Moses Adriko Bilharzia and Worm Control, Uganda Ministry of Health, Uganda
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MosesAdrikoBilharziaandWormControl,Uganda
MinistryofHealth,Uganda
§ Background/GeographicallocationofVectorControlDivision,Uganda.
§ LongtermscientificgoalsofVectorControlDivision,Uganda.
§ MainresearchquestionsofVectorControlDivision,Uganda.
§ Mainresearchquestionofyourproject(beitatanylevel,fromcloningagene,identifyinghowdrugresistancespreadtoepidemiology)
§ Uniqueskillsorexpertisethatsomeoneelsemightbenefitfrom.
§ Collaborationskill/resourcesthatsomeoneelsemighthavewillpromoteyourproject.
§ Difficultiesdoyoufaceindoingresearchinyourlocalarea?
PRESENTATIONOUTLINE
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UGANDA COUNTRYPROFILE§ East African§ 240,000 km2 in area§ 18% open water§ 2006 had 56 districts§ 2017 - 116 districts§ Most services decentralised
esp. Local Govt.DRC
NEW SUDAN
TANZANIABURUNDI RWANDA
KENYA
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§ Startedin1901withemphasisonmalariatransmission&vectorcontrolespeciallyinurbanareasandothercommunicablediseases.
§ VectorControlDivisioninvolvedindiversediseasecontrol/eliminationprogrammesactivitiesthroughoutthecountry:üBilharziaandWormControlProgramme(BWCP)üNationalSleepingSicknessControlProgramme(HAT)üProgrammetoEliminateLymphaticFilariasis(PELF)üNationalOnchocerciasisControlProgramme(NOCP)üOtheractivitiesinclude:• Epidemiology/RiskfactorsforLeishmaniasis• Generalvector/pestcontrolactivities/consultations
BACKGROUNDOFVECTORCONTROLDIVISION
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SCIENTIFICGOALS
Objectives:– Eliminationofmorbiditydue
toschistosomiasistoasapublichealthproblem
Goals:– ToimplementMDAin100%of
districtsimplementing.– Toachieveatleast75%
therapeuticcoverageduringannualMDAinschool-agechildrenandhigh-riskcommunities.
– Toeliminateheavyintensityinfectionsofschistosomiasisinschool-agechildrenandhigh-riskcommunities.
SchistosomiasisinUganda
Focusesonreducingdiseasethroughperiodic,large-scalepopulationtreatmentwithPraziquantelcombinedwithHealthEducation.
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?
RESEARCHQUESTIONS
MainResearchQuestionsforBWCP§ Whatfactorsaffecting
PraziquanteluptakeinendemicdistrictsinUganda
§ WhatisthelevelofavailableWASHactivitiesinrelationtocontrolandpreventionofschistoandSTHinendemicdistricts.
§ Howbestcanaschistoprogrammetargetingschoolagechildren sufficientlyreachthenon-enrolledchildren.
§ WhatfactorsaffectingproperandtimelyreportingofSAEs
§ WhatisthelevelofcommunityawarenessaboutschistosomiasisandSTHtransmission,preventionandcontrol
ProjectResearchQuestions§ Whatisthebestwaytomonitor
schistosome infectionsanddrugefficacy?
§ Hasdrugresistancebeenselectedfor?§ Whatisthepotentialforthespreadof
drugresistance?§ Whatotherfactorsdrivetransmission?§ Isastandardizedmulti-parallel-PCR
assaymoresensitivediagnostictoolfordetectingSTHandSchistosomamansoniprevalencecomparedtotheKato-KatzstooltestinthefaceofeliminationstageafterMDAstoppageforLF?
§ WhatisefficacyofMEBZandALBagainstSTHafterseveralyearsofMDA?
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MOHTechnician
Stool&serologicalanalysis
parasiteeggcollectiononFTAcards
Microscopy(KK,malariaandFlotac)
Kato-Katzpreparations
registration/heightandweight
fingerpricking/RDT/Hb/serology
clinicalexamination/treatment
exits&returnsday2
CoolerGenerator
1 2 4
Participants
DistrictTechnician
conductspriorsurvey
sensitisation&marshalling
LocalCDD
laterrecordssubsequentmalaria
treatmentsincommunity
ELISAs,FOBandCCA
ELISAplatereader5
3
questionnaire
6 7 82xcentrifuge
Freezer(-20C)
MOHTechnician
SCHEMATICORGANIZATIONOFFIELDSURVEYSINUGANDA
§PersonnelüSeniorTechnicalStaffsüJuniorStaffsüDistrictProgramcoordinators.ü VillageHealthTeams
§EquipmentsüMicroscopesüFreezersforsamplestorageüPCRMachineüElizer platereaderüHBPhotometersüHaematology AnalyzerMachine
§OfficeSpaceüLaboratorySpace
§Vehicles forfieldActivities.§ResearchCollaborationsSkills
§MolecularstudiesonHelminths.§ParasitologyworkonHelminths§ImmunologyofHelminthes.§MedicalMalacology
Opportunities/Capacitiesforcollaboration
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MorbidityduetoBilharzia§ Lackofresourcesforin-countrytechnicalcapacitybuildingandsupportoperationalresearchforschisto.
§ LackofresourcestocollectSanitation-relatedindicators(Handwashing,measuringfaecalcontaminationofenvironments).
§ HighOperationalCostsintheHard-to-reachAreas(Islands).
§ PoorLatrine/toiletcoverageinalllandingsites&Islands–(Contributetohighre-infections).
§ MissingLinkwithWASHpartnersonschisto.
CHALLENGESFORRESERARCHINUGANDA
Tomanyotherfriends&long-termcolleaguesinSchistosomiasiscontrolresearch
ACKNOWLEDGEMENTS
Snail-bornediseases
vMeBOP CourseCoordinatorsvWelcomeTrustvUniversityofBernvUniversityofGlasgowvLSTMvLSHTMvUniversityofCambridgevMeBOP CourseColleagues
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