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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