6th NTD STAG Working Group Meeting: M&E of PCT

Dr Ahmed Jamsheed MohamedWHO South East Asia Regional Office

9-11 February 2015

Endemicity of NTDs amenable to PCT

NTD Endemic countries No. of countries requiring PC

LF 9/11 6/9

STH 11 8/11

SCH 1/11 1

TRA 3/11 3

Integrated NTD PlansCountries with integrated NTD plans: 4/11

Country

Diseases covered Source of Funding

BAN LF, STH, VL (Draft) Gvt + donour (USAID, CNTD, CWW, J&J)

BHU Plan to develop in 2015 Gvt

INO LF, STH, SCH, yaws & leprosy

Gvt + donour (USAID, RTI, GNNTD)

MMR LF, STH and Trachoma Gvt + donour (GNNTD, JICA)

NEP LF, STH and Trachoma Gvt + donour (USAID)

TLS LF, STH and yaws Gvt + donour (GNNTD, Uni of Sydney & Rotary Club)

Regional progress: Feb 2015

Note: IUs requiring MDA might change based on the ongoing survey in BAN and INOData on IUs eligible for TAS is incomplete

IUs requiring MDA

MDA started TAS eligible/completed

TAS passed0

200

400

600

800

1000

1200

992

890

653

484

Regional updatesMapping completed by2009. However, BAN and INO

decided to resurvey some of the districts

BAN 18/19 districts passed TASResurveying: 13/15 completedMDA in 2015: 1 district

IND 30/255 districts passed TASTAS going on in 34 districtsTAS plan for 2015-16: 81 districtsMDA 2015: 164 districts

INO 45/233 districts passed TASTAS plan for 2015: 26 districtsResurveying: 107 districts (ongoing)MDA in 2015: planned for 158 districts

MMR 5/45 districts passed TASTAS plan for 2015: 12 districtsMDA not initiated: 7 districts

NEP 20/61 districts passed TASTAS plan for 2015: 11 districts

TLS Plan to restart MDA in 4 districts: Q3/Q4, 2015

Geographical coverage (LF)

Bangladesh India Indonesia Myanmar Nepal Thailand0

10

20

30

40

50

60

70

80

90

100

2011 2012 2013

Note: Maldives, Sri Lanka & Thailand under post MDA surveillance

Programme coverage (LF)

Bangladesh India Indonesia Myanmar Nepal Thailand0

10

20

30

40

50

60

70

80

90

100

2011 2012 2013

National coverage (LF)

Bangladesh India Indonesia Myanmar Nepal Thailand0

10

20

30

40

50

60

70

80

90

100

2011 2012 2013

Status of National Coverage in Sea Region, 2011-2013

Number of people treated (LF)

2014 MDAIndia: completed MDA in 45/136 districts. Rest of the districts expected to be complete by early Q2 in 2015Indonesia: data (93 districts) not available

Impact assessment

Bangl

ades

hIn

dia

Indo

nesia

Mal

dive

s

Mya

nmar

Nepal

Sri Lan

ka

Thaila

nd

Timor

-Les

te0

50

100

150

200

250

300

350

400

IUs requiring MDAStarted MDAMDA stoppedTAS eligible/completed

STH coverage 2013: PreSAC

Bangl

ades

h

Bhuta

n

DPRKIn

dia

Indo

nesia

Mya

nmar

Nepal

Timor

-Les

te

SEAR

-

20,000,000

40,000,000

60,000,000

80,000,000

100,000,000

120,000,000

PreSAC requiring PCPreSAC treated

STH coverage 2013: SAC

Bangladesh Bhutan DPRK India Indonesia Myanmar Nepal Timor-Leste SEAR -

50,000,000

100,000,000

150,000,000

200,000,000

250,000,000

300,000,000

SAC requiring PCSAC treated

Schistosomiasis coverage

2013 20140

2000

4000

6000

8000

10000

12000

14000

16000

18000

Target populationPopulation treated

2014: data may be incomplete

Recent publicationElimination of Lymphatic Filariasis-Current status and way

ahead (2014); P.K.Srivastava et al Journal of Communicable Diseases; 2(46) 85-94

Elimination of Lymphatic Filariasis in Goa: First Successful Transmission Assessment Survey in India (2014); P.K.Srivastava et al Journal of Communicable Diseases; 2(46) 7-16

A Tool for Monitoring Epidemiological Impact of MDA in the Elimination of Lymphatic Filariasis-An Indian Experience (2014); P.K.Srivastava et al Journal of Communicable Diseases; 2(46): 1-6

Gunawardena et al, 2014. Integrated School-Based Surveillance for Soil-Transmitted Helminth Infections and Lymphatic Filariasis in Gampaha District, Sri Lanka; Am. J. Trop. Med. Hyg., 90(4), pp. 661–666

SurveillanceLF: sentinel and spot checks, TAS, Post MDA

surveillance, line listing of lympheodema and hydrocele cases, using HIMS for operated hydrocele cases

STH: follow-up stool survey done in BANTRA: population based survey in NEPIntegrated STH and LF surveillance in Sri

Lanka

PCT data managementWHO standardized tools (JRSM, JRF, AWP) are used

by all countriesIndonesia has started using integrated NTD

databaseEfficiency and data flow is good in most of the

countries but needs improvement in larger countriesNo regional databaseData quality needs improvement in some countriesIndia has taken measures on strengthening data

management and M&E: a consultant and 6 additional staff at central level and 17 at state level has been recruited

Programme evaluation in 2014IndiaJMM of vector-borne diseasesIndependent appraisal of LF programme through the

Indian Council of Medial Research (VCRC)o 12 districts from six states were selected

IndonesiaNational programme evaluation meetingIn-depth review of 27 districts with various coverage

and performance issues (as per RPRG recommendation)Participated by National Taskforce on Filariasis, WHO

(HQ, RO & WCO), RTI along with central and district programme staff

Challenges and needsInadequate fundsLow priority and resource allocation in decentralized

settingsWeak procurement and supply chain managementHigh cost of TAS and difficulty in getting diagnosticsHR constraintsStrengthening M&EPoor urban coverageTackling Hot SpotsExpanding coverage and intensifying morbidity

managementMDA surveillance and sustaining achievementSurveillance in migrant population

Thank You