine oil oit Thermometer Life jacket b Floating device (capture tube) 2 B/ Dissectinq equipment Dissecting microscope (M5 ou M3) 2 Slides Cover slides Needles Mandrin 3 pairs Transformer 2 Spare bulb 20 Nail polish 2 stoppered bottles Dropper 3 stoppered bottles Table for dissection 2 Chairs 4 Enamel tray 2 Dissection reading sheet Pen 2 A25 -2- C/ For catchin Capturing tube Absorbant cotton lce chest 2 Alcohol d 70 or 80" Small cloth bag 22 Large format cloth bag 2 Pen 2 Watches 2 Stools or chairs 2 Elastic straps 2 packets Recording sheet D/ Samplinq Equipment Absolute alcohol Acetic Acid lce chest Plastic bag Pruning shears Plastic stoppered bottle of 50 ml or 100 ml E/ Transport Fou r-wheel-d rive veh icle 2 Fuel [/aintenance Spare parts A26 ANNEX 5 E o nd lr 0) tr C !"i o Yo.9) ,.4z Z ro o {- O .6'6 N EoH(! Eg .'i;'.. t{rc, '":, oii :1- oc -i @(l, ("'"" (0 :- . _-1, .r-: .'1 o J._'-. : 'F! , :- -: --, ocno &ct ti" .4, c'5 lr) 'dp o) o) gtr h.a .6 _oE l. o .: ro >| ', t.( H(/)9o o E9 o, OY .0, to c it tr qr9-o o- 9o $ 61, O) O) tFl>F s-E AG o.o !o- !: ,*roo S Oe '! .0 I. FiJ t', .is @ - llJ @ O) -o .9') LL o o O O O O o O O @ N (o l.r) cr) (\ asualeA9Jd A27 ANNEX 5 CU .9 {-, EP5 efi; =(tr gE€qIEt;q =E.. E II o E BF'ZEEgS d +J tr0 a d r TIo ot 0) L o rd o (U o0 rts, o o J qt - o a II-cl a A H o L- E {r, E IJJ o .h q) o E' g o 00 E, Il o E o o Ft Y t (\, lr a o f a tt E t \q) F I t o i x) t - t a '6 i \0) UJ E t U) I :f I t o o o I (! U) 3 l tr U) o I o co t .Fi o I .cT Y t !J 1 t (! L- 1 FI (0 o frf ,9 o A z. t.] 00 gq A28 ANNEX 5 r'-- I i o r_ o o) .g o) z o) 5E S.-c v, tut o\ .d(! 0\ o\ o,co q,! lr to to !o p0) o) ilo E o) po,5 o 'ia zo I EE o) d. o) o o, E o (o ttr o CD6 o (,r 0J $ a E b>!-\ o *o o (D c .€) 3o tr E 6Gtrc EE G - sg 5 oO G G' o0 (.) g) G\ o t-l-lO (, tr '13 o : -'-;-: ..- ' . t i.;tlr .93.Jo o tr\ 'rl O b N r4, 3o @ trlJ C') FrOoC 6r>sr tr *P oq\ ; '_.. , .3s (O o-He F- o{ q,@ of,3s Eotr> otU q oooooooo @l'-(Olr)SCON o c{ ,.3 o,) !tr)) lFl 6n ssuelE^9/d l9 -* ig1 r,. A29 ANNEX 5 o\ o\ € o\ o\ F{ EC) S-( € {-. () o\ o o0 f:. O{ o-{ o\ o\ GI r( ze tr6 o O() o r-{ f-. o v) o\ * 6B o \o o ! o\ H '-A o\ ct o\ o\ a.v, t-l @ rr(t) \/ Or a o\ +. oo o\ tr o 'r1 o\ \o o t_-( \ o\ 0< 01 ta N o\ o\ Ot =oo o\ I F{ a e o e o q{H F F-{ ,xt lr I qJ in c' 00 o\ L. z R< ca !+ (nGI e rr o\ o\ 0r o\ H F{ + E €N 0.) s .J o qJ e tr .tr tr .-{53 o\ .9 o qr -F) ra H ) o\ I E o\ o .Fl Ft{ t IJ o Fl o rd ca rq o\ c.l (a o\ o lr o\ Fl o0 \c rn .Fl \f, CO c.I l-{ A30 ANNEX 5 o\ o\ € o\ o\ F{ () F-+ a \-, o\ +. o $-{ f-. p< C) o\ o\ cq oo F{ op{ GI o A. fr o!J () z f- U () a t o o\ F-{ -P \o ct 0\ E g1 t-< O o\ @ o\ cl o\ F( 0\ a= o a o +)a o\ {rJ o\ \o o ) 0< N o\ o\ o\ $-{ ro o\ .o co o\ E I o o\ o\ tr F-{ o qr t-.t o\ L lr o o t-{ 4 @ 2 Fr ,($ ra GI 0) o\ : a CA !f, aGI E () o o\ o\ A E o\ H C\ F{ + o )-{ E o\ s lr o e o o\ t L. qr +) o\ .9 o CO F tr o .rl o\ .J o\ c t-l I o t4 r! ca o\ 6l -? o\ 0,) o\ tl Fl o0 \o (n \f ca c.I t.< 'ri A31 ANNEX 5 i: sSsr C aqa9 a a o IJ { U o\ tu \ g\ \ C,T I o tl dcu +r t6 .r.l a llt J).rl lr .-: s o- )IE A6 €, XI .e 'tp Nl ;=(!ct % E .:o %" az tt, 3z, ,b" ZL o & .9PH OJ c 17 O\ o 'ioHF{ b B p e.d ,s rJ-tA (n s.;e q' 2I{ ZGt'i V) ?1 t-t or't] I tao z g q) T{ E U) o !E +o 6t'-g.3t_(r)L sL {i, EcqG.< HE ,+ trE a/e E'o.o r! *e l-cGC) h -!3 ,r" 'G' fi #d +o % % % OJ tr % a €oo ,r{ o % EEEEEEEeqv6a] (slftu) rlqlO (cm/gl) dra5:srp ra1e6 A32 ANNr.rX 5 Figure 6 : Nigcr-Faya-Fic and tribrrt-arics BASSIN DU NIGER- FAYA - FIE & AFFLUENTS ?s 2 R IVE GAU CHE NN k Rrvrrrc rl ofllurnts lslloo Codr du bil (31o6) Porrt I--l^\ Fh dr birr -la \ E Poinl d. coptur. (2017) code du poht dc coptur. Koulil.oro {+++++ Limit! d';tots 2 o O Chrf lie u dr bosr oilrotionnrllr ou sou!-r.cl€r L524 Depot do corb,Jronl ovec codoge compoqnlo Echelle de crue ov€c bolrse orgos 2004) Y yo 20 l?oo"\ ((-o o H + (3103) Bor*oomono + I Modino ( 3to4) a t ubo + 4 + a M ALI L /I I t ( 2020) + ra rkoro I 653 a I HN I I -I 420 tl Sr€91P1 l+ t, (4ro5) Kou ( , a 531 IL,J'*t*^, GU N E A Yo nfoli lo + a \catJi l r Nienorrbole t + I It { )0 20 30 /.0 Km + ( 4t04 ) ( Mondiono Elcc + o A + o (/) o4o + ocP- BAMAXO, tO-O7-1992, Dr A.AKFOBOUA/B KOUIiI^ A33 ANNT'X 5 t_- --g*-\ - ara \. O o \_=: ' \/+7'a -2- t! it o .o of oY o X € @ o I \ \\ d CD 6 ) \ @ I .? E \\ o o (o o? @ cO- q O@ E o EE o C) O@ o E I qN @ 6 ra ra q o Y Y o i t { * 'L.r o @ ;I, o o- \, o -O I o O c .d co \.. 3 O o s O (! Y O lr t OJ \s 'F{ & (, 5 6 ! o OJ 00 z. 'ri z \ Z =o \ 9tN 0 o \ r a \ \\.\ a o €c \. !- a @ o, oo m rilil ar E I A34 ANNEX 5 I?igurc B : River Fie B" 2A Bo l0 Scrr:n foro Il z/z' Soo:nforo Avol //.// orowonion Koultkoro N io moko ( tlomoou Poctelr) \\ 1\\ -o Bogodioront ( \l \-\ S o no nkoro \ /a\ \ Bokoro Bokoro +1, +orcYJnron- DvoMn -! o a I Sdefougo U il - --- t// ll //' Sononko(o /r=* IJ -/z lt , 4 I Ii ono nkoro \ U Bolondougou ll n )l It ./ U -/ 0 €ogodougou-a }(os \ ]t 1P40 fra Doko bodo t( I lromon ,II ll I \ i,l o \ rt-:=< 4\ rl ') - Jdt { C t \ l/ I r\ u l) rl Nici' r .,..lomeou 1>iicire u r) lt il lt ,il tkoro A Am.Jnl ( Nioouleni N Forobokoro ou Sorondro4 --\ t\ -/ io ro a Koulik R E R E F IE K^ I -:a-Z\- Rrvrirc cr -tfluool [,/-- _ G,t. lo.*,r, I t.,C . Vrlogc . Front irr d',itots iI So no nforo Avol +++4+a f'qot dc lG1.monl ou ti'l 11"30 Pornl d. coplure Sonon f o;-o \ @ I : Rwlc .4 \ P'r1c t - to l0Kft\ t o A35 + Sononfor<.r x r30 ocP -BAll Ario.14,01 i n 9 4. l"{ - y Dlr.Ji ttA,/B taor ru /, B" 20 ri1;urc9:River!.aya ANNIiX 5 7'3 0 Fc qcon I t.\ ( t \{ \' \ 0 \\ \ t 0Xnr \\\ \ Tontoc koro \ Srro tq U Ia ll \ \ lJ (r* l] \ .\ c ll lr I] I F 7 Tongc rc nre I t*, lo ll o \,\ u ! j, \ \\ q \\ S€ korb J / 11 lTL t/t I I = .-\r I l\ 11 o --=--et-: ,u lr u IL \" I I n Avol 2 \. 0 ll I :, \t lr \ i'1 t_ [*- al \ I ..-,2 A $ tl -ao- ont igurlo {[ !FORET 'l D u lJ 9#^ \\ 8*T f \\_\\ -=-' Avol I ,! --?4 0 ,l ll z I \ 4 ft It \ X ttl ll \ (sro.to ,[ t It \ J il .-cnt Fcyo t l $ $ ,t ! ! // lt II ,/ , \ \ 'FAY I --{ LASSE E \\\ DE LA ssslo Jl l/ S .!^**,"r- Niekontombo \)\ \\\ illh \ \\ \\ F 4=*- $ ker 1-ombo k IL E E/"''shffi,gs.*z* t?" 1i,fi;;;\\ \ \ Sikoroni tl \\ \. \\\ \ . Drbo RIVIERE F-AYA ttat Rrvtirr ot o((luont E Llmrl. d. lo (o..t Gilrloryorrr a -- ,llo g o Amont Dibo prrncipolo Bovtr Poiot dr lrurrcmd e \ ::: _- Relr rrordorrr o@ -BAv^KO, rB -Or -199{, r.(r Y DIAnRA/ B XOUs4 7"3 A36 ..\ o I'i ;- l ! I 'x.l oL t- r-I.vo 1l Eil 61 I ANNIiX 5 E o- 0 -ll 'CJ Y fiIi :l 1 cr 9 o, \ Ell E O a I ,! rr ll 01 dr u cr- o 'F* E BII n, ld):t a -) !o; u : E b zll l ri o! lr -t; - 3 O ad) 3ll )< dJO oJ \ U):9 -r 9 ioil (nu _il dJf _ pll D.! L I 3 L.U-= .YLE E E i,ll 1 ! -1ll i7 .at a E t- z :ll :'OF;6! t- \\9 U- ll o!2i9 "l o'q1 l a\ I i kll JL O \ 1 t t 3 5 { ls a \ ( ; [' o \ tD I \ I f a-, // t\ T ? I I I t ( \ I .3 I _a I / \ ) II I 'a I i- \ ) E ll s o \ ! a .\ \ o ! d o b o \ 0,) : .: 'rl x t ,z :) 3 z a o a t- f- O C 9 a - o U D o (1 c L37 E o o o oq or oq $^ r+- u? oq o (9 (0 \ \ lI) o o @ o C" (\ @ (\ (o 6t o (o 1() ro a0 @ @ @ (&) o s @ @ o) E o E (9 t- o ro t\ (\l N \f o o N o lr) @ ct) \t !+ o ol \t o o (E @ o) (o N (\ t4, (u q, $ (l' t (\ (9 (Y) (\I $ $ (c) (\ $ E (9 6l (Y:) (Y) o o .g E z G o E' o o (Y) o @ o ro (o € o, CT, (\Io CD N 1() t (l, \f t $ (o@ F (Y) (o o rJ) (.o o lr) $ tO o) (o o o= 14, l() ro (9 lo ro o ct) @ .E o (\t c.) N I() (, x o (tF UI q) o oo z E E z (u ;e o o E.= .: 9E o Eo sl o E o) >E g o -otr> -o o '5s (E E ({) o-c cl) t t t (r) @ o l() C" N 1l) o.= F o (\t (Y) sf (\l (\ o t N (\l $t C{ (o cr, (o E} .2 o b: o lt .u6 (E E o .EE-cE o z oI *.. .t o] (! 9E EE(!q) or- o * tsb o (l' o; * * * * * * * C" * * * * ([.= = (5 @ cD o C\ (Y) t o, t- @ CD q) @ CD CD o oc o (t@ ct) cr, ct) o) CD o, o @= o o, o) o, CD CD ct tO C', o) CD o - CD N oE tr ct, PE Jo(!O .x* * A38 ANNEX 6 GROUND TREATMENT AFTER 2OO2 IN THE TINKISSO BASIN Qbieqtnre: Stud y the feasibility of ground larviciding of blackflies so as to sustain the control of onchocerciasis transmission in the Tinkisso basrn 1. Characteristics of basin The largest tributary of the left bank of the Niger. - Length: 520 km. - East-west direction before confluence. - 102 tributaries of first & second order ( a total of 2820 km) - Total length of main river and tributaries = 3340 km - [\4ain tributaries: Banie, Bouka I & ll, Leleko, Yro and Nono - Average rainfall (1 100 and 1700 mm) - Upper basin is mountainous, hence the succession of breeding sites. - Regular nature of flow in mid-June; lowest water level in mid October. - ln dry season, water level is at the lowest with cessation of flow in some areas. - Good navigability of the main Tinkisso River, except from March to June. 2. Epidemiologicalsituationandivermectindistribution 2.1. Epidemiologica! results The results of epidemiological evaluations carried out from 1985 to 1999 indicate a drop in the different parasitic loads, following the combined treatment with larvicides and ivermectin begun in 1988. Results: Toumanea 1 988 Prevalence = 78.7o/o CMFC = 52.12 1 999 Prevalence = 0.5o/o CMFC = 0.1 2.2. lvermectindistribution Distribution in the Tinkisso basin actually started in 1990 by OCP mobile teams. lt has continued to date throuqh CDTI. Overview of ivermectin distribution under CDTI Year No.Vrllages Population Pop. Treated Coverage 7o 1997 132 89309 64986 IJ 1 998 282 152037 64986 79.35 1 999 344 17 1779 1 36007 79.17 A39 -2 3. Entomological data From 1996, the good downward trend of transmission worsened at Fifa, and the gross ATP was between 442 and 1004. Corrected ATPs were over and above 100, and the maximum of 510 infective larvaeiman/year was recorded in 1998. This situation was normalised in 1999 when the ATP dropped to72 larvae/manlyear. The Savanna ATP dropped to 7 in 2000. 4. Larvicides used and larvae sensitivity to chemical insecticides Temephos, Vectobac 12AS, permethrin, Etofenprox and Teknar are the insecticides used in the basin. There is intermediate sensitivity to temephos 5 Evaluation of needs Human resources and training A five-member team (one entomologist, one entomologist technician, two captors, one driver and one boatman). Equipment: tools needed for dissection (1 pair of binoculars, etc..) treatment and ground prospecting (one boat and an outboard motor). 6 Points of capture, accessible points for prospecting and treatment (cf. Appended map). 7. Entomological evaluation of treatment Capture/dissection of blackflies and pool screening 8. Monitoring of the level of sensibility of vectors to larvicides used. Be careful with the use of organo-phosphorous chemicals (do not exceed 3 consecutive cycles). 9. Larvicide supply channel after OCP, and feasibility of coordinating ground treatment in the countries. A national supply channel has notyet been identified. Contacts have, however, been made with the following: the tt/inistry of Health; the Central Pharmacy (drug store) of Guinea the tVlulti-disease Surveillance Centre of Ouagadougou Suggest the creation of a medical entomologist position within the IVulti-Disease Surveillance Centre, to ensure management of residual entomological actrvities. A40 ..\t't- { ANNI'X 6 (-) .s -J\ -Y q J a J 0) L f o_ O c.-) g- q) -o ro a c c 50 0) 'o s O) s L.r) .c) o_ \a 1. J C) f- $< -s \ o J ]J Y @ O g (+{ I o a * P g F og. U BJ2Ol U) C) ()-1 +) C) ti 5 u oL a G. oTU C) (-) o o a 'oa C tr ---Y :f t 'ro ]v o. 'aC a CU CO 'o o --_Jl6 H a H& () H fr oU o )a A41 ANNEX 7 GROUND TREATMENT AFTER 2OO2 IN THE NIGER-MAFOU BASIN OBJECTIVE Study the feasibility of ground treatment so as to sustain the control of onchocerciasis transmission in the Niger-lVlafou basin. 1. CHARACTERISTICS OF THE MAFOU BASIN An important tributary on the right bank of the Niger. Length = 230 km South-North direction before the confluence. B tributaries of first and second order (a total of 980 km) Average rainfall = 1600mmlyear [/ain tributaries: Serinde, Kankan, Kinkou, Bale. Upper basin, rugged mountainous region with a series of pre-imaginal breeding sites. Regular flow all year round. Navigability is very uncertain. 2 EPIDEMIOLOGICAL SITUATION AND IVERMECTIN DISTRIBUTION 2.1. Epidemiologicalresults The results of epidemiological evaluations carried out show a remarkable drop in parasitic loads in the entire basin. Results: Yalawa 1986 : Prevalence = 78.1 / CMFC = 42.78 1999 : Prevalence= 16.2 / CIVIFC = 0.73 2.2. lvermectin distribution lvermectin distribution by national teams and OCP started in the basin in 1989. This has continued since 1997 to date through CDTI. ln 1997 651 villages were treated out of 1127 (57.8%) No of peopletreated =211571 outof 301 586(70.1%) L42 -2- 3. ENTOMOLOGICAL DATA The good downward trend in transmission got worse at Yalawa in 1997; ATp rose to 242 infeclive larvae/man/year. The situation became normal again in 1999, and in 2000 with a savanna ATP of 35 infective larvae/manlyear. 4 LARVICIDES USED The following were used in the basin: temephos, Vectobac 12AS, Permethrin, Etofenprox and Teknar. lntermediate sensitivity to temephos was observed. 5 EVALUATION OF NEEDS Human resources and training: a S-member team (1 entomologist, 1 entomologist technician, two captors, 1 driver and 1 boatman). Equipment: for dissecting (1 pair of binoculars, etc..) ground prospecting and treatment (1 boat, 1 outboard motor). 6 POINTS OF CAPTURE, ACCESSIBLE POINTS OF PROSPECTING AND TREATMENT (See appended map). On the 100, 200 and 300 stretches, 1 1 points out of 28 are accessible all year round. 7. ENTOMOLOGICAL EVALUATION OF TREATMENT Captu reld issecting blackfl ies and pool-screen ing 8 MONITORING OF LEVEL OF VECTOR SENSITIVITY TO LARVICIDES USED. Be careful using organo-phosphorous insecticides (do not exceed 3 consecutive cycles). I LARVICIDE SUPPLY CHANNEL AFTER OCP, AND POTENTIAL FOR COORDINATING GROUND TREATMENT !N THE COUNTRIES. A national supply channel is yet to be identified. Contacts have however, been made with the following: lVinistry of Health; Central drug store of Guinea lt/ u lti-d isease Surveillance Centre of Ouagad ougou Suggest the creation of a general medical entomologist post within the multi-disease su rveillance structu re for manag i ng resid ual entomolog ica I activities. L43 ANNI'\ 7 IiigLrrc I X adt P-', o H t-t O an zo CO)- $-( t-t (oE A fi, [L 9< H _o= tq L5o- a & OC FA -YO oJo ;C c) NL (!. z l$-- od a\ C) .1o lJ- A44 I ANNEX B GENERAL OUTLINE OF EXERCISE Carrying out feasibility study of blackfly larvrciding operations on the ground, in order to sustain the control of onchocerciasis transmission after the end of OCP activities. This study is exclusively centred on the foci identified by the EAC. These are where OCP wrll not have completely achieved its objectives by December 2002. Operations will be carried out by special national teams of the countries concerned, which operate within structures that are also national. These operations must be designed and carried out in close association with the chemotherapeutrc control through CDTI, and on the basis of the monitoring results of the epidemiological situation. Proposal of a plan for project presentation background of all action undertaken by OCP. a Current activities of control and surveillance; epidemiological and entomological; task distribution among national teams and OCP; means employed by these. Recent and current epidemiological results; trends. a Recent and current entomological results; trends. a Treatment: water stretches, seasons, application points, choice of insecticides, etc.. a Entomological surveillance: capture (sites, frequency, etc..) dissection? Pool- screening, other? a Projected duration of operations. . Numbers, profiles; . Technical equipment; . l\rleans of transport; . Operational means; " lnsecticide(s). kind, quantity, given the post-OCP situation of the market of larvicides previously used in large quantity, and sometimes exclusively by the Programme ,' Plan for envrronmental surveillance, useful insecticides, at least, once rn a year, a hydrobiologist should study the impact of the insecticide on the environment A45