Treating all, missing none: Lessons learned from a survey in Burkina Faso
A nurse from the Salembaoré Health and Social Promotion Centre meets with a family during a survey registration session. Photo: Lucien Mano, HKI-Burkina Faso
A nurse from the Salembaoré Health and Social Promotion Centre meets with a family during a survey registration session. Photo: Mano Lucien, HKI-Burkina Faso
Niorgho, Burkina Faso

Lymphatic filariasis (LF) is a highly debilitating and stigmatizing disease that impacts the lives of the poorest. LF can lead to severe swelling and cause permanent disability.

Since 2001, Burkina Faso has treated large numbers of people with medicines each year to prevent and break the transmission of LF and ultimately, to eliminate the disease as a nationwide public health problem. These efforts have been widely successful. Whereas LF was once a nationwide concern, Burkina Faso now only needs to treat 13% of the country’s 70 health districts.

In April 2019, USAID’s Act to End NTDs | West program supported the national neglected tropical diseases program in Burkina Faso to conduct a survey in three districts in the Centre-Est region, where treatments are still ongoing. During the survey, the team discovered a family in Niorgho village in which two members tested positive for LF.

A family receives preventive chemotherapy treatment for LF from a community drug distributor. Photo: Tapsoba Mahamadi, HKI-Burkina Faso  ​
A family receives preventive chemotherapy treatment for LF from a community drug distributor.
Photo: Mahamadi Tapsoba, HKI-Burkina Faso

The fact that the members of this family of long-term village residents tested positive for LF meant that they hadn’t taken the preventive medicines for many years. After talking with the family, the nurse who had accompanied the survey team discovered that despite health officials’ best efforts to follow every resident in each village requiring LF treatments, they had not been able to find and give preventive medicines to this particular family for nearly five years.

The reason they couldn’t find the family, the nurse discovered, was that the family traveled far from home to cultivate their fields at the same time each year; and they were never home during the one week of the year when health workers would visit their village to give out preventive medicines. In effect, the family had become seasonally hard-to-reach, and consequently, they had missed their annual LF treatments.

Upon learning the family’s story, the survey team and nurse educated the family on how LF can cause pain, permanent disfigurement, and life-long disability if left untreated. They also explained the benefits of treatment with LF medicines, which are safe and effective.

Now, community health workers such as the nurse conduct special follow-up visits to this family to ensure they receive their yearly LF medicines and to monitor their status. 

From this experience, the ministry of health has identified a clear strategy for reaching seasonal migrants. Before the country gives out LF medicines each year, nurses from each health center will identify any families or groups that have relocated to hard-to-reach areas and share strategies on how to reach such families and communities.

Burkina Faso’s national NTD program (NTDP) organizes social mobilization activities, such as community screenings of films on LF,  to let communities know when medicines will be distributed and encourage them to take the medicines. These activities provide opportunities for people to learn more about the disease, including how it is transmitted, prevented, and treated. In addition, teams from the NTDP will supervise the next LF medicine distribution event to make sure proper procedures are followed. 

The story of this family shows why it’s important to keep working on improving systems to follow hard-to-reach populations such as seasonal migrants. Such strategies and systems help ensure that all people who have or are at risk of LF infections get the medicines they need each year. By ensuring that no families are left behind, treating every eligible person in communities with LF and preventing its spread, countries like Burkina Faso are getting closer and closer to the end goal of disease elimination so that future generations of Burkinabes will not suffer from this disabling disease.

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