10:15 AM – 12:00 PM (CDT) Symposia and Scientific Sessions

 Overcoming the lymphatic filariasis and onchocerciasis cliff to accelerate the elimination of two filarial diseases     

Symposium

Lymphatic filariasis (LF) and Onchocerciasis (OV) are two major filarial diseases targeted by Act to End NTDs I West program. In most endemic countries, the LF and OV mass drug administration (MDA) represents the largest platform for the control and elimination of neglected tropical diseases as it often involves millions of people to be treated or surveyed. The two conditions share many programmatic features for program implementation, drug usage (both using lvermectin) and community-based platforms for mass drug administration. In several countries, the LF and OV programs are under the same leadership and management of one coordinator, which in many instances, facilitates the coordination and collaboration with donors, partners, and stakeholders, as well as the interactions with the Mectizan Donation Program (MDP).

A panel of implementing partners, endemic country program managers and scientists will share experiences and discuss the OV/LF cliff co-investigations, and join surveillance for LF and OV.   

Presenters:

• Dr. Georges Nko’Ayissi (Cameroon, Ministry of Public Health)

• Dr. Ernest K Mensah (FHI 360/Ghana)

• Dr. Katherine Gass (Task Force for Global Health)

• Dr. Kimberly Won (CDC)

• Dr. Dr. N'Gassa Kadia Marie Hugues (Cote d'Ivoire, Ministry of Health)  

 

12:00 – 1:45 PM (CDT) Poster Sessions

Assessing health system's performance for Neglected Tropical Diseases (NTDs) through WHO's Data Quality Assessment (DQA) tool in Four West African Countries

Poster Presentation (Session A)

The WHO's DQA for NTDs is an important Monitoring and Evaluation (M&E) tool that can be used after Mass Drug Administration (MDA) to analyze data quality. The tool evaluates two parts: 1) Verification of MDA data, which includes verification factor (VF, ratio of recounted and reported numbers) for up to five indicators, and 2) An assessment of data management and reporting system through M&E structure, Indicator reporting guidelines, Data-collection, reporting tools, Data management processes, and Links with the national reporting system.

Data across seven DQAs (84 service delivery points) from four West African countries within USAID's Act to End NTDs | West program will be summarized and explained in this poster presentation.

Presenters:

• Kaustubh Wagh (FHI 360)

 

 Maintaining elimination of trachoma as a public health problem: Post-validation surveillance plans in validated countries     

Poster Presentation (Session A)

Trachoma is targeted for global elimination as a public health problem by 2030. Repeated infections with Chlamydia trachomatis lead to inner eyelid scarring, causing the eyelashes to turn in and rub the cornea (trachomatous trichiasis, or TT) which can lead to blindness. The WHO-endorsed SAFE strategy (Surgery, Antibiotics, Facial cleanliness and Environmental improvement) is used to eliminate trachoma. To date, 15 countries have been validated by WHO as having eliminated trachoma. National programs submit dossiers to WHO to be validated. In these dossiers, plans to conduct post-validation surveillance (PVS) are described.

This poster will examine countries' approaches to post-validation surveillance. 

Presenters:

• Achille Kabore (FHI 360)

• Stephanie L. Palmer (FHI 360)

 

Assessing Impact of Ivermectin and Albendazole Mass Drug Administration on Transmission of Lymphatic Filariasis in 24 Districts in Senegal      

Poster Presentation (Session A)

Mapping of lymphatic filariasis was conducted in Senegal in 2003-2010 and found 51 of 79 districts endemic with Wuchereria bancrofti parasite antigenemia prevalence in sentinel sites of 1.0 to 78%. Annual mass drug administration(MDA) with ivermectin and albendazole was initiated in 2007. In 2018-2021, 17 districts in Senegal passed transmission assessment survey (TAS) for the first time and have since stopped MDA. In 2021, 24 districts with an average baseline antigenemia prevalence of 14% became eligible for pre-transmission assessment survey (pre-TAS) to assess the impact of MDA on the prevalence of W. bancrofti infection after achieving the required five effective annual MDA rounds with at least 80% program coverage. Following treatment and transmission assessment surveys, MDA has been stopped in the 24 districts and they are currently under post-treatment surveillance.   

Presenters:

• Rose Monteil (FHI 360/Senegal)

 

12:00 PM- 1:45 PM (CDT) Poster Sessions

7045 - Synthesis of findings from the literature and a qualitative research study on the impacts of gender, disability, and ethnicity in Neglected Tropical Diseases programming  

Poster Presentation (Session B)

Act | West conducted a gender and social inclusion analysis to determine how NTDs impact different population groups and how gender and social norms impact NTD programs. The study used a mixed methods approach, including a literature review; qualitative data collection in Côte d’Ivoire, Sierra Leone, and Ghana with a total of 477 participants; and quantitative analysis of programmatic data.

MDA training rates for community drug distributors (CDDs) and supervisors are almost universally higher for men than women, even though feedback on the effectiveness of female CDDs is overwhelmingly positive, and female CDDs often have more access to women in conservative households. The role of CDDs can lead to career and social opportunities for both men and women. However, challenges faced by CDDs are seen as a greater barrier for women, including transportation, safety, household responsibilities, and low or lack of wages. This presentation will look at ways that NTD programs can promote gender equity.   

Presenters:

• Jennifer Arney (FHI 360)

• Maureen Headland (FHI 360)

• Diana Stukel (FHI 360)

 

7099 - Remapping trachoma in Kolofata: potential recrudescence in an insecure district  

Poster Presentation (Session B)

Trachoma was a public health problem in 24 health districts in Cameroon. After implementation of the World Health Organization (WHO) SAFE strategy (surgery, antibiotics, facial cleanliness, and environmental improvement) since 2011, 21 districts have achieved the criteria to stop mass drug administration (MDA) and have maintained the status for two years in the absence of MDA. Kolofata was among the first districts to begin trachoma control activities in Cameroon with the support of Ophthalmo Sans Frontières.

As a result of ongoing insecurity and internal and external population movement, the National Program suspected Kolofata had a TF prevalence ≥5% and decided to conduct remapping in 2022. In accordance with WHO guidelines, the SAFE strategy will be implemented in Kolofata, including one round of MDA, TT surgery outreach, and efforts to improve the F&E components of the SAFE strategy.   

Presenters:

• Carine Fokam (Helen Keller Intl/Senegal)

 

7034 - Supervisor’s Coverage Tool (SCT) During Mass Drug Administration Against Lymphatic Filariasis in Kampti Health District of Burkina Faso in 2023 

Poster Presentation (Session B)

Lymphatic filariasis (LF) was endemic in all 70 health districts (HD) in Burkina Faso in 2000. Despite having started annual mass drug administration (MDA) in 2001, Kampti HD in the South West Region has experienced seven failures in LF pre-transmission assessment surveys (pre-TAS) and 13 rounds of MDA.

Following the most recent pre-TAS failure in 2021, a second additional round of MDA was conducted across six days in February 2023. The National Neglected Tropical Disease Program implemented the Supervisor's Coverage Tool (SCT) on the fifth day in 10 supervisory areas out of 170 villages to enable mop-up for an additional seventh and eighth day following the MDA campaign. 

When analyzing the data for an action plan, it is necessary to look at the details of the reasons for non-treatment, which can often be amplified by the high number of ineligible people. The SCT has made it possible to identify areas with inadequate coverage and to treat additional people through a mop-up.   

Presenters:

• Dieudonné Naré (Helen Keller/Burkina Faso)

• Yaobi Zhang (Helen Keller Intl)

• Benoit Dembélé (Helen Keller Intl/Senegal)

• Steven D Reid (Helen Keller Intl)

 

1:45 PM - 3:30 PM (CDT) Symposia and Scientific Sessions

82 - The status of Schistosomiasis after a decade of mass drug administration in Sierra Leone  

Oral Session

In 2008, schistosomiasis (SCH) was found to be endemic in 14 health districts (HDs) of Sierra Leone. Annual MDA began in 2009 to target school aged children (SAC) in six high/moderate endemic HDs and was scaled up in 2010 to all SAC and at-risk adults in the nine high/moderate endemic HDs. In 2022, after five rounds of MDA with effective SAC coverage, another school-based impact assessment was conducted in the same nine HDs. The sampling was statistically powered to estimate chiefdom prevalence; a total of 201 sites were selected using probability proportional to estimated population size of the chiefdoms with special consideration for large towns and small chiefdoms. In each site, a total of 24 children aged 5-14 years were tested. Although prevalence remains high in a limited number of communities, SCH prevalence in Sierra Leone has overall reduced significantly. A more focused and intensive strategy could help reach Sierra Leone reach SCH control.

Our findings suggest the most influential programmatic response could include implementing age and sex specific MDA mop-up, increasing the information coming through the health system to raise awareness of MDA, and focused attention on facilities serving relatively remote areas.   

Presenters:

• Elisabeth Chop (Helen Keller Int'l)

• Patricia Houck (Helen Keller Int'l)

• Anna Phillips (FHI 360)

• Angela Weaver (Helen Keller Int'l)

• Yaobi Zhang (Helen Keller Int'l)

 

8:00 AM – 9:45 AM (CDT) Symposia and Scientific Sessions

6484 - Community dialogue as an innovative approach to improve the effectiveness of NTD control programs to improve MDA coverage for LF in Burkina Faso  

Oral Session

Burkina Faso has implemented mass drug administration (MDA) for lymphatic filariasis (LF) for over 20 years in all 70 health districts (HD). Currently, 62 of the 70 districts have stopped treatment. However, LF transmission has persisted in 8 HDs despite multiple rounds of MDA with good, reported coverage and implementation of additional MDA quality improvement strategies since 2018. 

This oral session unpacks efforts by the National Neglected Tropical Disease Program to identify the factors for the persistence of transmission and implement a community dialogue in 2022.

Presenters:

• Dieudonné Naré (Helen Keller/Burkina Faso)

• Yaobi Zhang (Helen Keller Intl)

• Benoit Dembélé (Helen Keller/Senegal)

• Steven D Reid (Helen Keller Intl)

 

6485 - Characteristics of non-treated populations among select NTD MDA campaigns in West Africa: results from multi-level modeling using coverage evaluation surveys.  

Oral Session

Effective mass drug administration (MDA) is the cornerstone of preventive chemotherapy (PC) neglected tropical disease (NTD) programs. Coverage evaluation surveys (CES) are used to validate coverage shortly after MDA. Non-treated populations (MDA eligible people in endemic districts who do not participate in the treatment campaign) are of concern as they may enable ongoing transmission of infection. If these populations can be better characterized, programs can take more precise actions to identify and target them.

This session looks at the results from three-level (persons in households in villages) hierarchical models of non-treatment built using Act | West CES data from six surveys and conducted in 24 districts across Ghana, Niger, Senegal, and Sierra Leone. 

Presenters:

• Maureen K. Headland (FHI 360)

• Kaustubh Wagh (FHI 360)

• Diana Stukel (FHI 360)

 

11:00 AM – 12:45 PM (CDT) Poster Sessions

7045 - NTD Ambassadorial Engagements: Strategy for high-level decision making and advocacy towards resource mobilization for the control and elimination of NTDs in Ghana 

Poster Presentation (Session C)

Achieving the elimination targets set in the WHO 2030 Road map for neglected tropical diseases (NTDs) requires embedding multisectoral collaboration as a strategic priority to identify synergies for mainstreaming NTDs. Leveraging the health and socioeconomic impacts of NTDs to build strong partnerships, Ghana has eliminated three NTDs and reduced the overall NTD burden in the country. The NTD Ambassador champions the Ministry of Health NTD Program’s efforts to engage key decision-makers across sectors and build buy-in for sustainable, multisector collaboration to control and eliminate the 14 endemic NTDs. These efforts are leading to program and policy changes which create an environment that fosters institutionalized multisector collaboration.   

Presenters:

• Wunpini Sayibu (World Vision)

 

7099 - Using WHO schistosomiasis community data collection form to identify factors contributing to high prevalence in Mali 

Poster Presentation (Session C)

Baseline mapping conducted in 2004 showed that schistosomiasis (SCH) was endemic in all 75 health districts (HD) in Mali. Impact surveys conducted from 2014 - 2018 in 46 HDs showed that mass drug administration (MDA) with praziquantel was still needed according to World Health Organization (WHO) guidelines. To avoid over- or under-treatment in HDs, Mali was one of the first countries to implement MDA at the sub-district level in 2020, as recommended by WHO, to ensure the treatment strategy appropriately reflected the epidemiological situation.  

Presenters:

• Benoit Dembele (Helen Keller Intl/Senegal)

• Anna Philips (FHI 360)

• Steven Reid (Helen Keller Intl)

 

7034 - Effort towards elimination of lymphatic filariasis in Cameroon: Results of the last transmission assessment survey in 20 health districts of Adamaoua, Center and Far-north region  

Poster Presentation (Session C)

Cameroon is endemic for lymphatic filariasis (LF) in 144 of 200 health districts (HDs) in the country. The goal of Cameroon is to eliminate LF as a public health problem by 2026. Mass drug administration (MDA) using ivermectin and albendazole were implemented between 2008 and 2017 in all endemic HDs. The first transmission assessment survey (TAS-1) was conducted between 2014 and 2019 in 143 HDs and in 2021 in Akwaya HD. As all HDs passed, MDA was stopped in all 144 endemic HDs. To date, 143 out of 144 districts have successfully passed TAS2, except Akwaya (due in 2023).

The results of the TAS3 confirmed the sustained interruption of LF transmission in 20 HDs, bringing the number of districts that have passed the second surveillance survey (TAS3) to 59 in Cameroon. The national program will establish a post validation surveillance system in HDs that have completed TAS3. Cameroon is well placed to submit the elimination dossier for validation by WHO in 2026.   

Presenters:

• Carine Fokam (Helen Keller Intl/Senegal)

 

7035 - Implementing the lymphatic filariasis repeat pre-transmission survey in a context of insecurity in two health districts in Burkina Faso 

Poster Presentation (Session C)

Lymphatic Filariasis (LF) was endemic in all 70 health districts (HDs) of Burkina Faso. Since 2019, LF transmission assessment surveys (TAS) have been postponed in some areas of the country due to insecurity. In December 2022, the National Neglected Tropical Disease Program (NTDP) conducted a repeat pre-transmission assessment survey (re-pre-TAS) in two insecure HDs: Fada N'gourma and Tenkodogo. The objectives were to assess the prevalence of LF and to test the feasibility of a new approach to implement surveys in a context of insecurity.

The new strategy used local health center staff who were trained at the district level on survey methodology, use of filariasis test strips (FTS) and electronic data collection via ESPEN Collect. The use of local health workers allowed for the successful completion of the re-pre-TAS surveys. Lessons learned will be used to develop similar approaches for conducting surveys in other insecure areas, but FTS positive cases will be further investigated.   

Presenters:

• Dieudonné Naré (Helen Keller/Burkina Faso)

• Ernest Mensah (FHI 360)

• Benoit Dembélé (Helen Keller Intl/Senegal)

• Steven D Reid (Helen Keller Intl)

 

7025 - Field evaluation of Standard Q Filariasis Antigen Test for Lymphatic Filariasis (LF) during a pre-transmission assessment survey in Sierra Leone, 2022 

Poster Presentation (Session C)

As part of a multi-country evaluation, the SD Biosensor STANDARDTM Q Filariasis Ag Test (QFAT) was compared with the Abbott BiolineTM Filariasis Test Strip (FTS) for classifying lymphatic filariasis (LF) prevalence at a population level and for ease of use in field conditions in Sierra Leone. The evaluation was done in two districts, Bombali and Karene, where repeat pre-transmission assessment surveys (pre-TAS) were planned.

The results suggest that the QFAT is a credible LF diagnostic test when compared to the routinely used FTS; use of either test would result in the same program decision.   

Presenters:

• Ernest Mensah (FHI 360/Ghana)

• Benoit Dembélé (Helen Keller Intl/Senegal)

• Steven D Reid (Helen Keller Intl)

 

7051 - The journey to integrated and sustainable Neglected Tropical Disease (NTD) database systems: The movement of NTD data from local fragmented systems into Health Management Information Systems (HMIS) managed by Ministries of Health 

Poster Presentation (Session C)

NTD Programs operate to eliminate or control diseases such as LF, Trachoma, Onchocerciasis, SCH and STH, in endemic countries around the world. Such programs collect routine monitoring and outcome data in relation to their Mass Drug Administration (MDA) campaigns and Disease Specific Assessments (DSAs) to assist with programmatic decision making, to inform program progress, to report to donors and funders and to provide an evidentiary basis when submitting elimination dossiers to WHO. It is essential that countries have stable and secure database systems with complete current and historical NTD data to protect investments in elimination and control programs.

Despite this, many countries continue to use siloed Excel sheets for the day-to-day management of NTD program implementation, a situation which is fraught with numerous challenges including: lack of a shared single database across all diseases (i.e., lack of integration across diseases), lack of ability to access the database by multiple users simultaneously in a network-based setting to eliminate data divergence, lack of built-in data security mechanisms (password and virus protection along with regular back-ups), and limited NTDP personnel capacity to update and maintain the data systems over time.   

Presenters:

• Diana Stukel (FHI 360)

 

LB-8531 - Assessment of immuno-haematological effects of helminthiasis in patients with Mycobacterium tuberculosis complex infection Bobo-Dioulasso, Burkina Faso 

Poster Presentation (Session C)

The impact of helminthic infections on immune and haematological responses during active tuberculosis (TB) has not been investigated in Burkina Faso. In this prospective cross-sectional, the poster will evaluate the effect of helminthiasis on immunological and haematological parameters in newly diagnosed TB patients in Bobo-Dioulasso from 2019 to 2021.

Exploring different types of immune-haematological biomarkers would constitute an additional lead in the diagnosis and allow better follow-up and monitoring of Tuberculosis-helminthiasis coinfections.   

Presenters:

• Achille Kaboré (FHI 360)

 

3:00 PM - 4:45 PM (CDT) Symposia and Scientific Sessions

7162 Soil transmitted helminth infections following fourteen years of mass drug administration in Sierra Leone  

Oral Session

Baseline mapping surveys conducted in 2008/09 in Sierra Leone found soil-transmitted helminth (STH) infections in all 16 districts, with moderate prevalence in eight districts and high prevalence (≥50%) in eight districts. Since 2008, STH mass drug administration (MDA) has been integrated with lymphatic filariasis (LF) MDA for all persons five years and above in all districts.

This oral session looks into the results of recent impact surveys conducted in Sierra Leone and presents findings.

Presenters:

• Victoria Redwood-Sawyer (Helen Keller Intl)

• Anna Phillips (FHI 360)

• Yaobi Zhang (Helen Keller Intl)

 

8:00 AM - 9.45 AM (CT) Symposia and Scientific Sessions

Symposium 151 - Overcoming the Challenges of PC-NTD Hotspots      

Symposium

MDA is the main approach for NTD control. In some locations, however, prevalence does not decline as expected, termed “hotspots”. The initial question is whether this is due to programmatic issues, such as poor treatment coverage, or underlying epidemiological factors driving the force of infection. Treatment coverage (target population who receive MDA) is a common evaluation metric, but few examine individual compliance (swallowing of drugs) over multiple rounds of MDA. Systematic non-compliers, who persistently refuse or do not ingest medication over multiple years of MDA, can serve as a continued source of infection.

Individual anthelmintic compliance patterns were recorded over five rounds of community-wide MDA targeting soil-transmitted helminths in southern Ethiopia using unique biometric identifiers (fingerprint) to determine if compliance is random or systematic over time. Following at least ten years of effective schistosomiasis (SCH) MDA, impact assessments have been conducted across West Africa.

This presentation will illustrate geospatial anaylsis tools to identify persistent trachoma hotspots in Tanzania and Uganda.   

Presenters:

• Dr. Anna Philips (FHI 360)

• Dr. Upendo Mwingira (RTI)

• Rosie Maddren (Imperial College, London)

• Dr. Ernest Mensah (FHI 360/Ghana)

• Clara Bergert (RTI)