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Title: SYRIAN ARAB REBUPLEC REPORT Vector Control Interventions Intersectoral coordination Status of obsole


1
SYRIAN ARAB REBUPLEC REPORT Vector Control
Interventions Intersectoral coordinationStatus
of obsolete stocksDr. Atef Al Tawil
(MOH).Eng. Ayman Al Khatib (MOH).Eng. Shagaf Al
Nahawi (MOLAE).Mrs. Mayada Sheikh Al Hadadin
(MOA).First Regional Meeting Of The Global
Enviromental Facility (GEF) Supported Countries
In The Eastern Mediterranean Region.MUSCAT,
OMAN, 6-8 MARCH 2006.
2
Malaria Other Parasitic Diseases Dept.
  • 1- Leishmania
  • Three different types of Leishmaniasis occur
    in Syria
  • Anthroponotic Cutaneous Leishmaniasis (ACL).
  • Zoonotic Cutaneous Leishmaniasis (ZCL).
  • Zoonotic Visceral Leishmaniasis (ZVL).
  • 2- Malaria
  • Indigenous Malaria (Vivax).
  • Imported Malaria (Falciparum,Vivax, Ovale
    and Malarie).
  • 3- Schistosomiasis
  • (Indigenous Imported).

3
Epidemiological situation of Leishmaniasis in
Syria
  • Cutaneous leishmaniasis is considered,
    at present, a big health problem, because of its
    rapid spreading from two focused areas (Aleppo
    and Euphrates plain ) before 1960 into eight
    provinces (wide distribution).
  • 1- ACL (L. Tropica )
  • - Main L. problem, 85 of CL belong to this
    form.
  • - Main infected provinces are
  • - Aleppo and Edlib (northwestern).
  • - Lattakia and Tartous (coastal region).
  • - Hama and rural Damascus (intermediate).
  • Vector is Ph. Sergenti.
  • Parasite is L. Tropica Mon 76.
  • Reservoirs are Patients.

4
  • 2- ZCL ( L. Major )
  • - 15 of C L.
  • - Less indemicity in (Rural Dams, Deir Ezzour
    and Al Hasakeh).
  • - Parasite is L. Major Mon 26.
  • - Vector is Ph. Papatasi.
  • - Reservoirs are Psammomys obesus, Meriones and
    Nesokia indicas.
  • 3- ZVL (L. Infantum)
  • - The total reported cases is very low.
  • - It is distributed in villages of 4 provinces
  • (Edlib, Latakia, Aleppo and Daraa).
  • - Parasite is L. Infantum Mon -1.
  • - Vector is Ph. Tobbi.
  • - Reservoirs are stray dogs.

5
Geographical distribution of CL ( 2005)
AL Hasakeh
Aleppo
AL Raqqa
Edlib
Latakia
Hama
Deir Ezzor
Tartus
Homs
  • ???? ?????? ???? lt ?? 01

Damascus
1-5 o
???? ?????? ????? 0.5 0.1
Rural Damascus
AL Qunaitera
0.5 1 o
???? ?????? ????? gt 0.5
AL Sweida
Daraa
lt 0.5 o 0
6
No. of reported cases of CL in Syria (1995 2005)
7
No. of reported CL cases of Provinces (2005)
8
No. of reported ZVL cases in Syria (1995 2005).
9
  • Epidemiological situation of Malaria in Syria
  • Malaria (indigenous imported)
  • UP to the 1950, malaria was endemic throughout
    the country (100 000 cases).
  • An eradication programme led to an interruption
    of transmission during 1960s
  • - The maximum incidence of indigenous malaria
    was recorded in 1993 (961 cases)
  • especially in AL Hasakeh and Aleppo provinces
    bordering Turkey Iraq.
  • Malaria vectors are 4 species of 9 species found
    in Syria.
  • - Primary malaria vector is Sacharovi and
    secondary malaria vector is Claviger.
  • No indigenous malaria case was reported during
    2005.
  • - Two deaths from 28 imported malaria cases
    during 2005.

10
Fig(1) Distribution of indigenous imported
malaria cases in Syria according to years (
2000 2004 ).
Distribution of indigenous imported Malaria
cases in Syria according to years (1996 2005).
11
  • Epidemiological situation of Schistosomiasis in
    Syria
  • Schistosomiasis
  • - Schistosomiasis isn't essentially endemic in
    Syria, the old foci were in the northeastern
    provinces bordering Turkey and Iraq along Belikh
    and Euphrates rivers during the Second World War.
  • - The Total No. of positive cases ranged between
    2444 cases in 1987 to 433 cases in 1993 to only 1
    case in 2004.
  • - Host intermediate is Bulinus Truncatus.
  • - Five cases were reported during 2005 in AL
    Raqqa province .

12
No. of positive Schistosomiasis cases (1993-2005)
13
Vector Control Plan of MOH
  • 1- Early active and negative case detection.
  • 2- Diagnosis and Treatment.
  • 3- Vector control (chemical and biological) .
  • 4- Training.
  • 5- Cooperation and coordination with other
    concerned sections
  • and authorities.
  • 6- Health education and community participation.
  • 7- Environmental re-formance.

14
1-Early active case detection Through
conducting surveillance in highly endemic areas
and case close-contacted
individuals and school children. 2- Negative
case detectionUnknown high fever, travelers
coming from endemic areas, skin lesions and
haematuria. 3-Laboratory diagnosis treatment
It is conducted in specialized centers concerned
in diagnosis and treatment, till complete cure is
achieved, free of charge.Treatment depends on WHO
protocols.
Activities
15
4-Vector control (chemical and biological)
including - Spraying of houses with residual
insecticides throughout two insecticides
spray campaigns, using various kind of
insecticides belong to Organophosphor (OP) or
Pyrethroids (P). Recently we used Carbamate
(WP), monitoring and evaluation. - Chemical
larviciding (Temephos), every 7-10 days, it
begins from 1st of April to the 1st of
November. - Application of mollusicide ( 70 )
Bayluscide. - Biological control (Gambusia fish
planting). 5-Using insecticide treated nets (
4000 INTs -Malaria). 6- Health education and
community participation.7- Cooperation and
coordination with other concerned sections
and authorities (MOA, MOE, MOLAE, Police, Army,..
.)8- Environment re-formance and management.
16
Usage of Pesticides in Syria Historically
  • During the step of Malaria eradication program
    between
  • 1955 - 1970 the only pesticide have been used
    to control malaria vectors was DDT 75 WP.
  • It was supplied by WHO and used in all over the
    country.
  • 200 tons at lest were used every year.
  • - We stopped importation of DDT in 1976 but
    still used until 1980 when we started used (OP or
    P) compounds.
  • - C compound using started in 1992.

17
Pesticides used for public health purposes in
Syria.
  • According to the government instructions there
    are two main
  • authorities responsible to deal with
    pesticides MOA and MOH.
  • They are responsible of all affaires of
    pesticides
  • except the importation.

18
  • Pesticides for public health purposes in Syria
    are used by
  • 1- Private sector as household pesticides to
    control
  • (flies,
    cockroaches, rodents, etc).
  • - Annual quantities consumption by this
    sector are estimated at 700 tons.
  • - 70 are crawling insecticides products
    of TP formulations at low
  • concentrations of a.i .
  • - 15 r. of anticoagulants ready bait .
  • - 12 i. of EC formulation products.
  • - 3 i. of ULV or thermal fog products .
  • 2- Public Sector by two main authorities
  • - MOH to control vectors of Malaria, Leishmania
    and Schistosomiasis
  • in epidemic areas 40 tons / year.
  • MOLAE to control pests and insects harmful to
    public health in all
  • over the country by municipalities workers 200
    tons / year.

19
Sources of Pesticides Before 1996 all of the
countrys needs of pesticides used in Public
Health field were imported from well-known
international companies after they tested and
approved by the technical committee of
pesticides. In 2005 sources of 75-90 of our
needs became from local formulators, a.i still
imported from adopted companies.
20
Types and Formulations used in P.H field
  • 75 Pyrethriode compounds ( cypermethrin 25
  • alpha-cypermethrin 10 deltamethrin 5 ).
  • - 15 OP compounds( chlorpyrefos- methyl 40).
  • 10 C compounds (bendiocarb 80 )
  • 80 were in EC formulations, 20 WP.
  • Because of the system of tender and the
    economical factors we
  • can not choose the pesticides witch we prefer.

21
Our urgent needs
  • Changing the method of the supply of
    pesticides.
  • New evaluation of pesticides (the last
    susceptibility test was in 1994.
  • Training for personal who deal with pesticides
    and vector control at all levels .

22
Pesticide Management in Syria
  • 1-Legislations and regulations
  • Pesticide registration, Trade, handling and
    monitoring in Syria are regulated by
  • - Decree 1 of 1982 (MOH ).
  • - Decree 2206 of 1991(MOA).
  • - Decree 18 of 2002 (MOA).
  • - Decree 64 of 2003 (MOA).
  • - Law 18 of 2004.

23
  • 1-1 Registration
  • imported pesticides have to be
  • a- Registered in a developed country.
    b- Not prohibited for use by any of relevant
    international
  • organizations FAO,WHO, EU, or EPA.
    c- Approved by WHO for vector control
    pesticides.
  • An exporting company has to be
  • a- Basic producer of the active ingredient of
    its commercial product b- Established in
    developed country which has complete system for
  • pesticide registration, or its product has
    been registered for use
  • in such countries.

24
  • It is also allowed to import a pesticide which
    is a conclusion of cooperation between two
    or, more basic producers. The
    pesticide shall undergo /1-2/ years of efficacy
    field trials under local conditions before its
    approval and registration.
  • Pesticide is subject to revision for
    re-registration every five years.

25
2-International and local cooperation
  • 2-1) Syria has ratified the followings
  • - Basel convention (1992) and its amendments
    2004.
  • - Rotterdam convention (PIC) 2003.
  • - Stockholm convention (POPs) 2005.
  • - The Revised Text of the IPPC 2004.
  • 2-2) The international programs concerned with
    these conventions
  • have been providing Syria with the
    technical information to
  • help in prevention of hazards associated
    with the use of these
  • chemicals and developing national
    programs for an efficient of
  • the conventions. 2-3) Besides, the close
    cooperation among MOA, MOH MOLAE
  • in exchanging technical information has
    been very helpful in the
  • establishment of more active system of
    pesticide management.

26
Obsolete Pesticides in Syria- A
three stage project for centralization and
safeguard of obsolete pesticides in Syria is
being executed by MOA MOLAE under the
direct supervision of FAO experts.
27
  • - First stage
  • During this stage an initial survey was carried
    out to estimate
  • the obsolete pesticide quantities in the stores
    of the relevant
  • governmental departments.
  • - Second stage The field inventory data
    indicated the existence of 580-600 tons of
  • obsolete pesticides, of which 1575 Kg DDT has
    been stored at MOH
  • stores since 1978 .
  • -Re-package of 450 tons which have been
    centralized in two big stores
  • -The remaining (150 tons) shall soon be
    re-packaged and centralized.
  • Third stage After the end of re-packaging and
    centralization, the total quantities
  • of obsolete pesticides shall be transported
    abroad for safe disposal.

28
  • The first and second stages expenses have been
    sponsored by FAO.
  • International organizations are invited to help
    us to achieved the
  • disposal of the above mentioned pesticides.
    Total coasts as an estimation are 1.5 million
    Dollars which cover transportation and
    incineration.

29
  • Thank you
  • For your attention
  • SYRIAN ARAB REBUPLEC (MOH, MOA, MOLAE)
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