WHO District Level NTD Training Course

Revised: 30.6.2015(Global version) WHO District Level NTD Training course

Learner’s Guide

Module 8: Other Preventative Measures and Related Sectors

Session 8.1: Introduction to WASH and Vector Control

Part 1: Introduction:

Session Purpose:

The purpose of this session is to introduce the learner to the concept of intersectoral collaboration and the importance of WASH and Vector Control (VC) interventions for the control/elimination of 5 neglected tropical diseases (NTD) targeted for preventive chemotherapy(PC).

Prerequisite modules/sessions:

Module1

Learning Objectives:

By the end of this session, learners will:

 Understand why Water, Sanitation, and Hygiene (WASH) and Vector Control (VC) are important in control and elimination of Neglected Tropical Diseases (NTDs)  Understand how to collaborate with existing WASH and VC sectors in the district

Abbreviations and Acronyms

LF – Lymphatic filariasis

NTD – Neglected Tropical Disease

ONCHO - Onchocerciasis

PC – Preventive chemotherapy

SCH – Schistosomiasis

STH – Soil-transmitted helminthiasis

WASH – Water, Sanitation, and Hygiene

VC – Vector Control

Part 2: Key concepts:

Concept 1: WASH and NTDs

Water, sanitation, and hygiene (WASH) interventions are essential for the long-term control, and even elimination, of four of the PC NTDs: soil-transmitted helminthiasis (STH), trachoma, schistosomiasis (bilharzia), and lymphatic filariasis (LF).

Table 1: WASH intervention and disease impacted

Intervention Definition Disease impacted

Water Access to safe water for: drinking, face washing, hand LF,SCH and body washing and cleaning of foodstuffs and STH, Trachoma clothes to prevent or minimize reinfection.

Sanitation Sanitary latrines keep infected human excreta from SCH, STH coming into contact with humans, animals and Trachoma vectors, thereby minimizing the risk of reinfection in treated individuals and preventing new infections.

Hygiene Personal and environmental hygiene campaigns in LF, SCH communities to promote positive behaviors to prevent STH, Trachoma infection and morbidity and disabilities.

Concept 2: Vector control and NTDs

Vectors are living organisms that can transmit infectious diseases between humans or from animals to humans. Many of these vectors are bloodsucking insects, which ingest disease- producing microorganisms during a blood meal from an infected host (human or animal) and later inject it into a new host during their subsequent blood meal. LF, SCH, trachoma

and onchocerciasis are diseases transmitted by vectors. Vector control methods should be selected from a list of the available methods. Certain vector control methods are of known efficacy in particular settings.

Table 2 lists the vector control methods and their applicability to each vector-borne disease; however, methods must also be assessed locally.

Table 2: Methods used to control vector-borne diseases

(mosquitoes) Filariasis Lymphatic flies) (black Onchocerciasis (snails) Schistosomiasis (flies) Trachoma vector) (no STH

Category Sub-Category

Source reduction + Habitat manipulation + + Irrigation management & Environmental + + design Proximity of livestock + Waste management + + Mechanical Polystyrene beads + Natural enemy conservation + Biological Biological larvicides + Fungi + Insecticide-treated bednets + Indoor residual spraying Chemical Insecticidal treatment of habitat + + Chemical repellents + Adapted from Table 4.2 of WHO’s Handbook for integrated vector management

Concept 3: Inter sectoral Collaboration

In general WASH, VC, and NTD sectors work independently to achieve their complementary goals because of different health and development priorities. Incidence of diarrheal disease has traditionally been the health indicator of most importance to the WASH sector, and crop yield is the indicator of choice for the VC sector. Because WASH and VC break the cycle of transmission of many NTDs,

inter sectoral collaboration at the district level is vital for effective NTD control and elimination.

Power point slides:

Slides: 1-9 of Introduction to WASH and Vector control

Part 3: Activities

Facilitators will choose sessions depending on the disease endemicity in a country and plan exercise such as (i) Role play–3 groups- WASH, Vector control sector and district NTD unit (ii) Open discussion on how to collaborate with WASH and Vector control (iii) Case studies

Part 4: Summary Job aide related to this module( include where applicable) Job aides for the session 8.1(introduction)

Key words (maximum 10) Key action points for district level personnel

Part 5: References and Additional Resources

References 1) Accelerating work to overcome the global impact of NTDs – A Roadmap for Implementation, WHO. 2011.

2) Integrated Vector Management – PAHO/WHO. http://www.paho.org/hq/ integrated- vector-management-IVM and Itemid. (2014)

3) RTI Integrated Vector Management project. http://www.ivmproject.net/about/index.cfm?fuseaction=static&label=vbdzcontrol. (2014)

4) Water, Sanitation, and Hygiene Online Manual Resource. http://www.washntds.org (2014).World Health Organization – NTDS. www.who.org. (2014)

Module 8: Other Preventative Measures and Related Sectors

Session 8.2: Soil-Transmitted Helminthiasis (Intestinal Parasites)

Part 1: Introduction:

Session Purpose:

The purpose of this session is to introduce WASH interventions that contribute to the control soil-transmitted helminthiasis (STH).

Prerequisite modules/sessions

Module 1 and Session 8.1

Learning Objectives:

By the end of this session, learners will be able to:

 Explain how WASH interventions control STH

 Propose strategies for collaborating with water, sanitation, education, and other sectors to effectively control STH.

Abbreviations and Acronyms

NTD – Neglected Tropical Disease

STH – Soil-Transmitted Helminthiasis

WASH – Water, Sanitation, and Hygiene

Part 2: Key concepts:

Concept 1: Transmission of STH infection

STH is caused by infection with intestinal parasites. The most common are roundworm, whipworm and hookworm. These parasites thrive in warm and humid climates and in communities with limited access to water and basic sanitation. STH is spread through contact with feces of infected individuals. Infection occurs when:

 Humans ingest the infective eggs of roundworm and whipworm by eating contaminated food and eating with unwashed hands or utensils;

 Hookworm larvae penetrate of the skin, usually of the feet.

Symptoms of STH include malnutrition, anemia and fatigue. Children with STH experience poor cognitive and physical development.

Concept 2: WASH and STH Control

Improving access to water and sanitation and good hygiene practice is essential to stop the cycle of STH transmission. Mass drug administration campaigns with a single dose of donated Albendazole or mebendazole (Vermox™) target children at risk of STH. However, reinfection nearly always occurs following treatment when access to improved water and sanitation facilities and knowledge of good hygiene practices (WASH) are limited. Thus, WASH is essential to interrupt the cycle of STH transmission.

 Water - Access to potable water for hand washing and cleaning of food stuffs minimizes reinfection.

 Sanitation - Sanitary latrines keep infected human excreta from the areas where people live, work, and play, further minimizing the risk of re-infection in treated individuals and preventing new infections.

 Hygiene Education - Hygiene education promotes personal and environmental hygiene in communities where STH is endemic.

Concept 3: Intersectoral Collaboration and STH Control

Many WASH interventions can be undertaken at the district and community levels to control STH. Use the following table to identify partners and organizations from other sectors to implement the following WASH activities.

Table 1: Inter sectoral Collaboration to Control STH (Group Planning Activity)

Intervention Activities Strategies for Sector/partner including other organization sectors

Water Facilitate the provision of sustainable safe water services for hygiene and drinking

Promote household treatment and proper storage of water

Sanitation Ensure access to household and school latrines to minimize open defecation

Ensure that processes are in place for regular cleaning and maintenance of latrines

Hygiene Promote wearing shoes when walking outside

Education Promote hand-washing before cooking and eating and after defecating

Power point slides:

Slides 1-9 from WASH (Session 8.2-8.5) and pick up additional slides from Session 8.1: introduction

Key message:

• Infection occurs when soil or food contaminated with fecal matter harboring eggs is ingested, or when larvae living in soil penetrate bare skin. • Treatment is an important part of control. • Reinfection of intestinal parasites nearly always occurs following treatment when access to WASH is limited. • WASH interventions break the cycle of STH transmission.

Part 3: Activities:

The course facilitator will distribute the table 1 ( given above) to 3 groups of participants. The participants will complete the exercise and one from each will present.

Part 4: Job aides

Key words (maximum 10) Key action points for district level personnel

Part 5: Reference and Resources:

1. Strunz EC, Addiss DG, Stocks ME, Ogden S, Utzinger J, et al. (2014) Water, Sanitation, Hygiene, and Soil-Transmitted Helminth Infection: A Systematic Review and Meta-Analysis. PLOS Med 11(3): e1001620. (Accessed June 23, 2015 http://www.plosmedicine.org/article/fetchObject.action?uri=info:doi/10.1371/journal.pme d.1001620&representation=PDF).

2. Children Without Worms (2014). Controlling STH is an urgent matter. Accessed 23 June 2015 – www.childrenwithoutworms.org).

3. WASH NTD (2013). Water, sanitation, and hygiene online manual resource for neglected tropical diseases (Accessed 21 June 2015 http://www.washntds.org/).

4. World Health Organization (2015). Neglected tropical diseases – Intestinal Worms (Accessed 21 June 2015 http://www.who.int/intestinal_worms/en/).

Module 8: Other Preventative Measures and Related Sectors

Session 8.3: Blinding Trachoma

Part 1: Introduction:

Session purpose:

The purpose of this session is to introduce WASH and Vector control interventions that help to eliminate blinding trachoma.

Prerequisite modules/sessions:

Module 1 and Session 8.1

Learning objectives:

By the end of this unit, learners will be able to:

 Explain how WASH interventions and VC eliminate blinding trachoma  Propose strategies for collaborating with water, sanitation, education, and other sectors to effectively eliminate blinding trachoma

Abbreviations and Acronyms

SAFE Strategy – Surgery, Antibiotics, Facial Cleanliness, and Environmental Change

TT – Trachomatous trichiasis

VC – Vector Control

WASH – Water, Sanitation, and Hygiene

Part 2: Key concepts

Concept 1: Transmission of Trachoma infection

Blinding trachoma is an infectious eye disease which leads to blindness if not detected and treated early. Blinding trachoma is caused by recurring bacterial infection of the eyes, which results in scarring of the eyelids; eventually the eyelids turn inwards, causing the eyelashes to scrape the cornea, resulting in pain and irreversible blindness.

Infection is spread by eye-seeking flies (which breed in human feces), or with fingers, hands, clothing or bedding contaminated with discharge of the eyes and nose from an infected individual.

Concept 2: The SAFE Strategy

The SAFE strategy is an integrated approach to combating the disease that includes components of WASH and VC: Surgery to correct inturned eyelids, Antibiotic treatment with Zithromax®, Facial cleanliness to remove infectious discharge, and Environmental sanitation to reduce open defecation. Facial cleanliness requires access to water and knowledge of good hygiene practice. Environmental sanitation requires access to safe and hygienic latrines to minimize open defecation and reduce breeding opportunities for flies, the vectors.

Concept 3: WASH and Blinding Trachoma Elimination

Improving access to water and sanitation and good hygiene practice is essential to eliminate blinding trachoma. Access to treatment for TT is essential to mitigate the consequences of disease. Access to WASH is to prevent disease is just as vital.

 Water – Access to water for face-washing and washing of clothing and bedding prevents infection.

 Sanitation – Increasing access to and use of household latrines minimizes open defecation and breeding sites of flies and thereby, helps to control the vector and one of the routes of transmission.

 Hygiene Education – Promoting regular face washing removes eye and nasal discharge contaminated with bacteria. Promoting regular washing of clothing and bedding with soap prevents further spread of disease.

Concept 4: Vector control in eliminating blinding Trachoma

The following vector control (VC) interventions are closely related to WASH interventions and help to eliminate blinding trachoma:

 Reduce or eliminate breeding places by promoting access to and use of latrines.

 Prevent flies from entering homes or schools.  Eliminate flies or larvae using physical or chemical methods.

Concept 5: Inter sectoral collaboration in eliminating blinding Trachoma

Many WASH and vector control (VC) interventions for trachoma by collaborating with district and community levels to eliminate blinding trachoma. Use the table 1 to identify partners from other sectors to implement the following WASH and VC interventions.

Table 1: Inter sectoral collaboration in eliminating blinding Trachoma

(Group planning activity)

Intervention Activities Sector/partner Strategies for inter- organization sectoral collaboration

Water Facilitate the provision of sustainable safe water services for face-washing and washing of clothing and bedding to prevent infection.

Sanitation Increase access to and use of household latrines to minimize open defecation and breeding sites.

Ensure regular cleaning and maintenance of latrines.

Hygiene Promote regular face washing to remove Education eye and nasal discharge contaminated with bacteria.

Promoting regular washing of clothing and bedding with soap to prevent further spread

Vector Reduce or eliminate breeding places by Control promoting access to and use of latrines

Prevent flies from entering homes or schools

Eliminate flies or larvae using physical or chemical methods

Power point slides:

Facilitator to pick up relevant slides from Session 8.2-8.5 on WASH in NTDs and Session 8.2-8.5 on Vector control and Session 8.1 on Introduction

Key messages

1. Infection is spread by eye-seeking flies (which breed in human feces), or with fingers, hands, clothing or bedding contaminated with discharge of the eyes and nose from an infected individual. 2. Improving access to water and sanitation and good hygiene practice is essential to eliminate blinding trachoma. 3. VC interventions are closely related to WASH interventions and help to eliminate blinding trachoma 4. The SAFE strategy is an integrated approach to combating the disease that includes components of WASH and VC.

Part 3: Activity:

The facilitator will divide participants into 3 groups and ask them to work on inter-sectoral collaboration (Refer to table 1 above). The one rapporteur will present their plan.

Part 4: Job aides:

Key words (maximum 10) Key action points for district level personnel

Part 5: References and additional resources:

References

1. WASH NTD (2013). Water, sanitation, and hygiene online manual resource for neglected tropical diseases (Accessed 21 June 2015 http://www.washntds.org/).

2. World Health Organization (2015). Neglected tropical diseases – Trachoma (Accessed 21 June 2015 http://www.who.int/trachoma/en/).

3. Emerson P, Frost L, Bailey R, Maby D (2006). Implementing the SAFE Strategy for trachoma control: A toolbox of interventions for promoting facial cleanliness and environmental improvement. The Carter Center Trachoma Control Program (Accessed 23 June 2015 https://www.cartercenter.org/documents/2302.pdf).

4. International Trachoma Initiative (2015). About trachoma – resources (Accessed 23 June 2015 http://www.trachoma.org/resources).

Module 8: Other Preventative Measures and Related Sectors

Session 8.4: Schistosomiasis (Bilharzia)

Part 1: Introduction:

Session Purpose:

The purpose of this session is to introduce WASH and VC interventions that contribute to the control schistosomiasis (SCH).

Prerequisite modules/sessions:

Module 1 and Session 8.1

Learning Objectives:

By the end of this unit, learners will be able to:

 Explain how WASH and VC interventions control SCH

 Propose strategies for collaborating with water, sanitation, education, and other sectors to effectively control SCH

Abbreviations and Acronyms:

SCH – Schistosomiasis

VC – Vector Control

WASH – Water, Sanitation, and Hygiene

Part 2: Key Concepts:

Concept 1: Transmission of Schistosomiasis infection

Schistosomiasis (SCH), also known as bilharzia, is caused by infection with parasitic blood flukes. People become infected when they come into contact with water bodies harboring freshwater snails that are the vector for the parasite. The parasite leaves the snail and enters the skin of people when they are in the water. The eggs of these parasites cause massive damage to tissues and organs, resulting in illness and even death. Morbidity is

caused by eggs deposited in the human host by the parasite that are not passed out in the urine or stools but become lodged in body tissues. The symptoms are related to the number and location of the eggs.

Concept 2: WASH and SCH Control

The eggs of the parasites causing schistosomiasis are shed by infected individuals through the feces and urine, which contaminate water bodies. People bathing, washing clothes or working in the water acquire the disease when parasites enter the skin. Access to basic sanitation and clean water and behavior changes are essential to break the cycle of transmission.

 Water – Access to safe water for drinking and non-drinking purposes, such as laundry, bathing, and swimming decreases contact with contaminated surface water.

 Sanitation – Increasing access to latrines near freshwater and encouraging use of latrines reducing open defecation and urination community-wide minimizes water contamination; individual household-level sanitation coverage is not sufficient to prevent transmission of SCH because a single inflected individual can contaminate a water body.

 Hygiene Education – Promoting behavior change to discourage the use of contaminated surface water for activities such as bathing, washing clothes, and swimming breaks the cycle of SCH transmission.

Concept 3: Vector control in SCH Control

The snails (the vectors) are sensitive to temperature changes and require consistent ecological conditions to survive. Environmental changes, such as removing vegetation that the snails need to breed, and molluscicides are effective vector control measures.

Concept 4: Inter sectoral Collaboration in SCH Control

Many WASH and VC interventions can be undertaken at the district and community levels to control SCH. Use the following table to identify partners and organizations from other sectors to implement the following WASH and VC interventions.

Table 1: Inter sectoral Collaboration to Control SCH (Group Planning Activity)

Element Activities Sector/partner Strategies for organization including other sectors

Water Increase access to safe water for drinking and non-drinking purposes, such as laundry, bathing, and swimming to decrease contact with contaminated surface water.

Sanitation Reduce open defecation and urination community-wide to minimize water contamination

Hygiene Promote behavior change to discourage the use Education of contaminated surface water for activities such as bathing, washing clothes

Vector Reduce or eliminate breeding places by Control removing vegetation in the bodies of water

Use molluscicides to kill the snails

Power point slides:

Facilitator to pick up relevant slides from Session 8.2-8.5 on WASH in NTDs and Session 8.2-8.5 on Vector control and Session 8.1 on Introduction.

Key messages:

1. The eggs of the parasites causing schistosomiasis are shed by infected individuals through the feces and urine, which contaminate water bodies.

2. Access to safe water for drinking and non-drinking purposes, such as laundry, bathing, and swimming decreases contact with contaminated surface water. 16

3. Reducing open defecation and urination community-wide minimizes water contamination and breaks the cycle of SCH transmission

4. Snails are vectors of SCH. Removing vegetation around the body of water reduces their ability to reproduce.

Part 3: Activities:

The facilitator will divide participants into 3 groups and allocate the exercise from Table 1 on Inter-sectoral collaboration. One participant will present key plan from each group.

Part 4: Job- aides:

Key words (maximum 10) Key action points for district level personnel

Part 5: References and Resources

1. WASH NTD (2013). Water, sanitation, and hygiene online manual resource for neglected tropical diseases (Accessed 21 June 2015 http://www.washntds.org/).

2. World Health Organization (2015). Neglected tropical diseases – Schistosomiasis (Accessed 21 June 2015 http://www.who.int/schistosomiasis/en/).

3. World Health Organization (2012). Handbook for integrated vector management. Geneva, WHO (Accessed 21 June 2015 http://whqlibdoc.who.int/publications/2012/9789241502801_eng.pdf).

4. Schistosomiasis Control Initiative (2015). What we do. (Accessed 23 June 2015 http://www3.imperial.ac.uk/schisto/whatwedo).

Module 8: Other Preventative Measures and Related Sectors

Session 8.5: Lymphatic Filariasis

Part 1: Introduction:

Session Purpose

The purpose of this session is to introduce WASH and VC interventions that contribute to lymphatic filariasis (LF) elimination.

Prerequisite modules/sessions

Module 1 and Session 8.1

Learning Objectives

By the end of this unit, learners will be able to:

 Explain how WASH and VC interventions eliminate LF

 Propose strategies for collaborating with water, sanitation, education, and other sectors to effectively eliminate LF

Abbreviations and Acronyms

LF – Lymphatic filariasis

VC – Vector Control

WASH – Water, Sanitation, and Hygiene

Part 2: Key Concepts:

Concept 1: Transmission of Lymphatic filariasis

Lymphatic Filariasis (LF) is a parasitic disease spread by mosquitoes. Microfilariae circulating in the blood of an infected person are taken up in a blood-meal by a mosquito, where the microfilariae develop into infective larval stages. When the mosquito bites a human, the parasite is transmitted to the human and the lifecycle continues

The adult parasites disrupt the operation of the body’s lymphatic system, resulting in severe swelling and permanent disfigurement of the limbs and genitalia. Sufferers are prone to bacterial skin infections that can result in inflammation and swelling. These infections worsen the effects of lymphedema and can lead to further complications, including severe infection and permanent disability. These disabilities result in economic loss for the community, as well as physical and mental suffering for patients.

Concept 2: WASH in eliminating LF

Secondary infections occur when bacteria enter the body through lesions on limbs affected by lymphedema, leading to painful infections and further swelling. Washing affected limbs and feet daily with clean water and soap, and especially keeping the spaces between fingers and toes clean, will decrease the frequency of infection. Hygiene in conjunction with exercise and wound treatment can also reduce swelling and enable the individual to gain more mobility.

 Water – Increasing access to clean water encourages water use for hygiene

 Hygiene Education – Washing limbs (especially between fingers and toes) daily with clean water and soap prevents infections and reduces morbidity caused by the disease.

Concept 3: VC and LF Elimination

The choice of which VC interventions to implement for LF elimination should take into account the breeding habits and biting behavior of the different vector species. Control measures targeted at vectors of malaria and vectors of dengue are likely to have an impact on transmission of LF in areas where these diseases overlap in their distribution. Refer to Table 8.1.2 for common VC methods.

Concept 4: Intersectoral Collaboration and LF Elimination

Many WASH and VC interventions can be undertaken at the district and community levels to eliminate LF. Use the following table to identify partners and organizations from other sectors to implement the following WASH and VC interventions. 19

Table 1: Inter sectoral Collaboration to eliminate Lymphatic filariasis

(Group Planning Activity)

Element Activities Sector/partner Strategies for including organization other sectors

Water Increase access to clean water to encourage water use for hygiene

Hygiene Wash limbs (especially between Education fingers and toes) daily with clean water and soap to prevent infections and reduce morbidity caused by the disease

Vector Control Cover and/or treat water storage systems to limit mosquito habitat (WASH-related) Decrease open sewer systems and black water drainage that provide breeding sites for vector mosquitoes

Power point slides:

Facilitator to pick up relevant slides from Session 8.2-8.5 on WASH in NTDs and Session 8.2-8.5 on Vector control and Session 8.1 on Introduction.

Key messages:

1. LF is a parasitic disease spread by mosquitoes, the vector

2. WASH interventions – removing standing water from the environment – can reduce the number of mosquitoes that transmit LF

3. Increasing access to clean water encourages limb washing to reduce morbidity caused by disease.

Part 3: Activities:

The facilitator will divide participants into 3 groups and allocate the exercise from Table 1 on Inter-sectoral collaboration. One participant will present key plan from each group.

Part 4: Job- aides:

Key words (maximum 10) Key action points for district level personnel

Part 5: References and additional resources:

1. WASH NTD (2013). Water, sanitation, and hygiene online manual resource for neglected tropical diseases (Accessed 21 June 2015 http://www.washntds.org/).

2. World Health Organization (2015). Neglected tropical diseases – Lymphatic Filariasis (Accessed 21 June 2015 http://www.who.int/lymphatic_filariasis/en/).

3. World Health Organization (2012). Handbook for integrated vector management. Geneva, WHO (Accessed 21 June 2015 http://whqlibdoc.who.int/publications/2012/9789241502801_eng.pdf).

4. Addiss DG, Brady MA (2007). Morbidity management in the Global Programme to Eliminate Lymphatic Filariasis: a review of the scientific literature. Filaria Journal, 6:2 doi: 10.1186/1475-2883-6-2 (Accessed 23 June 2015 http://www.filariajournal.com/content/pdf/1475-2883-6-2.pdf).

Module 8: Other Preventative Measures and Related Sectors

Session 8.6: Onchocerciasis (River Blindness)

Part 1: Introduction:

Session Purpose:

The purpose of this session is to introduce VC interventions that contribute to the elimination of onchocerciasis (ONCHO).

Prerequisite modules/sessions:

Module 1 and Session 8.1

Learning Objectives:

By the end of this unit, learners will be able to:

 Describe VC interventions used to control ONCHO

Abbreviations and Acronyms:

ONCHO – Onchocerciasis

VC – Vector Control

WASH – Water, Sanitation, and Hygiene

Part 2: Key Concepts:

Concept 1: Transmission of Onchocerciasis infection

Onchocerciasis (ONCHO) is a parasitic disease caused by a filarial worm that is transmitted to humans through the repeated bites of infected black flies, which breed in fast-flowing rivers and streams. ONCHO is both an eye and skin disease. The death of microfilariae causes severe and unrelenting itching and disfiguring skin disease. In the eyes, the death of microfilariae may lead to visual loss and irreversible blindness in some individuals. The primary intervention to eliminate ONCHO is treatment with ivermectin distributed through mass drug administration campaigns in endemic areas.

Concept 2: WASH and ONCHO control

ONCHO is a water-related disease because the vectors require fast-moving rivers as breeding sites. However, WASH interventions do not contribute to ONCHO elimination.

Concept 3: Vector control in controlling ONCHO

Vector control involves killing the larvae of the black fly vectors through aerial spraying of insecticides. VC was the primary intervention in the 1970s and 1980s. However, this intervention is no longer considered feasible or cost-effective.

Power point slides:

Facilitator to pick up relevant slides from Session 8.2-8.5 on WASH in NTDs and Session 8.2-8.5 on Vector control and Session 8.1 on Introduction.

Key Message:

1. The primary intervention to control Onchocerciasis is ivermectin distributed through mass drug administration campaigns in endemic areas.

2. Vector control in Onchocerciasis would be useful in controlling the diseases.

Part 3: Activity:

Participants are divided into 2 groups and each will discuss on involving different sectors in Onchocerciasis control.

Part 4: Job aides

Key words (maximum 10) Key action points for district level personnel

Part 5: References and additional resources:

1. World Health Organization (2015). Neglected tropical diseases – Onchocerciasis (Accessed 21 June 2015 http://www.who.int/onchocerciasis/en/).

2. World Health Organization (2012). Handbook for integrated vector management. Geneva, WHO (Accessed 21 June 2015 http://whqlibdoc.who.int/publications/2012/9789241502801_eng.pdf).