Baseline Mapping of Neglected Tropical Diseases in Africa: The Accelerated WHO/AFRO Mapping Project.

Maria P Rebollo,Adiele Nkasiobi Onyeze,Benido Impouma,Alexandre Tiendrebeogo,Patrick Lammie,Kebede Deribe,Andrew Majewski,Jorge Cano,Eric A Ottesen,Mutale Nsakashalo Senkwe,Honorat G M Zouré,Kisito Ogoussan,Ekoue Boniface Kinvi

doi:10.4269/ajtmh.20-1538

Abstract

.Mapping is a prerequisite for effective implementation of interventions against neglected tropical diseases (NTDs). Before the accelerated World Health Organization (WHO)/Regional Office for Africa (AFRO) NTD Mapping Project was initiated in 2014, mapping efforts in many countries were frequently carried out in an ad hoc and nonstandardized fashion. In 2013, there were at least 2,200 different districts (of the 4,851 districts in the WHO African region) that still required mapping, and in many of these districts, more than one disease needed to be mapped. During its 3-year duration from January 2014 through the end of 2016, the project carried out mapping surveys for one or more NTDs in at least 2,500 districts in 37 African countries. At the end of 2016, most (90%) of the 4,851 districts had completed the WHO-required mapping surveys for the five targeted Preventive Chemotherapy (PC)-NTDs, and the impact of this accelerated WHO/AFRO NTD Mapping Project proved to be much greater than just the detailed mapping results themselves. Indeed, the AFRO Mapping Project dramatically energized and empowered national NTD programs, attracted donor support for expanding these programs, and developed both a robust NTD mapping database and data portal. By clarifying the prevalence and burden of NTDs, the project provided not only the metrics and technical framework for guiding and tracking program implementation and success but also the research opportunities for developing improved diagnostic and epidemiologic sampling tools for all 5 PC-NTDs—lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiasis, and trachoma.

Highlights

Mapping is an essential element for each of the neglected tropical disease (NTD) programs advocated by the World Health Organization (WHO)
The accelerated mapping project, established standards and guidelines required for these NTD mapping surveys; agreement that 1) the targeted focus for this mapping would be the district or “admin 3”, 2) use would be made of the WHO-agreed, standardized mapping methods to identify the prevalence of each of the five Preventive Chemotherapy (PC)-NTDs in every district of every country, and 3) data would be collected and accessible centrally
More refined assessments might later be required for specific programmatic needs[9] or to address the known limitations of existing diagnostic tools in low-prevalence settings, and the principal goal of the accelerated mapping project was to ensure that PC-NTD endemicity status would be defined broadly for every district in AFRO’s 47 countries

Summary

Introduction

Mapping is an essential element for each of the neglected tropical disease (NTD) programs advocated by the WHO. It consists of the epidemiological surveys that provide baseline information on a disease’s geographical distribution, the level of disease endemicity, and the populations or age-groups in need of preventive chemotherapy (PC)—all of which information is critical for planning, implementing, monitoring, and evaluating NTD programs.[1,2] the appropriate targeting of mass drug distribution (MDA) requires an understanding of the geographical distribution of NTDs sufficient to identify those areas that need the MDA interventions and those that do not, based on WHO guidelines. The region comprised a population of nearly one billion people in 47 countries spread over a vast

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Conclusion