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158 reach non-enrolled school age children and awareness in the community patients reported a considerable positive impact on their work and 44.6% if targeting 2020 to control both schistosomiasis and soil-transmitted (78/175) reported improved sex lives. Of those patients operated, 77% helminths in Ethiopia. (54/70) indicated satisfaction after surgery and noted improvement in their daily lives. Dissatisfied patients had developed postoperative secondary 500 infections that were managed with supportive therapy. This study shows that the management of hydrocele surgery can be done in a district TO INTEGRATE OR NOT TO INTEGRATE? DEVELOPING AN hospital setting in Mali without major complications and achieve general EVIDENCE-BASED TOOL FOR NEGLECTED TROPICAL DISEASE patient satisfaction. Consequently, the LF morbidity management and CONTROL disability prevention project will be expanded to other HDs. Claire J. Standley1, Ellie Graeden2, Justin Kerr2, Erin M. Sorrell1, Rebecca Katz1 502 1George Washington University, Washington, DC, United States, 2Talus ACHIEVING THE ENDGAME: IMPROVING INTEGRATED CASE Analytics, Boulder, CO, United States SEARCHES FOR GUINEA WORM DISEASE AND TRACHOMA While evidence from clinical and modeling studies have demonstrated the TO ACHIEVE ERADICATION AND ELIMINATION TARGETS potential benefit of integrating vertical disease programs, few evidence- Lucas E. Buyon1, Randall Slaven2, Paul Emerson3, Jonathan King4, based tools exist to assist decision makers in evaluating and comparing Donald Hopkins2, Kelly Callahan2 approaches for integration of control measures, to determine the most 1Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United impactful and cost-effective approaches for their setting. We have created States, 2The Carter Center, Atlanta, GA, United States, 3International an application available for mobile devices or on the web, with a simple Trachoma Initiative, Atlanta, GA, United States, 4World Health user interface, to support on-the-ground decision-making for integrating Organization, Geneva, Switzerland disease control programs or their components, given local conditions and practical constraints. The model upon which the tool is built provides Guinea worm disease and trachoma are both neglected tropical diseases predictive analysis for the effectiveness of integration of schistosomiasis (NTDs) slated for eradication and elimination as a public health problem, and malaria control, two common parasitic diseases with extensive respectively, by the World Health Organization. In 2010, The Carter Center, geographical and epidemiological overlap, and which result in significant the Ghana Ministry of Health and local partners, carried out integrated morbidity and mortality in affected regions. Working with data from case searches for rumors of possible cases of Guinea worm disease and countries across sub-Saharan Africa and the Middle East, we present here persons with trachomatous trichiasis (TT), the end stage of trachoma. a proof of principle for the use of our tool in providing guidance on how These case searches were conducted to meet eradication and elimination to optimize integration of vertical disease control programs. targets. The first series of case searches were carried out in four districts, which were searched community to community, with patients referred to 501 a centralized surgical facility. This method of searching did not adequately cover the target population and resulted in low surgical uptake. The SURGICAL MANAGEMENT OF MORBIDITY DUE TO second series of case searches, which were conducted house-to-house LYMPHATIC FILARIASIS: HYDROCELE SURGERY IN HEALTH with patients being offered immediate investigation of suspected Guinea DISTRICT HOSPITALS IN MALI worm disease cases and TT surgical care either in the home or an adjacent primary care facility. This method resulted in higher surgical uptake. 1 2 2 Massitan Dembélé , Benoit Dembele , Zana Berthé , Seydou The house to house immediate resolution approach was also shown to 2 3 2 2 Goita , Salif Seriba Doumbia , Boubacar Guindo , Modibo Keita , be more cost effective. The cost to investigate suspected cases of both 1 4 2 Abdoul Karim Sidibé , Steven Reid , Marily Knieriemen , Yaobi diseases in the house to house immediate response approach was about 5 Zhang USD$13.99 per case examined, compared to a cost of $19.78 per case 1Direction Nationale de la Santé, Ministère de la Santé et de l’Hygiène examined in the community with referral to surgical facilities approach. Publique, Bamako, Mali, 2Helen Keller International, Bamako, Mali, A review of the two approaches showed significant cost differences and 3Malaria Research and Training Center, Filariasis Research Unit, Bamako, favorable outcomes to the house to house immediate response approach. Mali, 4Helen Keller International, New York, NY, United States, 5Helen This approach should be considered an option for disease “end game” Keller International, Regional Office for Africa, Dakar, Senegal where case searches are required to meet targets. This approach should Mali is committed to national lymphatic filariasis (LF) elimination by be considered in an integration fashion with other NTDs to maximize cost 2020. The program has two main components: interrupting transmission saving and efficient use of resources. of LF through mass drug administration and managing morbidity and preventing disability. Mali has achieved great progress toward LF 503 elimination: to date, 31 of the 63 health districts (HDs) have reached the ARE WE REACHING EVERYONE AS WE MOVE FROM criteria to stop MDA. However, improvements in morbidity management and disability prevention are more difficult to achieve. Interventions for CONTROL TO ELIMINATION OF NTDS: FINDINGS FROM AN the surgical management of hydrocele and lymphedema management INTEGRATED TREATMENT COVERAGE SURVEY IN NORTHERN were introduced in 2012. These interventions are very demanding by NIGERIA the patients because of social impacts in their daily live. From 2014-15, Nazaradden Ibrahim1, Safiya Sanda1, Laura Senyonjo2, Sunday the national program, with the support of HKI with funding from the Isiyaku1 End Fund, performed surgical treatment of 369 LF patients in 16 HDs. 1Sightsavers, Kaduna, Nigeria, 2Sightsavers, Haywards Heath, United General practitioners performing surgery were trained on hydrocele case Kingdom management and hydrocele cases were identified at the community level. Surgeons obtained informed consent prior to the surgical procedure Countries like Nigeria have developed and are implementing programmes and maintained patient records. A descriptive analysis to show the for integrated control of Neglected Tropical Diseases (NTDs). Sightsavers impact of hydrocele management was performed on 175 patients who is leading consortium of partners in scale-up for elimination of NTDs were included in this analysis based on the completeness of the patient in northern Nigeria. However, little data are available to verify reported record. The median age of patients was 52 years and 75% (132/175) coverages of previously conducted Mass Drug Administration (MDA). were married. The majority of patients 82.3% (144/175) did not report The purpose of this presentation is to validate the reported coverage postoperative complications. The median duration of hospitalization from Community Drug Distributors (CDD) through integrated post-MDA was 4 days (ranging 2-55 days). Results showed that 32.6% (57/175) astmh.org 159 coverage survey in Kaduna, Katsina and Niger states. This also highlights 505 differences by drug type, persons with disabilities (PWD) and reasons for non-compliance. A population based survey using two-stage cluster FINDINGS FROM A SITUATIONAL ANALYSIS FOR sampling methods was conducted to verify the proportion of individuals INTEGRATED COMMUNITY CASE MANAGEMENT IN RURAL who ingested the drugs during last rounds of MDA. Washington Group HEALTH ZONES OF HAUT-KATANGA IN THE DEMOCRATIC (WG) questions were integrated into the questionnaire. Since not all drugs REPUBLIC OF THE CONGO were distributed at the same time, to reduce recall bias, drug samples were shown to participants during the survey. A total of 7,688 persons Jean-Yves Mukamba1, André Bope Bope2, Annie Ndaya B3, Eric were enrolled from six Local Government Arears (LGAs) in three states. Swedberg4, Troy Martin5 Overall, the therapeutic coverages in survey population were lower than 1PATH, Kinshasa/Gombe, Democratic Republic of the Congo, 2PSI, those reported by CDDs. 58.6% (95% CI 56.0-61.2) and 68.7% (95% Kinshasa/Gombe, Democratic Republic of the Congo, 3National Program CI 66.1-71.3) swallowed Mectizan/Albendazole in Kubau and Soba on Diarrhea Prevention, Kinshasa/Gombe, Democratic Republic of the LGAs of Kaduna state respectively. Two LGAs in Katsina had coverage of Congo, 4Save the Children, Fairfield, CT, United States, 5PATH, Seattle, WA, 54.9% and 50.4% (95% CI 52.3-57.4 and 47.6-52.9) while the reported United States coverage was 18% and 102% respectively. Niger had survey coverage Though rich with resources, the population of Katanga province in the of 66.2% (95% CI 64.9-70.4) in one LGA while they reported 32%. Democratic Republic of Congo (DRC) is primarily rural, poor and harbors Large proportions of eligible persons with severe disability were missed some of the highest child mortality rates in country. The province also has during MDA for all drugs. Among eligible population in Kaduna, 3.5% of the lowest ratio of health care workers (HCWs)

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