COVID-19 pandemic response and Field Epidemiology and Laboratory Training Programs in ECOWAS.

The COVID-19 pandemic has been persistent with a huge demand for human health resources which is a vital component of its preparedness and response. Globally, the public health workforce through field epidemiology and laboratory training programme (FELTP) has been instrumental to global health security. We determined the status of FELTP in the region and its contributions to the COVID-19 pandemic response in the ECOWAS region. We conducted a desk review, shared a questionnaire among member states and organized a two-day online regional consultative meeting on field epidemiology training on 30th-31st March 2022 during which there were presentations, group discussions and deliberations on the status and contribution of FETP during the COVID-19 pandemic. Data collected were analyzed in themes. All countries in the ECOWAS region had established at least one tier of FELTP, 11 (73.3%) had established two tiers of FELTP and only 3 (20.0%) had established all three tiers of the program. Despite the pandemic, the cumulative number of graduates increased from 2996 to 4271 frontline, 41 to 380 intermediate, and 409 to 802 for advanced FELTP between 2019 and 2022. However, the progress has been disproportionate across countries. The key activities supported through FELTP graduates included pandemic response coordination, surveillance, data collection/management, laboratory support, case management, risk communication, infection prevention and control, COVID-19 vaccination, and research. Despite improvements in the FELTP in the Economic Community of West African States (ECOWAS) region, there is a need for continuous stakeholder engagement for its implementation, resource mobilization for sustainability, and leveraging critical partnerships.

Progress towards elimination of onchocerciasis in the Region du Sud-Ouest of Burkina Faso which was previously subject to a recrudescence event after vector control.

BACKGROUND: The Sud-Ouest region of Burkina Faso (especially the Bougouriba valley) has been historically problematic with respect to onchocerciasis control, with a recrudescence of infections after vector control carried out the WHO Onchocerciasis Control Programme was halted in 1989. After 1996, mass drug administration of ivermectin was instigated to control the recrudescence so that it would no longer constitute a public health problem. However, in 2010 WHO changed its recommended policy from control to elimination, and in 2013 biannual Community-Directed Treatment with Ivermectin (CDTI) was instigated. Epidemiological surveys were carried-out in 2011 and 2018 to determine whether CDTI was producing a decline in infection levels and progress towards elimination. METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional study was conducted across 20 villages in four health districts in 2011 and 29 villages in 2018. Individuals aged five years and above were examined by skin-snip, and the prevalence and microfilarial load was determined for each village. In 2011, 75% of villages had some infections and 20% had prevalences >5%, with a mean prevalence across all villages of 2.63% (range 0.0-9.7%), and community microfilarial load ranging from 0 to 0.25 microfilariae per biopsy. In 2018, nine villages (= 31% of total) had some infections, with prevalences ranging from 0.41% to 3.54%, and a mean prevalence across all villages of 0.37%. Community microfilarial load ranged from 0 to 0.1. Amongst those people found to be microfilarial positive, 87% had a history of migration. CONCLUSIONS/SIGNIFICANCE: The endemicity of onchocerciasis infection in the Sud-Ouest region has declined to low levels and seems to be progressing towards elimination. Our findings indicated that biannual CDTI is having good effect, but it should continue for a number of years to ensure elimination of transmission. However, progress towards elimination has a troublesome history in this region, and it would be advisable to select more sentinel villages to have confidence in any future epidemiological and entomological surveys, especially Stop-MDA surveys. With positive individuals migrating between countries, cross-border collaboration needs more attention to ensure effective treatment for onchocerciasis elimination.

[Evaluation of therapeutic coverage of mass treatment campaign against lymphatic filariasis in two health districts in Burkina Faso]. / Évaluation de la couverture thérapeutique de la campagne de traitement de masse contre la filariose lymphatique dans deux districts sanitaires au Burkina Faso.

Background & rationale: Burkina Faso has been implementing preventive chemotherapy against lymphatic filariasis since 2001. While 61 health districts (HDs) have stopped mass drug administration (MDA), transmission persists in 9 HDs despite good reported MDA coverage. To validate the reported coverage, an independent post-MDA survey was conducted in Tenkodogo and Fada N'Gourma HDs in September 2018. Materials & methods: The study population consisted of all persons in the visited communities. The Coverage survey sample builder (CSSB) tool was used to calculate the sample size and to conduct the random selection of households. A total of 30 villages per HD were selected. The investigators were Ministry of Education agents and health workers not involved in MDA. Data were collected on smartphones through the KoBoCollect application regarding age, sex, drug ingestion (ivermectin + albendazole), adverse events, and whether respondents understood MDA guidelines. Stata Version 14 software was used for data analysis. Results: A total of 3,741 individuals were surveyed, 53.3% were female and the median age was 14 years. Surveyed epidemiological coverage was 74% [95% CI: 72-76.1] in Fada N'Gourma and 79.1% [95% CI: 77.2-80.9] in Tenkodogo, compared to reported coverages of 82.6% and 83% respectively. Village-level coverage ranged from 32.9% to 100% in Fada N'Gourma and from 56.7% to 93.3% in Tenkodogo. In total, 99% of those treated said they had swallowed the drugs in front of the community drug distributor (CDD) and confirmed the use of dose poles. The main reasons for non-treatment were non-visitation of the compound by CDD (54%) and absences during MDA (43%). Results showed that surveyed coverage was lower than reported coverage in both HDs, yet both were above the 65% threshold recommended by WHO. However, major variations of coverage have been noted among villages. Directly observed treatment appeared to have been well respected. Discussion & conclusion: The main challenges to increase coverage will be the systematic revisiting of households with absentees and the targeting of all households in each village.