6th Regional Program Managers

1
6th Regional Program Managers Meeting (PMM)
forElimination of Lymphatic Filariasis (ELF) in
the AmericasWrap-Up 2005
Eric Ottesen Emory LF Support Center Maceió,
Alagoas, Brazil
Lymphatic Filariasis Elimination in the
Americas 6th Regional Program Managers
Meeting San José, Costa Rica, 2526 October 2005
2
Wrap-Up 2005 The year of Realizations!
Regional LF Program Managers Meeting Costa Rica,
2005
2
3
Highlighting the Realizations!

• 1. Success comes to Costa Rica!
• a) long endemicity
• b) identification and treatment of mf-positives
  (1976-80)
• c) vector control initiatives (intensified in
  1987)
• d) antigenemia confirmation of absence of
  infection

4
Distribution by Neighborhood of 6,155 Persons
from the City of Puerto Limón, Costa Rica,
19761980, Showing Number of Slides and Positives
5
Distribution by School of Persons Examined for
the W. bancrofti antigen, City of Puerto Limón,
20022003
6
Highlighting the Realizations!

• 1. Success comes to Costa Rica!
• a) long endemicity
• b) identification and treatment of mf-positives
  (197680)
• c) vector-control initiatives (intensified in
  1987)
• d) antigenemia confirmation of absence of
  infection
• Commitment to developing surveillance strategy,
  laboratory back-up, reportable cases
• - will no let this success slip away! -
• 3. We need to celebrate and advertise this
  success!!

7
Highlighting the Realizations!

• 1. Dominican Republic on target!
• a. The MDA has up-scaled successfully
• 1) great social success
• 2) 80-90 coverage!
• b. Effective decrease in mf and ICT at
  sentinel sites

8
MDA 2002
MDA 2003
MDA 2004
9
Monitoring of Sentinel Sites
Sentinel Sites 2002 2002 2004 2004
Sentinel Sites ICT MF ICT MF
Bo. Pueblo Nuevo 21.5 4 3 0.0
Batey No. 7 36 14 10 0.9
La Sombra 9.4 4 2 0.2
10
Highlighting the Realizations!

• 1. Dominican Republic on target!
• a. The MDA up-scaled successfully
• 1) great social success
• 2) 80-90 coverage!
• b. Effective decrease in mf and ICT at
  sentinel sites
• 2. Model of inter-institutional collaboration
• 1) Institute of Dermatology lymphedema
  management
• 2) UNAP primary health care services

11
Situation of Filariasis Mapping
12
Highlighting the Realizations!

• 1. Dominican Republic on target!
• a. The MDA up-scaled successfully
• 1) great social success
• 2) 80-90 coverage!
• b. Effective decrease in mf and ICT at
  sentinel sites
• 2. Model of inter-institutional collaboration
• 1) Institute of Dermatology lymphedema
  management
• 2) UNAP primary health care services
• 3. Mapping to be completed this year

13
Highlighting the Realizations!

• Brazilian program (a federation of independent
  programs with central guidance) achievements!

14
Epidemiological Situation
Positives
Year
Mf Prevalence 19932005 in Maceió, Alagoas,
Brazil
15
Highlighting the Realizations!
Belém
16
Highlighting the Realizations!

• Brazilian program achievements!
• a. Belem LF gone
• b. Maceio LF gone

17
Highlighting the Realizations!

• Brazilian program achievements!
• a. Belem LF gone
• b. Maceio LF gone
• c. Pernambuco rapid upscaling total target
  population coverage anticipated by 2008
• d. Very active morbidity assessment much care
  can be accommodated by a strong
  public-health system

18
Highlighting the Realizations!

• Brazilian program achievements!
• a. Belem LF gone
• b. Maceio LF gone
• c. Pernambuco rapid upscaling total target
  population coverage anticipated by 2008
• d. Very active morbidity assessment much care
  can be accommodated by a strong
  public-health system
• Immediate challenge Investigate formerly-endemic
  areas, especially Salvador where re-occurrences
  have been identified.

19
Highlighting the Realizations!

• Haiti program achievements!
• a. Progressive program expansion
• 1) MDA reached 1,200,000 last year 80
  coverage!
• 2) Microfilaremia, vector infection
  progressively decreasing at sentinel sites
• 3) Mapping complete
• 4) New clinics, surgical facilities, hope
  clubs opening
• b. Collateral de-worming benefits well
  documented
• Salt strategy to be instituted this year in
  limited area

20
Highlighting the Realizations!

• Storms prevented participation of key colleagues
• Guyana
• Haiti
• Suriname
• Trinidad/Tobago
• U.K.
• U.S.

21
Highlighting the Realizations!

• Programs are working!
• Programs are starved for funds!
• Governments are contributing heavily
• New strategies to ensure program funding must be
  identified
• integration into mainstream health-care system
• packaging LF with other disease-specific
  programs
• Emphasizing the public health value of the
  low-cost PELFs
• Documenting and emphasizing the societal (e.g.,
  poverty reduction, development-facilitating
  aspects of LF programs, especially when
  integrated or packaged

22
Highlighting the Realizations!

• The LF programs in the Americas have the greatest
  opportunity to make the most needed operational
  research contributions
• Of benefit to the Global Program
• Of direct benefit to the programs in the Americas
• Opportunities are present in literally all of the
  country programs in the Americas

23
Highlighting the Realizations!

• Group 1 Funds-finding conclusions
• Group 2 Morbidity Control conclusions
• Group 3 Verifying Elimination conclusions

24
Highlighting the Realizations!

• Partner Presentations
• GSK
• WINDREF
• Technical
• Global Program update
• Integration opportunities
• HealthMapper Use (or not)
• Belem LF Elimination

25
Highlighting the Realizations!

• Still to come!
• Official recognition of program success presented
  to Ministries of
• Costa Rica
• Suriname
• Trinidad and Tobago
• Next years PMM in Trinidad and Tobago

26
Wrap-Up 2005 The year of Realizations!
Regional LF Program Managers Meeting Costa Rica,
2005
26