InterimReportSchistosomiasisinMadagascar(SOMA)

1

▌Projectsummary

TheWHOpublisheddatain2016thatdemonstratesthecurrentneedforandcoverageoftheschistosomiasistreatmentPraziquantel(PZQ),abothapreventativeandatreatmentforalreadyinfectedpatients,inMadagascar.AccordingtotheWHO,8.6millionpeopleinMadagascarwouldneedtoreceivetreatmenttoreducethelocalburdenofSchistosomiasis.However,only19%ofthosein-needcurrentlyreceivePZQ,makingMadagascarahigh-burdencountryforschistosomiasisinfectionaswellasforschistosomiasis-relatedmortalityandmorbidity.TheSOMA(SchistosomiasisinMadagascar)projectaimstoreducetheburdenofschistosomiasisinfectionintensityandprevalenceinat-riskpopulations.TheSOMAprojectconsistsof2phasesofmassdrugadministration(MDA)campaignsofPZQinhigh-riskpopulationsaswelltheestablishmentofefficientandeffectiveresourcesforschistosomiasispreventionandcontrol,i.e.:WASHeducation/trainingprogramsandwaterandsanitationinfrastructure.▌Communitymobilization

Afterdiscussionofthelocalinfrastructureandengagingwithpoliticalaswellashealthofficials,theSOMAteamaddressedcommunitymobilizationonthreedifferentlevels:1)informingmayorsineachcommunityand2)informingdistricthealthagents/hospitalstaffathealthfacilitiesintargetareasaboutthestudyandprospectiveactivitydates;and3)informingthe

InterimReportApril2,2019

InterimReportSchistosomiasisinMadagascar(SOMA)

2

generalpopulationusingthelocalcatholicradiostation“RadioMaria”toannouncethetreatmentonthecommunity-specificmarketday.InJanuary,threemeetingswereheld:1)onemeetinginTsarasaotrainvolvingthemayor,approximately30villagechiefs,and30communityrepresentatives;2)onemeetinginAmbositrainvolving18communitymayors;and3) onemeetinginAmbositrainvolving20mayors,approximately20physiciansand15districthealthauthorities.TheteamprovidedbackgroundinformationonSchistosomiasis,aswellasanintroductionandexplanationoftheimportanceoftheSOMAprograminthelocallanguage,Malagasy.ThepoliticalandhealthofficialsexpressedtheirsupportforSOMAactivities,theimportanceofaddressingpeople’shealth,andfortakingafirststeptoimprovehealthinthisregionwiththisprogram.Duringthemeetings,alllevelsofleadershipinattendanceagreedtodistributethediscussedinformationonthediseasebackgroundandprogramactivitiesintheirrespectivecommunitiesandtopreparealistofparticipantstoestimatethePZQneedsofeachcommunityduringtheMDA-campaign.Themeetingswerecoveredbythebroadcaststation,TVMadagascarandwereairedduringthedailynewssegment.▌WASHactivities

InterimReportSchistosomiasisinMadagascar(SOMA)

3

▌DefinitionofWASHactivities

InresponsetothelimitedsuccessofflyersandothereducationalmaterialstypicallyusedforWASHcampaigns,theSOMAteamdiscussedpossiblealternatives.Themaincomponentincludedtheconstructionoftoiletfacilitiesatkeylocationsthroughoutthecommunity.Inaddition,amoremodernfacilitywillbeconstructedwithinaschoolareaofonecommunity(includingprimary,secondaryandhighschools),withtheengagementofparentsandchildren,toprovideaccesstosafewater.BuildingmaterialswerepurchasedandtransportedtothestudysitesinJanuaryandFebruary,2019andlocalteamsstartedtheconstructionoftoiletfacilitiesatasecondaryschoolandatthemarketinAmbositra,aswellasatthecommunitycenterinAndina.Uponcompletion,theIVIstudyteamvisitedthesitefortheinaugurationofthetoiletfacilities.

NewtoiletatthecommunitycenterNewtoiletatthemarket

ThepermanentsafewateraccessfacilitieswillbebuiltinMayandJune2019,aftertheendoftherainyseason.▌Massdrugadministration

Approximately80,000peopleinAmoron'iManiaandapproximately10,000peopleinVakinankaratraaretargetedforPZQtreatment.BecauseprimaryandsecondaryschoolsalreadyprovidePZQtreatmentfortheirstudentsthroughajointWHO/MerckPZQdonationprogram,theSOMAprojectistargetingadults,highschoolchildren,andchildrenwhodonotattendschool.TheamountofPZQneededforthetargetedstudypopulationwascalculatedandthestudyteamdecidedtoprocureallsuppliesandPZQinMadagascartoavoidpotentialshippingissue-relateddelays.PreliminaryPZQadministration“parexample”wasconductedforallgovernmentalandhealthofficialmeetingparticipantsinAmoron´iManiaandVakinankaratraregionsthroughoutthecommunitymobilizationarea.ThemainPZQadministrationcampaignwilltakeplaceinJulyandAugust2019.

InterimReportSchistosomiasisinMadagascar(SOMA)

4

▌AboutSchistosomiasis

Schistosomiasis,achronicinfectioncausedbyparasiticworms,isapoverty-related,neglectedtropicaldisease.Itpotentiallyaffectsonebillionpeopleinnearly80countries.Anestimated200millionpeoplearealreadyinfected,andanadditional800millionpeopleareatriskofinfection.Theestimatednumberoffatalitiesrangesfrom24,072to200,000globallyperyear,withthenumberbelievedtohavedecreasedconsiderablyfrom200,000in2000(WHO).Schistosomiasisisusuallyspreadbycontaminatedwater,andismorecommoninareaswithpoorsanitation.ThankyouThisprojecthasbeenmadepossiblebyfundingfromtheYanghyunFoundationinSouthKorea.