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TopicView:Neglected tropical diseases

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Country Summary

Zimbabwe

O conteúdo em Portugês estará disponível em breve.


This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

Namibia

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

Mozambique

As doenças tropicais negligenciadas representam uma grande carga para a saúde pública em Moçambique. Estas doenças estão fortemente associadas com as condições precárias de saneamento do meio e níveis de pobreza. A população que vivem nas zonas rurais carregam o maior peso destas doenças.

O recente mapeamento epidemiológico de schistosomiase e helmintíase transmitida por solo revela que estas doenças ocorrem em todo o país. A prevalência global nas crianças de 5-15 anos de schistosomiase urinária é de 47% e da helmintíase transmitida pelo solo é de 53% com cerca de metades dos distritos híper-endémicos (taxas de prevalências acima de 50%). (Augusto G et al, 2010)

A filaríase linfática é também endémica em Moçambique, em particular nas províncias do norte e centro do país com uma taxa até 82% em alguns distritos da província de Nampula. Dos 128 distritos, 103 são endémicos e cerca de 16 milhões de pessoas estão em risco de contrair a doença. Estudo realizado em 2005-06 encontrou uma prevalência nacional é de 13%.

Mauritius

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

Mauritania

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

Mali

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

Sierra_Leone

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

Guinea

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Résumé analytique

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Nombre de cas déclarés de lèpre en Guinée et dans les pays limitrophes, 2008
Nombre de cas déclarés de lèpre en Guinée et dans les pays limitrophes, 2008.JPG

...: Données indisponibles

Charge de morbidité

Endémicité des maladies

Chimioprophylaxie

Couverture de maladies spécifiques

Etat de la surveillance

Notes de fin: sources, méthodes, abréviations, etc.

Kenya

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Analytical summary

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Number of reported cases of leprosy in Kenya and neighboring countries, 2008
Number of reported cases of leprosy in Kenya and neighboring countries, 2008.JPG

Disease burden

Infection/disease endemicity

Preventive chemotherapy

Disease-specific coverage

State of surveillance

Endnotes: sources, methods, abbreviations, etc.

Guinea-Bissau

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Resumo analítico - Doenças tropicais negligenciadas

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Nombre de cas declarés de lèpre en Guinée-Bissau et dans les pays limitrophes, 2008
Nombre de cas declarés de lèpre en Guinée-Bissau et dans les pays limitrophes, 2008.JPG

Fardo de doença

Endemicidade da infecção/doença

Tratamento preventivo

Cobertura específica para as doenças

Estado da vigilância

Notas de fim: fontes, métodos, abreviaturas, etc.

Ghana

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Analytical summary

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Number of reported cases of leprosy in Ghana and neighboring countries, 2008
Number of reported cases of leprosy in Ghana and neighboring countries, 2008.JPG

...: No data

Disease burden

Infection/disease endemicity

Preventive chemotherapy

Disease-specific coverage

State of surveillance

Endnotes: sources, methods, abbreviations, etc.

Niger

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

Nigeria

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

Seychelles

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

Zambia

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

Uganda

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

Togo

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

Tanzania

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

Swaziland

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

South_Sudan

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

South_Africa

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

Senegal

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

Rwanda

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

Sao_Tome_and_Principe

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Nombre de cas déclarés de lèpre au Sao Tomé-et-principe[1] et dans les pays limitrophes, 2008
Nombre de cas declares de lepre au Sao Tome-et-principe et dans les pays limitrophes 2008.JPG


Gambia

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Analytical summary

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The prevalence of neglected tropical diseases has increased over the years in the Gambia, mainly due to lack of Government-coordinated community-based intervention programmes, poverty at household level and related social determinants. Currently, there is no evidence-based information determining the extent of the burden of neglected tropical diseases on families, communities and the state.

Contributing factors may be related to inadequate coordination and management of data and information from the public, nongovernmental organization and private facilities and institutions. According to data from public health facilities, including the Department of Social Welfare, the burden of these diseases far exceeds that of infectious diseases. Efforts are underway to increase awareness and expand data sources through the Integrated Disease Surveillance and Response framework, which will also include private and nongovernment organization data.


Disease burden

Infection/disease endemicity

Preventive chemotherapy

Disease-specific coverage

State of surveillance

Endnotes: sources, methods, abbreviations, etc.

Gabon

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Lèpre, schistosomiase, trypanosomiase humaine africaine et ulcère de Buruli sont des MTN bien présentes au Gabon.

Bien qu’occultées par la prééminence donnée au VIH/sida, à la tuberculose et au paludisme, elles pèsent sur la société et le système de santé, touchant les populations économiquement faibles et nécessitant des soins intensifs (trypanosomiase en phase neurologique), des hospitalisations prolongées, des soins chirurgicaux et de réadaptation (lèpre, ulcère de Buruli) qui accroissent les dépenses de santé.

Le contexte social et culturel gabonais entraîne pour la lèpre et l’ulcère de Buruli stigmatisation et exclusion sociale, ce qui aggrave la misère des personnes affectées. Toutes ces maladies sont l’objet d’un programme sanitaire spécifique, mais l’insuffisance des ressources humaines, matérielles et financières empêche leur prise en charge optimale.

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Résumé analytique

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Nombre de cas déclarés de lèpre au Gabon et dans les pays limitrophes, 2008
Nombre de cas déclarés de lèpre au Gabon et dans les pays limitrophes 2008.JPG

...: Données indisponibles

Charge de morbidité

Endémicité des maladies

Chimioprophylaxie

Couverture de maladies spécifiques

Etat de la surveillance

Notes de fin: sources, méthodes, abréviations, etc.

Botswana

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Analytical summary

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A few tropical diseases are endemic to certain parts of Botswana but are of a magnitude that does not warrant deliberate control programmes similar to those of tuberculosis, malaria and HIV/AIDS. Such diseases tend to be concentrated in the northern part of the country where the moisture conditions of the 20 000 km2 Okavango delta present a favourable environment for their proliferation and transmission.

Major factors determining the prevalence and distribution of the majority of the water contact diseases include:

  • surface water availability and permanence
  • human water contact behaviour such as the risk of water contamination
  • environmental and climate factors such as rainfall and temperature.

The prevalence and distribution of the diseases therefore vary from time to time, depending on the rainfall and water flow pattern.


Disease burden

Infection/disease endemicity

Preventive chemotherapy

Disease-specific coverage

State of surveillance

Endnotes: sources, methods, abbreviations, etc.

Burkina_Faso

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Les maladies tropicales négligées font l’objet d’un programme vertical au Burkina Faso. Les informations disponibles concernent surtout la filariose lymphatique, la Lèpre,

Dans le cadre de l’élimination de la filariose lymphatique au Burkina Faso, un programme national a été adopté et est mis en œuvre depuis 2001. Ce programme utilise essentiellement deux stratégies de lutte :

  • L’interruption de la transmission de la filariose lymphatique ;
  • La réduction des incapacités et invalidités liées aux complications de ce fléau que sont l’éléphantiasis et l’hydrocèle.

Angola

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Analytical summary

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Number of reported cases of leprosy in Angola and neighboring countries, 2008
Number of reported cases of leprosy in Angola and neighboring countries 2008.JPG

...: No data

Disease burden

Infection/disease endemicity

Preventive chemotherapy

Disease-specific coverage

State of surveillance

Endnotes: sources, methods, abbreviations, etc.

Algeria

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Résumé analytique

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Number of reported cases of leprosy in Algeria and neighboring countries, 2008
Number of reported cases of leprosy in Algeria and neighboring countries 2008.JPG

Charge de morbidité

Endémicité des maladies

Chimioprophylaxie

Couverture de maladies spécifiques

Etat de la surveillance

Notes de fin: sources, méthodes, abréviations, etc.

Malawi

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

Madagascar

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

Liberia

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Epidemiological mapping of neglected tropical diseases shows a wide distribution and overlap of onchocerciasis, lymphatic filariasis, shistosomiasis and leprosy in all 15 counties in Liberia. Neglected tropical diseases are a group of preventable and treatable diseases that have received little attention to date. They tend to affect the most vulnerable members of society.

The most common neglected tropical diseases in Liberia as well as the strategies to treat endemic populations are onchocerciasis, lymphatic filariasis, shistosomiasis, soil-transmitted helminthes and leprosy.

Lesotho

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This analytical profile on neglected tropical diseases is structured as follows:

4.9.1 Analytical summary
4.9.2 Disease burden
4.9.3 Infection/disease endemicity
4.9.4 Preventive chemotherapy
4.9.5 Disease-specific coverage
4.9.5.1 Buruli ulcer
4.9.5.2 Guinea worm disease
4.9.5.3 Human African trypanosomiasis
4.9.5.4 Leishmaniasis
4.9.5.5 Leprosy
4.9.5.6 Lymphatic filariasis
4.9.5.7 Onchocerciasis
4.9.5.8 Schistosomiasis
4.9.5.9 Soil-transmitted helminthiasis
4.9.5.10 Trachoma
4.9.6 State of surveillance

AFRO

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Analytical summary

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Neglected tropical diseases are, in the main, parasitic diseases that thrive in conditions of poverty and low environmental standards. These diseases impose a heavy burden on populations in the WHO African Region, not only because they are neglected, but also due to the high levels of disability and hence lost productivity they represent to already vulnerable communities. In addition, the chronic nature of neglected tropical diseases places a perpetual burden on weak and overstretched health systems.

Neglected tropical diseases account for 25% of all disability-adjusted life years attributable to infectious and parasitic diseases, and for 10% of mortality. While these diseases constitute a significant public health problem in the communities where they are endemic, their restriction to particular geographic areas and/or environmental conditions often prevents them from acquiring priority status at national level.


Disease burden

More than 50%[2] of the estimated global burden of Neglected Tropical Diseases (NTDs) occurs in African countries, and approximately 1 billion people suffer from one or more NTDs worldwide. The heavy and disproportionate burden of NTDs in the African Region affects many communities, resulting not only in heavy morbidity but also in high levels of deformity and disability. In addition, the chronic nature of many NTDs perpetuates the cycle of poverty and imposes a heavy burden on already weak and over-stretched health systems.

The major NTDs occurring in the Africa region include Guinea worm disease, leprosy, lymphatic filariasis, loasis, onchocerciasis, human African trypanosomiasis, and schistosomiasis. Others are soil-transmitted helminthiasis (STH), Buruli ulcer, yaws and other endemic treponematoses, leishmaniasis, trachoma, and endemic zoonoses. These diseases are most prevalent among poor and under-served communities, causing approximately 534 000 deaths annually[3]. Although NTDs may be of public health significance in the communities in which they are endemic, they are often not considered priorities and hence are neglected at all levels – community, national and international.

The incapacitation of NTD patients, as well as the impact on agricultural productivity, grossly contributes to poverty over generations. In terms of Disability Adjusted Life Years (DALYs) and deaths, of the 29% of the global burden attributable to infectious and parasitic diseases, NTDs account for 25% of DALYs and 10% of the deaths[4]. Lymphatic filariasis alone was estimated to result in 4.7 million DALYS annually, according to 2001 data[5]. In economic terms, the price of neglect is too high, as NTDs continue to fuel, in part, the current cycle of poverty, ill health and under-development in the African Region.

Infection/disease endemicity

Neglected tropical diseases are, largely, long-standing infectious diseases that thrive in impoverished settings, especially in the heat and humidity of tropical climates. Most are parasitic diseases, spread by insects ranging from mosquitoes, blackfly, and snails, to sand flies, tsetse flies, the “assassin bug”, and so-called flies of filth. Others are spread by contaminated water and soil infested with the eggs of worms. NTDs almost exclusively affect poor and powerless people living in rural parts of low-income countries, that is to say those with low literacy and little political voice. These diseases therefore contribute to maintaining the cycle of poverty and stigmatization.

Preventive chemotherapy

In 2006, WHO launched an Integrated Strategy for Preventive Chemotherapy, based on available, safe and effective drugs that can be administered preemptively to all populations at risk. A preventive chemotherapy strategy employs mass drug administration and is already being rolled out using a variety of methods such as school health days, child health days, vaccination campaigns, community directed treatment initiatives, and other proven mass drug administration activities.

The integrated preventive chemotherapy treatment against five major NTDs (onchocerciasis, lymphatic filariasis, schistosomiasis, soil-transmitted helminthiasis, and trachoma) costs less than 1 US dollar per person per year – a cost-effective intervention. However, even this modest cost is beyond the reach of most resource-constrained nations. Success will depend on uninterrupted access to low-cost medicines and rapid national scaling-up to cover populations at risk.

This strategy is being implemented in countries of the African Region. However, national coverage levels are very low. Ten years after the adoption of Resolution WHA50.29 on the elimination of lymphatic filariasis, the Mass Drug Administration (MDA) coverage in the African Region is low, standing at 16%. The minimum recommended coverage is 65%. Similarly, less than 10% of school age children receive antihelminthic (anthelmintic) drugs.

Disease-specific coverage

Buruli ulcer

Buruli ulcer (BU), a debilitating disease caused by Mycobacterium ulcerans, is the third most common mycobacterial disease in healthy humans after M. tuberculosisand M. leprosy. Cases have been identified in at least 22 countries of the African Region since the early 1940s.

In January 1998, WHO established a Global Buruli Ulcer Initiative (GBUI), aimed at developing a global strategy to support affected countries throughout the world in controlling the disease. In May 2004, the World Health Assembly adopted Resolution WHA 57.1 on BU control and surveillance.

By the end of 2005, it was clear that BU, with an estimated 43 000 cases, had become a major endemic disease and a public health problem in WHO African Region.

BU control is based on early diagnosis of cases and treatment with the WHO recommended regimen combining rifampicin and streptomycin, administered daily for 4 or 8 weeks. Late diagnosed cases with large ulcers or bone involvement require further case management through surgery and physiotherapy.

In terms of endemicity, 15 countries are confirmed as BU endemic. Cote Ivoire has reported approximately 22,000 cases. Eleven countries are potentially endemic; these neighbour the previous group and possess similar characteristics that favour BU, such as inter-tropical areas, marshy areas, and forest areas near slow-flowing rivers.

Most affected countries are integrating BU control measures with those for tuberculosis and leprosy, using the same laboratory facilities and supervising staff and logistics at intermediate and district level.

Guinea worm disease

Dracunculiasis (Guinea worm disease) eradication is based on measures recommended in Resolutions WHA39.21 and WHA57.9, and the 2004 Geneva Declaration on Dracunculiasis Eradication.

Dracunculiasis is now close to eradication: the disease is now endemic in only three African countries. Significant progress has been made in the African Region toward the eradication of dracunculiasis, a disease caused by worms of the species Dracunculus medinensis, mainly transmitted through the skin as larval forms while bathing in infested waters. The annual incidence of the disease decreased from 11 882 cases in 2003 to 457 cases in 2009, representing a 91.6% reduction. At the end of 2009, 32 countries were certified free of Guinea worm disease, and seven countries are in the pre-certification stage. Ethiopia, Ghana and Mali are currently the only countries still endemic for Guinea worm disease.

Human African trypanosomiasis

Human African Trypanosomiasis (HAT or sleeping sickness) occurs in 36 countries of sub-Saharan Africa, where over 36 million people are at risk of the disease. The annual incidence is estimated at 450 000, but less than 5% of the population at risk is under surveillance. HAT is caused by a flagellate protozoan parasite – Trypanosoma brucei rhodesiense (especially in east Africa) and T. b. gambiense (in west Africa). Uganda is the only country in the African Region where both species exist. The parasite is transmitted by tsetse flies (Glossina species).

Figure 1: HAT Case Reports in AFRO Region (WHO 2008) Fig23section49NTDfig1 HAT.png


HAT constitutes an important public health problem in 10 of the 36 countries concerned[6] . The disease occurs mostly in remote areas, affecting populations with little or no access to health services. Poor surveillance systems exacerbate the problem.

Leishmaniasis

Leishmaniasis affects more than 300 million people worldwide. It is caused by 20 species pathogenic to humans belonging to the genus Leishmania, protozoa transmitted by the bite of a tiny 2–3 millimetre long insect vector, the phlebotomine sand fly. There are two basic clinical presentations: visceral leishmaniasis (VL), also known as kala azar, and cutaneous leishmaniasis (CL). Cutaneous leishmaniasis tends to resolve spontaneously but causes significant social and psychological stigma. VL is characterized by irregular bouts of fever, substantial weight loss, swelling of the spleen and liver, and anaemia – occasionally serious. If left untreated, the fatality rate in developing countries can be as high as 100% within two years. The African Region is the second largest repository of leishmaniasis, accounting for 17% of the global disease burden.

Leprosy

Leprosy, an infectious and disabling disease, is caused by the Mycobacterium leprae. Transmission of M. leprae is aerial, and takes place directly between persons. It is associated with heavy and negative social stigma due to the physical damage that accompanies complications. The isolation and the social rejection of those infected tend to transform it into a disease of poverty. Promiscuity and poor housing hygiene conditions favour the spread of the disease.

Following Resolution WHA44.9, leprosy has been a major issue among health programmes for the last 10 years, with greatly increased political commitment. Most national leprosy elimination programmes have reached their targets, with the result that there has been a significant overall reduction of the number of leprosy cases in the African Region. All 46 countries have achieved the elimination of leprosy at national level. The number of new leprosy cases has decreased from 52 751 in 2000 to 31 097 in 2008, while the prevalence rate at the end of 2008 was 0.43 cases per 10 000 inhabitants. However, the proportion of children and the proportion of leprosy cases with disability degree 2 have remained at approximately 10% for many years. The disability and stigma attached to the disease are factors that aggravate poverty.

Figure 2: Leprosy prevalence rate in AFRO Region in 2008 Fig23section49NTDfig2 LEPROSY.png


To sustain present achievements and strengthen the quality of leprosy services to further reduce the burden of the disease in Member States, the WHO African Region is developing a new strategy to target the elimination of leprosy at health district level.

Lymphatic filariasis

Lymphatic Filariasis (LF) is caused by several filarial species dwelling within lymphatic vessels. Found in warm, humid, tropical countries, these filarial parasites are transmitted by mosquitoes. In some regions, they share the same vectors as malaria parasites. In Africa, only one species – Wuchereria bancrofti – is responsible for LF. Of the 120 million infected people in 80 countries worldwide, the African Region accounts for about 38%. In African countries, the main chronic manifestations are hydroceles and lymphoedema/elephantiasis. LF is now recognized as the second major cause of permanent and long-term disability (WHO, 1995).

In recognition of the burden and impact of LF, the World Health Assembly resolved in 1997 to eliminate the disease as a global public health problem within a period of 20 years. As a consequence, a Global Programme for Elimination of Lymphatic Filariasis (GPELF) was launched, and each endemic member country was expected to set up a Programme for Elimination of Lymphatic Filariasis (PELF).

Significant progress has been made towards LF elimination. By 2008, the number of people treated through mass drug administration (MDA) for LF elimination had increased from less than 0.5 million in four countries in 2000 to 57.8 million in 17 countries. Approximately 216.4 million cumulative treatments have been given through mass drug administration schemes (MDA) over the same period, covering 50% of targeted endemic countries. These interventions have led to the reduction of microfilaria prevalence to thresholds of interrupting transmission in Zanzibar, Togo, Comoros, and some districts in Ghana, Burkina Faso and Kenya. However, these efforts represent coverage of only 14% of the total population at risk in Africa.

Figure 3: Mass Drug Administration for LF (2000-2008) Fig23section49NTDfig3 LF.png

Onchocerciasis

Onchocerciasis, characterized by skin and eye lesions, is a parasitic disease caused by Onchocerca volvulus. It is transmitted by small black flies of the Genus Simulium that breed in rapidly flowing rivers and streams. The adult parasites have a life span of 8–15 years, during which time they release thousands of microfilariae every year. These microfilariae enter the skin and eyes, causing inflammation and disease. WHO estimates that at least 17.7 million people are infected, 500 000 are visually impaired, and 270 000 blinded from onchocerciasis in 37 endemic countries, of which over 95% are found in Africa.

The main strategy used to control onchocerciasis is Community Directed Treatment with Ivermectin (CDTI) in meso-endemic and hyper-endemic communities. The aim of the treatment strategy is to achieve 100% geographic coverage of endemic areas, in which at least 65% is in meso and hyper-endemic areas.

Figure 4: Community-directed tretment with Ivermectin areas in APOC countries

Fig23section49NTDfig4 ONCHO.png


Ivermectin is a microfilaricidal drug, and in the absence of macrofilaricides, it should be administered over a long period (13–20 years) in order to eliminate onchocerciasis as a public health problem. Therefore, long-term compliance with ivermectin treatment by all eligible communities in both meso-endemic and hyper-endemic areas is crucial in achieving sustainable disease control.

Schistosomiasis

Schistosomiasis, a parasitic disease of man and other mammals, is caused by infections with trematodes of genus Schistosoma. There are five schistosome species that infect humans, and three occur either mainly in Africa (S. haematobium and S. mansoni) or are restricted to the continent (S. intercalatum). Sub-Saharan Africa carries 85% of the global burden of about 200 million infected people; at least 160 million people in 43 African countries suffer from schistosomiasis, and the majority of these are children.

The schistosomiasis control strategy comprises morbidity control through annual mass de-worming exercises to reach all persons residing in the endemic areas, using WHO guidelines. Supportive control measures include intensive health education to the affected communities, and provision of sanitary facilities and safe water especially in schools.

WHO has set a target to treat at least 75% of all school-age children at risk of schistosomiasis and soil-transmitted helminthic infections by 2010[7]. By the end of 2009, eight countries had undertaken mass treatment of whole target populations, while 12 more countries have partially covered populations at risk through mass treatment with Praziquantel.

Soil-transmitted helminthiasis

Almost all Member States in the African Region are endemic for soil transmitted Helminthiasis (STH) to varying degrees. Ascaris lumbricoides, hookworms, and Trichuris trichuria are the most common causative agents. The control of STH is also being revived in the light of new data citing the negative impact on child development and school performance. Resolution WHA 54.19, passed in 2001, called for joint implementation of control of schistosomiasis and STH, with a target of reaching 75% morbidity-control coverage of school-age children by 2010.

The adopted strategy comprises periodic administration of anti-helminthic drugs through school-based, health facility-based, and community-based approaches. The drugs of choice are albendazole or mebendazole. Supporting strategies, as for schistosomiasis control, are health education, and improvements in water supply and sanitation.

Trachoma

Trachoma is one of the oldest known infectious diseases of the eye, with references dating back to ancient Egypt. Trachoma continues to plague the developing world, remaining endemic in the poorest regions. WHO has endorsed a strategy based on surgery for those who already have complications (trachoma trichiasis). Antibiotics (Zithromax, given as a community directly observed treatment to endemic communities), and face washing, improved personal hygiene and environment improvements, are among the most important measures necessary to eliminate blinding trachoma.

State of surveillance

Way forward

The overall goal of the WHO Joint Strategic Plan for Control of NTDs in the African Region (2010–2015), is to establish strong, sustainable, country-owned programmes capable of achieving the regional and national goals agreed for the control, elimination and eradication of targeted NTDs.

In order to achieve this goal, this Strategic Plan defines four Strategic Areas:

  • Strategic Area 1: Strengthen Advocacy, Coordination and Partnerships
  • Strategic Area 2: Enhance resource mobilization and Planning for Results
  • Strategic Area 3: Scale-up access to interventions, treatment and system capacity building
  • Strategic Area 4: Enhance monitoring, surveillance and operations research.

Endnotes: sources, methods, abbreviations, etc.

References

1. Neglected Diseases : A human rights analysis, WHO, TDR/SDR/SEB/ST/07.2 (2007)

2. Hotez PJ, Molyneux DH, Fenwick A, Ottesen E, Ehrlich Sachs S, Sachs JD. Incorporating a rapid-impact package for neglected tropical diseases with programs for HIV/AIDS, tuberculosis, malaria. PLoS Med 2006;3:e102-e102

3. Engels D & Savioli L (2006) Reconsidering the underestimation of burden caused by neglected tropical diseases. TRENDS in Parasitology, Vol. 22, No. 8.

4. Disease Control Priorities Project (DCCP, World Bank, WHO) 2006.

5. Angola, Republic of Congo, Cameroon, Central African Republic, Chad, Democratic Republic of Congo, Equatorial Guinea, Gabon, Republic of Guinea, Ivory Coast 6WHA Resolution 54.19 (2001)


Tables and figures

Figure 1: HAT Case Reports in AFRO Region (WHO, 2008)

Figure 2: Leprosy prevalence rate in AFRO Region in 2008

Figure 3: Mass Drug Administration for LF (2000-2008)

Figure 4: Community-directed tretment with Ivermectin areas in APOC countries

References

  1. No data...
  2. Neglected Diseases : A human rights analysis, WHO, TDR/SDR/SEB/ST/07.2 (2007)
  3. Hotez PJ, Molyneux DH, Fenwick A, Ottesen E, Ehrlich Sachs S, Sachs JD. Incorporating a rapid-impact package for neglected tropical diseases with programs for HIV/AIDS, tuberculosis, malaria. PLoS Med 2006;3:e102-e102
  4. Engels D & Savioli L (2006) Reconsidering the underestimation of burden caused by neglected tropical diseases. TRENDS in Parasitology, Vol. 22, No. 8.
  5. Disease Control Priorities Project (DCCP, World Bank, WHO) 2006.
  6. Angola, Republic of Congo, Cameroon, Central African Republic, Chad, Democratic Republic of Congo, Equatorial Guinea, Gabon, Republic of Guinea, Ivory Coast
  7. WHA Resolution 54.19(2001)

Title

Doenças tropicais negligenciadas

Benin

O conteúdo em Portugês estará disponível em breve.

Le Bénin, à l’instar de beaucoup d’autres pays africains mène une lutte contre les maladies invalidantes telles que la bilharziose, l’onchocercose la filariose lymphatique et bien d’autres. Cette lutte est menée par des programmes qui donnent des résultats encourageants. Pour améliorer et pérenniser les acquis ainsi obtenus, le Ministère de la santé a mobilisé autour de cette cause, certains partenaires internationaux, pour élaborer et mettre en œuvre un plan de lutte intégrée contre les maladies tropicales négligées. Deux groupes de maladies tropicales négligés existent au Bénin. Le premier groupe est constitué par des maladies pour lesquelles des stratégies de lutte ont été définies. Ce groupe comprend l’onchocercose, la filariose lymphatique, les vers intestinaux, la bilharziose, et le trachome. Le deuxième groupe est dénommé maladies à prise en charge des cas comprend, la trypanosomiase africaine ou maladie du sommeil, le ver de guinée, la lèpre et l’ulcère de Buruli.

Burundi

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Résumé analytique

O conteúdo em Portugês estará disponível em breve.

Le groupe des maladies concernés [1] sont l'onchocercose, les géo helminthiases, la schistosomiase, le trachome, la cécité, la cysticercose et la lèpre.

L’Onchocercose est connue comme méso ou hyper-endémique dans 10 Districts sanitaires sur les 45 que compte le pays. Un traitement de masse utilisant la stratégie de « Directives Communautaires (TIDC) » a été mise en œuvre en 2005 à Cibitoke - Bubanza ainsi qu’à Bururi et Rutana en 2006. Le taux de couverture thérapeutique varie de 68% à 76% en 2009.Le MSPLS, en collaboration avec ses partenaires, est en phase de mettre en place une stratégie de l’élimination de la transmission de l’onchocercose.


Charge de morbidité

Endémicité des maladies

Chimioprophylaxie

Couverture de maladies spécifiques

Etat de la surveillance

Notes de fin: sources, méthodes, abréviations, etc.

Référence

  1. Maladies négligées. doc 920Ko

Cameroon

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Résumé analytique

O conteúdo em Portugês estará disponível em breve.

Nombre de cas notifiés de lèpre au Cameroun et dans les pays limitrophes, 2008
Nombre de cas notifiés de lèpre au Cameroun et dans les pays limitrophes, 2008.JPG

Charge de morbidité

Endémicité des maladies

Chimioprophylaxie

Couverture de maladies spécifiques

Etat de la surveillance

Notes de fin: sources, méthodes, abréviations, etc.

Ethiopia

O conteúdo em Portugês estará disponível em breve.

Leprosy, dracunculiasis, onchocerciasis, leishmaniasis, schistosomiasis, soil-transmitted helminthiasis, lymphatic filariasis and trachoma are among the neglected tropical diseases prevalent to varying degrees in different parts of Ethiopia. A target intervention for prevention and control of neglected tropical diseases is included in the Health Sector Development Programme IV, which covers the period from 2010 to 2014.[1] The eight neglected tropical diseases prioritized are dracunculiasis, onchocerciasis, leishmaniasis, lymphatic filariasis, trachoma, soil transmitted helminthiasis, schistosomiasis and podoconiosis.[2]

Democratic_Republic_of_the_Congo

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Résumé analytique

Charge de morbidité

Endémicité des maladies

Chimioprophylaxie

Couverture de maladies spécifiques

Etat de la surveillance

Notes de fin: sources, méthodes, abréviations, etc.

Eritrea

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Analytical summary

O conteúdo em Portugês estará disponível em breve.

Number of reported cases of leprosy in Eritrea and neighboring countries, 2008
Number of reported cases of leprosy in Eritrea and neighboring countries, 2008.JPG

...: No data

Disease burden

Infection/disease endemicity

Preventive chemotherapy

Disease-specific coverage

State of surveillance

Endnotes: sources, methods, abbreviations, etc.

Equatorial_Guinea

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Résumé analytique

Charge de morbidité

Endémicité des maladies

Chimioprophylaxie

Couverture de maladies spécifiques

Etat de la surveillance

Notes de fin: sources, méthodes, abréviations, etc.

Côte_d'Ivoire

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Résumé analytique

Charge de morbidité

Endémicité des maladies

Chimioprophylaxie

Couverture de maladies spécifiques

Etat de la surveillance

Notes de fin: sources, méthodes, abréviations, etc.

Comoros

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Résumé analytique

Charge de morbidité

Endémicité des maladies

Chimioprophylaxie

Couverture de maladies spécifiques

Etat de la surveillance

Notes de fin: sources, méthodes, abréviations, etc.

Congo

O conteúdo em Portugês estará disponível em breve.

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Résumé analytique

L’année 2010 a été la 4e année de la mise en œuvre du plan national de la lutte contre les maladies chroniques non transmissibles (MNT). Ce plan avait une durée de cinq (5) ans, depuis 2007. Les activités diverses étaient prévues dans les domaines suivants : la formation du personnel, les évaluations annuelles et à mi -parcours, les supervisions du niveau central au niveau périphérique, la célébration des journées mondiales, la sensibilisation de la population par les journaux et les émissions radio télévisées.

Seules ont pu être réalisées les activités suivantes : (i) Organiser la célébration de la journée mondiale contre le tabac ; (ii) Organiser les émissions radio télévisées et publier les articles dans les journaux sur les méfaits du tabac alcool et autres drogues ; (iii) Former les agents des CSI et HR sur la prise en charge des MNT ; (iv) Elaborer et adopter des instructions de prise en charge des MNT ; (v) Publication de ces instructions ; (vi) Organiser la compagne de dépistage des MNT ; Organiser les missions de supervision de CSI ; (vii) Elaborer les algorithmes et les modules de formation ; (viii) Elaborer et valider le plan stratégique de lutte contre le tabac [1].

Charge de morbidité

Endémicité des maladies

Chimioprophylaxie

Couverture de maladies spécifiques

Ulcère de Buruli

L'ulcère de Buruli a fait son apparition en 2000 dans les départements du Kouilou, du Niari et de la Bouenza. En 2005, 293 cas cumulés ont été enregistrés et répartis comme suit : 77,8% dans le Kouilou, 12,3% dans le Niari et 12,1% dans la Bouenza.

Trypanosomiase humaine africaine

Le taux de prévalence moyen national est actuellement autour de 2 à 3%. Actuellement, les foyers de Ignié et Ngabé sont les plus brûlants. Les dernières prospections dans quelques foyers donnent des indications suivantes :

- foyer d’Ignié : 3% (année de prospection Mars 2009) ;

- foyer de Ngabé-Mpouya : 1% (année de prospection Juin 2009) ;

- foyer de Loudima : 0.2% (année de prospection Juin 2007) ;

- foyer de Mossaka : 0.1% (année de prospection Mars 2007) ;

- foyer de Loukoléla : 0.7% (année de prospection Février 2008).

Les autres foyers n’ont plus été visités depuis près de quatre années, mais les cas détectés passivement sont enregistrés.


Les foyers

La THA touche cinq (5) départements du pays : Niari, Bouenza, Pool, Plateaux et Cuvette. Près de treize (de 13) districts administratifs sont concernés :

- Niari : district de Kimongo ;

- Bouenza : districts de Loudima, Boko-Songho, Madingou, Nkayi; Yamba;

- Pool : districts d’Ignié, Ngabé, Mindouli;

- Plateaux : districts de Mpouya, Gamboma, Makotimpoko ;

- Cuvette : districts de Mossaka, Loukoléla.

Les anciens foyers de Mbomo et Nkellé (Cuvette Ouest) sont silencieux depuis plus de vingt ans au regard de la surveillance. Par contre on enregistre des cas qui ressortent des zones jusque là indemnes qui nécessitent une documentation poussée afin d’établir l’origine probable de leur contamination. Ces cas de figures sont retrouvés dans les districts de Gamboma (Plateaux), Mindouli (Pool), Tsiaki (Bouenza) et Pointe-noire.


Carte des foyers de la THA au Congo

Shema23.PNG


Les structures de lutte

Depuis la mise ne place du programme en 1980, onze (11) centres de dépistage et de traitement ont été créés. A ce jour, seulement six (06) sont fonctionnels et les cinq (05) autres, pour des raisons diverses ne sont pas opérationnels.

Centres fonctionnels Centres non fonctionnels
Brazzaville (base du programme) ;

Nkayi, Loudima, Madingou (Bouenza)
Gamboma (Plateaux)
Mossaka (Cuvette)

Boko-Songho (Bouenza)

Dolisie (Niari)
Ngabé, Mindouli (Pool)
Mpouya (Plateaux).

Lèpre

En 2005, 215 cas ont été enregistrés soit un taux de prévalence de 0,67 pour 10.000 habitants. 9,1% des cas nouveaux sont constitués par les enfants. Par ailleurs, 207 cas ont été détectés soit un taux de 0,64% pour 10.000 habitants. Le pourcentage des multi bacillaires parmi les nouveaux cas est de 79,2%. Principaux indicateurs:

Malades dépistés / année : 145 dont
- Multi bacillaires (MB) : 114
-Et Pauci bacillaires (PB) : 31
Soit un taux de détection de 0,38 lépreux pour 10.000 habitants

Malades restants en traitement (Prévalence) : 366 malades dont
- Multi bacillaires (MB) : 292
- Et Pauci bacillaires (PB) : 64
Soit un taux de prévalence de 0,98 lépreux pour 10.000 habitants

Rapport prévalence/détection : 366/145 = 2.52
Pourcentage des Multi bacillaires (MB) : 79,3%
Pourcentage des enfants : 8,2%
Pourcentage des invalidités de degré 2 : 6,2%
Pourcentage des PB à lésion unique : 67,74 %
Pourcentage des femmes : 45,5%
Nombre cas guéris : 63 malades,
Couverture sanitaire en Poly chimiothérapie (PCT) : 100%

En 2009, le seuil d’élimination qui était acceptable est entrain de remonter jusqu’à 1 car le taux de prévalence est de 0,98 lépreux pour 10.000 habitants, donc la surveillance de la maladie doit être accrue et les activités intensifiées en dotant plus de moyens financiers pour les activités sur le terrain.


Points forts :

  • Maintien du seuil d’élimination lèpre depuis 2003 ;
  • Couverture sanitaire en PCT élevé : 83,5% ;
  • Taux de détection stable, mais toujours élevé (existence encore des cas de lèpre) ;
  • Faible pourcentage des infirmités de degré II au dépistage : 6,2% ;
  • Taux de guérison élevé : 83,4% (analyse des cohortes) ;
  • Bonne connaissance de la maladie par les populations du pays ;
  • Réduction du stigmate, de l’ostracisme et de la ségrégation ;
  • Bons résultats de l’évaluation du programme lèpre par l’OMS AFRO ;
  • Programme lèpre en bonne voie d’intégration ;


Points faibles :

  • Pourcentage élevé de multi bacillaire (79,3 %) ;
  • 6 départements sur 12 ont des seuils d’élimination fluctuants (instables) ou ne l’ont pas encore atteints ;
  • Démotivation de beaucoup de personnels de santé aux activités lèpre ;


Contraintes:

  • Existence de zones d’accès difficile (zones enclavées, aquatiques, de cataractes marécageuses, de forêts et insécurité) ;
  • Existence de populations pygmées nomades/migrantes, analphabètes et peu émancipées pour bien intérioriser les messages ;
  • (Insuffisance de personnels dans certains secteurs médecins infirmiers superviseurs lèpre…) ;
  • Insuffisance de moyen de déplacement (hors bords motos pirogues) ;
  • Insuffisance de budgets pour la réalisation de toutes les activités programmées dans les différents plans d’action des secteurs et de la coordination ;
  • Difficultés de suivi et contrôle de certains malades notamment les pygmées (Nomadisme ou migration) difficile (zones enclavées, aquatiques, de Cataractes marécageuses, de for

Onchocercose

Le Projet TIDC- Congo s’est exécuté dans toute l’aire du Projet, c’est à dire dans les 748 communautés TIDC (133 hyper et 615 méso- endémiques) de la zone cible de Brazzaville, des Départements du Pool, de la Bouenza, du Niari et du Kouilou. Toutes ces communautés ont été traitées (couverture géographique de 100%).

Dans toute la zone du Projet, une population totale de 755124 personnes a été recensée par les DC. Le but ultime de traitement (BUT) est identique à l’objectif annuel de traitement (OAT) soit 634304 (84% de la population totale). 611399 personnes ont été traitées soit 81,0% de la population totale recensée et 96,4% de l’objectif annuel de traitement.

Dans cette zone couverte par le Projet, les populations sont, pour la grande majorité, sédentaires. Dans les zones forestières des régions du Niari et du Kouilou, on rencontre une minorité des pygmées qui sont par essence un peuple nomade mais qui, de plus en plus deviennent, sédentaires avec l’intégration.

Toutes les séances de formation/ recyclage du personnel de santé des départements, districts et centres de santé, se sont faites en « cascade ». 158 agents des aires de santé ont été recyclés dans l’ensemble des districts sanitaires; 360 DC ont été nouvellement formés et 1275 recyclés, soit un total de 1635 DC formés dont 318 femmes.

Le ratio DC population traitée est de 1 DC pour 374 personnes traitées (1DC/775personnes traitées en milieu urbain et 1DC/229 personnes traitées en milieu rural). 205 des 748 communautés ont des DC femmes soit 27,4 % des communautés (66 communautés sur 246 en milieu urbain soit 26,8% et 139 sur 502 en milieu rural soit 27,7%).

Pour la 9ème année de mise en œuvre du Projet, les principaux défis ont été :

  • Le maintien de la décentralisation effective des activés et leur intégration dans le système national de santé à la veille du désengagement progressif et retrait de l’APOC ;
  • le maintien d’une couverture géographique à 100% et d’un taux de couverture thérapeutique à plus de 65%.

L’implication effective des FSPL, le renforcement de la supervision par le PNLO à tous les niveaux du système sanitaire et le plaidoyer auprès des autorités politiques et administratives ont permis de relever ces défis.

Le taux de couverture thérapeutique s’est considérablement amélioré, passant de 74,2% en 2008 à 81,0% en 2009. Ce résultat est la conséquence d’une supervision active, particulièrement à Brazzaville où la couverture thérapeutique a atteint pour la première fois la barre de 80% (65,4% en 2008 et 81,4% en 2009). Notons que sur un total de 25 districts administratifs, 16 ont atteint ou dépassé le seuil de 80% de couverture thérapeutique soit 64% des districts administratifs.

Aucun effet secondaire grave n’a été signalé.


- Les forces :

  • l’implication des sous- préfets des districts et chefs des communautés dans la mobilisation sociale et la sensibilisation de la population ;
  • le recensement de la population par les DC formés et les responsables des communautés ;
  • la confection des toises par les communautés ;
  • l’enlèvement de l’ivermectine par les communautés à partir des centres de santé ;
  • la mobilisation des populations par les communautés ;
  • la disponibilité des DC pendant la distribution ;
  • l’engagement des DC à poursuivre les activités TIDC ;
  • la contribution appréciable de la population aux activités TIDC ;
  • la connaissance des avantages du traitement par la population ;
  • la couverture géographique stable (100%) ;
  • l’intégration des activités au niveau du département sanitaire et de l’aire de santé (FSPL) ;
  • l’existence d’une équipe de district sanitaire compétent ;
  • la commande du Mectizan suit un circuit simple ;
  • l’implication des autorités administratives à tous les niveaux dans le processus de gestion de TIDC.


- Les faiblesses :

  • la difficulté à recruter des nouveaux DC et des DC femmes dans des projets où la couverture géographique est de 100% depuis plusieurs années reste la principale faiblesse.


- Les défis majeurs ont été :

  • le maintien d’une couverture géographique de 100% ;
  • le maintien des taux de couverture thérapeutique à plus de 80% dans l’aire du Projet en vue de l’élimination de la maladie;
  • la surveillance des effets secondaires pour un dépistage précoce des éventuels effets secondaires graves dans ce contexte de co-endémicité Loase-Onchocercose.

Schistosomiase

La Schistosomiase urinaire. Elle sévit dans plusieurs foyers avec des taux de prévalence qui varient entre 5 et 35% en milieu scolaire. Au total 2 018 cas ont été enregistrés en 2002, répartis entre les départements de la Bouenza (62,9%), du Kouilou (19,1%), de Brazzaville (10,4%) et du Niari avec 6,2% des cas. Une recrudescence de la schistosomiase a été observée dans les anciens foyers du Niari, de la Bouenza, du Kouilou et s’accompagne d’une extension de la maladie dans d’autres départements, notamment ceux de la Lékoumou.

Etat de la surveillance

Notes de fin: sources, méthodes, abréviations, etc.

Chad

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Résumé analytique

Charge de morbidité

Endémicité des maladies

Chimioprophylaxie

Couverture de maladies spécifiques

Etat de la surveillance

Notes de fin: sources, méthodes, abréviations, etc.

Central_African_Republic

Esta seção do perfil do sistema de saúde está estruturado da seguinte forma:

Résumé analytique

Charge de morbidité

Endémicité des maladies

Chimioprophylaxie

Couverture de maladies spécifiques

Etat de la surveillance

Notes de fin: sources, méthodes, abréviations, etc.

Cape_Verde

Das doenças negligenciadas apenas a lepra existe em Cabo Verde, apesar de se encontrar em declínio, e há referências para a filaríase linfática sem registo de número de casos;

Ilha de Santo Antão

Até a década dos anos 70 e início de 80, a lepra tinha uma prevalência relativamente elevada em Cabo Verde (3% em 1983), particularmente nas ilhas da Brava, Fogo, Santo Antão, Santiago e S. Vicente[3].

Os doentes mais graves do Fogo e Santo Antão eram internados nas gafarias de Praia Ladrão no Fogo e Barbasco, depois Sinagoga, em Santo Antão. O tratamento era, então, à base da monoterapia com Dapsona[4]. Os doentes menos graves eram tratados e seguidos a domicílio por agentes das Delegacias de Saúde.

A grande “viragem” na história da Hanseníase em Cabo Verde dá-se com a assinatura do acordo de cooperação entre o Ministério da Saúde e a AIFO (Associação Italiana Amigos de Raoul Follereau) em 1978.


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