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Planning for Trachoma Elimination, District by District

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Planning for Trachoma Elimination, District by District SUMMARY PROCEEDINGS ELEVENTH ANNUAL TRACHOMA CONTROL PROGRAM REVIEW PLANNING FOR TRACHOMA ELIMINATION, DISTRICT BY DISTRICT Atlanta, Georgia March 29-31, 2010 Supported by: Conrad N. Hilton Foundation Lions Clubs International Foundation Pfizer Inc. 1 “Planning for Trachoma Elimination, District by District” The Eleventh Annual Trachoma Control Program Review The Carter Center Atlanta, Georgia March 29-31, 2010 TABLE OF CONTENTS Acknowledgements…………………………………………………………………………………….……… i Acronyms…………………………………………………………………………………………………..……. ii Executive Summary……………………………………………………………………………….…………... iii Ethiopia Trachoma Control Program……………………………………………………………………….. 1 Mali Trachoma Control Program…………………………………………………….………………………. 7 Niger Trachoma Control Program……………..…………………………..………………………………... 11 Nigeria Trachoma Control Program………………………………………………………………………… 15 Governments of Sudan and Southern Sudan Trachoma Control Programs……………...………… 19 Maps and Summary Tables and Figures Map 1: Prevalence of TF in children aged 1-9 years, Sudan, Southern Sudan, and Ethiopia……… 29 Map 2: Prevalence of TT in adults 15 years of age and older, Sudan, Southern Sudan, and Ethiopia……………………………………………………………………………………………… 30 Map 3: Prevalence of TF in children aged 1-9 years, Ghana, Mali, Niger, and Nigeria…………...... 31 Map 4: Prevalence of TT in adults 15 years of age and older, Ghana, Mali, Niger, and Nigeria…… 32 Table 1: Summary of National Data from Trachoma Interventions……………………………………. 33 Table 2: National Trachoma Control Programs Annual Targets 2010………………………………… 34 Table 3: Carter Center-Assisted Implementation of SAFE, 1999…………………………………....... 35 Table 4: Carter Center-Assisted Implementation of SAFE, 1999-2009………………….…….……… 36 Fig. 1: Villages with Health Education, Carter Center-Assisted Countries………………….………… 37 Fig. 2: Household Latrines Constructed, Carter Center-Assisted Countries…………………………. 38 Fig. 3: Azithromycin Distribution, Carter Center-Assisted Countries………………………………….. 39 Fig. 4: Persons Operated for Trichiasis, Carter Center-Assisted Countries………………………….. 40 Special Sessions Lions Clubs of Ethiopia: District 411A Update……………………………………………………………….. 41 World Health Organization Update……………………………………….……………………………………. 42 Helen Keller International Update……………………………………………………………………………... 43 Pfizer Inc Update……………………………………………………………………………………………....... 44 International Trachoma Initiative Update……………………………………………………………………... 45 Research Triangle Institute International Update…………………………….………………………………. 46 The Carter Center Development Approach…………………………………………………………………... 47 TANA Study Update…………………………………………………………………………………………….. 48 TTT Project Update……………………………………………………………………………………………… 50 Global Trachoma Mapping Project………………………………………………………….…………………. 52 Integrated NTD Mapping………………………………………………………………………….…………….. 53 Cost of Surveys………………………………………………………………………………………………….. 55 Planning for Elimination in the Northern States of Sudan…………………………………………………... 57 Kayes and Koulikoro Data……………………………………………………………………………………… 58 Surgical Outreach in Mali……………………………………………………………………………………….. 60 Surgeon Audit and Recurrence………………………………………………………………………………... 61 Prevalence Survey Toolbox………………………………………………………………….…………………. 62 Coverage, Attitudes, and Uptake of Antibiotics………………………………………………………………. 63 Review of Coverage Survey Methods…………………………………………………………………………. 64 Appendix I: The Disease……………………………………………………………………………………... 66 Appendix II: Carter Center Trachoma Control Program Peer-Reviewed Articles 2009…………… 67 Appendix II: Achievements toward Ultimate Intervention Goals……………...……………………… 69 Appendix III: Agenda……………………………………………………………………………..…………… 87 Appendix IV: List of Participants…………………………………………………………...………………. 90 ACKNOWLEDGEMENTS The Carter Center Trachoma Control Program would like to acknowledge the support of the following donors: Corporations: Individuals: Pfizer Inc Edward E. Altemus Environmental Systems Research Institute, Inc. Charles and Deborah Austin Richard C. Blum Foundations and Organizations: Carol A. Crotty The Richard Allan Barry Family Charitable Foundation John and Cheryl Dimar The Arthur M. Blank Family Foundation Stanley and Wendy Drezek Bill & Melinda Gates Foundation Donal Grogan Community Foundation of Western Massachusetts William and Mary Ann Hardman Conrad N. Hilton Foundation Kathleen Hayes and Stephen Updegrove Delta Gamma Fraternity, Theta Chapter John and Terri Hussman The Elfenworks Foundation Morton P. Hyman The Hayes Foundation Ann L. Kalhorn The John C. and Karyl Kay Hughes Foundation Mark and Sandra Niblick The John P. Hussman Foundation, Inc. John J. Moores Lions Clubs International Foundation William H. Overby London School of Hygiene and Tropical Medicine Greg Randolph National Democratic Institute for International Affairs Walter and Tracy Schier Newpeak Foundation Lalit and Veneta Shahani The New York Eye and Ear Infirmary Virginia O. Skinner Francis I. Proctor Foundation Alan and Melodie Solway Rock Paper Scissors Foundation Ruth D. Wagoner Saint Alban’s of Bexley Episcopal Church The Stahl Family Foundation UNICEF And to many others, our sincere gratitude. ACRONYMS AMREF African Medical and Research OLS Operation Lifeline Sudan Foundation ORDA Organization for Rehabilitation BoC Board of Councilors and Development in Amhara BLTR Bilamellar Tarsal Rotation PCR Polymerase Chain Reaction cbm Christoffel Blindenmission PCT Preventative Chemotherapy CDC U.S. Centers for Disease Control PDB Prevention of Blindness and and Prevention Deafness CEO Chief Executive Officer PNLC(C) Programme National de Lutte CLTS Community Led Total Sanitation contre la Cecité CNHF Conrad N. Hilton Foundation RTI Research Triangle Institute CRS Cluster Random Sampling International DANIDA Danish International SAFE Surgery, Antibiotics, Facial Development Agency Cleanliness & Environmental DFID UK Department of International Improvement Development Sanplat Modified Mozambique Sanitation FINIDA Finnish International Platforms Development Agency SSI SightSaver’s International FMOH Federal Ministry of Health STH Soil Transmitted Helminths GET2020 Alliance for the Global STTEM Survey Toolkit for Trachoma Elimination of Blinding Trachoma Elimination Monitoring by 2020 TANA Trachoma Amelioration in GOS Government of Sudan Northern Amhara GOSS Government of Southern Sudan TEC Trachoma Expert Committee GTM Grarbet Tehadisso Mahber TRA Trachoma Rapid Assessment (Ethiopian NGO) TF Trachomatous Inflammation- HEW Health Extension Worker Follicular HKI Helen Keller International TI Trachomatous Inflammation HPD Health Programs Development Intense IDP Internally Displaced Persons TT Trachomatous Trichiasis IMRF International Medical Relief Fund TTT Treatment of Trachomatous IQR Inter-quartile Range Trichiasis IRB Institutional Review Board UIG/UTG Ultimate Intervention/Treatment ITI International Trachoma Initiative Goal JAMAL Arabic equivalent of SAFE UNICEF United Nations Children’s KAP Knowledge, Attitudes, and Education Fund Practices USAID United States Agency for LCIF Lions Clubs International International Development Foundation WHO World Health Organization LF Lymphatic Filariasis LGA Local Government Area (specific to Nigeria, analogous to a district) LSHTM London School of Hygiene and Tropical Medicine MALTRA Malaria and Trachoma Program MDA Mass Drug Administration MDG Millennium Development Goal MOH Ministry of Health NGO Non-Governmental Organization NPPB National Program for the Prevention of Blindness NTD Neglected Tropical Disease EXECUTIVE SUMMARY Planning for Trachoma Elimination, District by District The Eleventh Annual Program Review of trachoma control programs was held at The Carter Center, March 29-31, 2010. In addition to the six Carter Center-assisted programs, we were joined by our donors and partners from the World Health Organization, U.S. Centers for Disease Control and Prevention, International Trachoma Initiative, Helen Keller International, London School of Hygiene and Tropical Medicine, University of California San Francisco, Conrad N. Hilton Foundation, Pfizer Inc, Arthur M. Blank Foundation, Bill & Melinda Gates Foundation, Research Triangle Institute, the Task Force for Child Survival and Development, Sight Savers International, and the Lions Clubs International Foundation. In keeping with the theme of “Planning for Elimination, District by District,” presentations focused on program progress towards elimination goals to engender a shared vision in which every trachoma- endemic district has access to the SAFE strategy by 2015. All endemic districts must be actively controlling trachoma by 2015 to meet the target of Elimination by 2020! As in previous years, the primary objectives of the program review were to assess the status of the national trachoma control programs, identify challenges encountered in planning and implementing those programs, discuss solutions and shared experience, and to promote sharing and standardization of information. Discussions during the program review meetings are country-specific, but the impact is global. The achievements, challenges, solutions and lessons learned continue to guide the evolution of the GET 2020 Alliance. These proceedings reflect the thoughts, discussions and proposals made during the Eleventh Annual Program Review of trachoma control programs. Program review meetings offer a unique forum for trachoma control program managers, Carter Center staff, and partners to work face-to-face to review accomplishments and plan for the future. This year there was a tangible urgency from planners, partners
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