ITI is a program of The Task Force for Global Health.
Guinea is gradually recovering from an Ebola virus disease outbreak in 2014 – 2016, which affected the entire country and killed over 2,500 people, with a fatality rate of 67%. Ebola dealt Guinea’s already weak economy an enormous blow, causing widespread unemployment and severe economic hardship. Ebola took a particular toll on the country’s under-resourced health care workers, who risked and in some cases lost their lives caring for Ebola patients.
Trachoma was first identified as a public health problem in 2001, with estimated 33% TF and 2.7% TT in Upper Guinea. The trachoma program is managed by the National Program for the Fight against Onchocerciasis, Blindness and NTDs (PNLOC/MTN). New baseline mapping started in 2011 and has continued through 2016. In all, the program has mapped 31 districts, with 15 districts using the GTMP protocol. The baseline surveys indicated that 18 districts were endemic.
The program first applied for Zithromax® in June 2010 and TEC conditionally approved two districts, Faranah and Kissidougou, for 2011, pending mapping results. Following mapping, the first MDA was scheduled for late 2012, with financial support from USAID through RTI Envision and implementation support from HKI. Other trachoma partners include Sightsavers, OPC and Plan International. The first shipment of Zithromax® arrived in Guinea in November 2012 and the MDA took place in Faranah and Kissidougou in June 2013. With additional baseline mapping in 2013, the program planned to scale up to all nine districts with TF > 10% in 2014.
The Ebola outbreak in March 2014 delayed that year’s MDAs by several months and caused a general climate of fear and a breakdown of trust between the population and health workers. Widespread refusals resulted in low coverage in 2014 for all PCT-NTD MDAs. The NTD program responded with a communication strategy using multiple IEC channels such as radio and town criers, and in close collaboration with community leaders. These efforts significantly boosted coverage in 2015 and 2016 and are a success story that can be replicated in other outbreak situations.
Collaborative Ebola response efforts by health workers, policy makers, administrators, and non-governmental organizations across the country have strengthened individual and community hygiene. Activities included information, education and communication campaigns and the construction of water points and latrines. The NTD program believe that this has had a positive effect on NTD prevalence nationally.
CURRENT IMPLEMENTATION STATUS
Late 2016 impact surveys in three districts showed that they had reached the elimination threshold for TF and moved into surveillance. In 2017, the program will expand MDAs to all districts between 5-9% TF, conduct more impact surveys, facilitate supply chain training and a TAP workshop, and scale up the trichiasis program through planning and capacity-building activities to reach the estimated backlog of approximately 27,000 cases.
Zithromax® Shipments by Year