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77
NATION _ WIDE RAPID EPIDEMIOLOGICAL MAPPING oF ONCHOCERCTASIS (REMO) REF,TNEMENT OF NIGERIA, , OCTOBER 30 - DECEMBER 13,2OOO . MISSION REPORT FOR woru,o HEALTH ORGAI\TZATION (WHO) AFRTCAN PROGRAMME FOR ONCHOCERCIASTS CONTROL (APOC) OUAGADOUGOU, BI'RKINA FASO. BY DR B. E. B. NWOKE OYHO Temporary adviser) Professor of Medicawubtic Heau! rarasuotogt & Eniomologt School of Biological Sciences Imo Stote University, Nigeria PMB 2000 Owerri, Nlgeria Tel: (234) E3 230 69E DECEMBER I2,2OOO
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Transcript of nigeria - WHO | World Health Organization
NATION _ WIDE RAPID EPIDEMIOLOGICAL MAPPINGoF ONCHOCERCTASIS (REMO) REF,TNEMENT OF
NIGERIA,, OCTOBER 30 - DECEMBER 13,2OOO
. MISSION REPORT
FOR
woru,o HEALTH ORGAI\TZATION (WHO) AFRTCANPROGRAMME FOR ONCHOCERCIASTS CONTROL (APOC)
OUAGADOUGOU, BI'RKINA FASO.
BY
DR B. E. B. NWOKE OYHO Temporary adviser)Professor of Medicawubtic Heau! rarasuotogt & Eniomologt
School of Biological SciencesImo Stote University, NigeriaPMB 2000 Owerri, Nlgeria
Tel: (234) E3 230 69E
DECEMBER I2,2OOO
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aSUMMARY
l.Onchoceiciasis in all the refined zones/areas of Sokoto,Zamfara,Adamawa,Kntsina, JigawnrNnsflrawa, Kaduna,Knno, Rnd ogun States is not aserious public health problem to warrant CDTI strategy,
2.Of the four outstanding LGAs in Imo State(Obowo,Ezinihitte,Ngor Okpala,Ahiazuand Abor),only the zone of Ngor Okpala LGA is CDTI area.
3.Only the northern part of Ovia south west and Ovia north west LGAs of EdoState(bordering Ondo State) is a CDTI area.
4In Ondo State,Irele,Okitipupa,Idanre and odrgbo LGAs wcre outstaldilg.'r5epresent result showed that only Idnre LGA rone *ai GDTI area.
S.The two LGAs refined in Ekiti state(Ikole and oye) are all GDTI area
6'Eight LGAS were refined in osun State. onchocerciasis is serious within the zonesof Ayeda Ade,Irepodun and Egbeofe LGAs.
7'Of the six outstanding LGAs in oyo State,the zones of the northern LGAs ofIrepo,olorunsogo,and oriri as wefl as Ido LGA are CDTI area.
9-91 th.e Hadeji River Basin of Yobe State,lg community were examined and12(63%) of them had no onchocercal nodule.Five(72%) of the communities who werepositive for onchocercal nodule had l-9% nodie prevarece and onry one.community,Dagona had 2OYo nodule rate.This result will be made clearer whenintegrated into the Atlas GIS.
'9.A total of 43 communities were refined from six LGfu in GombeState :Balanga,Akko,Billiri,Nafada,Dukkil and Funakaya.Except in the zones of Akkoand Dukku LcAs,'onchocerciasis is a serious probl.* in a[ the other LGAsexamined.
I2'REMO exercise was refined in 4l comminities in,2l LGAS in Borno state.ofthis,only the zones of Bama and Kala Balge LGAs are CDTI area.onchocerciasis isapparently absent or of low endemicity in ti'e other 19 LGAs in this Sahefian ,egion ofLake Chad basin.
l3.The'REMO exercise was conducted in Alkaleri,Kirfi,Bpuchi, Bogoro,TafawaBalewa,Dass,Toro,Ganjuwa and Duazo LGAs of iauchi state.A total of 35communities were rgfi.ned tl JHt study.The result showed that onchocerciasis wasabsent n-16(46%) of them.onty the zone of Toro LGA has the disease endemicity towarrant CDTI approach.
LIST OF CONTENT
1.0
2.0
3.0
4.0
5.0
6.0
7.0
31
3.2
3.3
7.1
SUMMARY -------- 2
INTRODUCTION
Study Area
MATERIALS AND METHODS
4
6
()
Training 6
RESULTS AND DISCUSSION 8
REFERENCES 44
ACKNOWLEDGEMENT --.------. -45
APPENDTX ____-_ _ 46
Mission Schedule 46
7.2 List of NOCP Participants 47
7.3 List of National ScientistVConsultants ----------------'- 47
7.4 Refined REMO Data --- ----- - 49il
L+
2.O INTRODUCTION
Human onchocerciasis is a serious public health problem in Nigeria and other westAfrican countries (prost,l986;Nwoke,ileo; od;iiy-;;;;g the..people at the end ofthe road" - the farmi'F.p^9P^YluJion who produce the urr[ oiou, food and industrial rawmaterials (Nwoke et at ilsl;. It is estimut.d thut about I I nrlilion Nrg;rt.;, .r; infectedby the parasite and more than 100,000 are blinded by it *i,r, or".40 million at risk. withthis picture, onchocerciasis is no long". a disease tnut ,touta be taken for granted in '
Fortunately, the advent of ivermectin (Mectizan) as an effective drug of choice for large -scale treatmeltt of onchocel'ciasis Itas revolutioniz-ed the Jir.ur. ,la,agenrent an4 givengreat hope for the contror. And with the wuo/apoC;;gy put in prace in thecontinent, there is greater.hope at sight for the.m"rtir. una successful control of thiscluonic and debilitating disease.
APOC is committed,through partnership with.Ministry of Health (MoH) and variousNon - Governmental DevJopment organizations fNcporl to control onchocerciasis inall endemic African countries through'mass iue.m".ti, airiiii"uiSr. j,'tTrro"o,i"n,,opoint out here that there is general alreement that the drug should be distributed first tocommunities whose members are atiisk_of aereloping ihE r"u..e and disabling ocular ordermal complication of onchocerciasis lTaylor.et ir,- i,g;; This risk is accepted to bedirectly related to the intensity of infection in the;;;;ity (Remme et al, r989).Furthermore, the demonstration of good correration bd;;, the prevarence ofonchocercal nodules and the skin m-icrofilariae i, u
"onr*rnity (Nwok e, r992b,wHo,1992;1995) provideda.bre-akthrough in_the.upia .pia..ioiogi"ut mapping ofonchocerciasis @EMO) (Ngoumou-& Wulrh,'1993).--
--
Informed by the advantage of REMO in onchocerciasis control, uNICEF by 1993 - lgg4supported the first nation - wide REMO exercise in the country with wHo providingtechnical guidance and logistic support. This pionee, *o.k hu, played a significant role inourunderstanding ofthe disease puit"rn in the;r*" Gmade et al, l99g) (Fig. I)The APoc strategy is.community ownership of the contror efforts through masstreatment of a! high risk areavzones - lsing the community oirected Treatment withIvermectin (CDTI) approach. However r"iJr."tir. pi.rr*g and implementation of theCDTI' APoc as a mitter of priority_requires *;p;.'d;ir. epidemiorogicar datagenerated using the wHo deveropid,na. upprorfi n i!;or;;i;i;-e;? Muiping oronchocerciasis (REMO) from aliendemic cbuntries. rn. nbnao results help to delineatethe main onchocerciasis endemit ur.ur/rone-s tlrat ."quirc ibrr priority and at the sametime ensure adequate coverage of all the high risk areas.
Informed by this, wyglApoc, June g - I0,l99g organized a national workshop at wHooffice, Lagos, on REMO/GIS on the definition;i46il'ffi.ty areas in Nigeria. withDr' Nutral (crD/Hearth Map, Geneva) and Dr. No,,l B'giilepocr in attendance, a1
5
14. REMO was refrned in 60 communities from 16 LGAs of Kebbi State. Onchocerciasisis not a major public health pioblem in the state except at Danko Wasogun LGA(bordering southern Zamfara state)
15. Thirty communities were examined from 9 LGAs in Kogi State. Only Omalaz;lneshowed definite CpU communities.
I6. By the present ex€rcise, REMO was relined in 29 communities of 8 LGAs in KwaraState. Onchocerciasis is endemic in allthe LGfu examined to warrant CDTI exceptEdu LGA.
17. Atotal of 83 communities from 8 LGAs in Tarabastatewere refined. The zones ofIbi, Gassol, Laq Karim Lamido, Jalingo and yorro LGAs were not CDTI areas.Only the area of Ardokola was CDTI zone. The REMO exercise in southern part ofSarduana LGA showed that the lowland areas, especially within the Donga riverbasin are definite CDTI as recorded in the lgg3lg4 ngUO. On the other hand thepresent result showed that the cold higtrland communities around Gembu zone whichhitherto were mapped definite CDTI by 1993t94 are not GDTI zone.
18 In Plateau State, 3l communities were refined in l0 LGAs. Only communities withinthe zones of Bassa, Jos East and Pankshin LGAs are CDTI ureai. The other 7 LGASare within the less endemic lowland zone of the State.
19. Akwa Ibom results showed that
1.0
b
the available REMO data were reviewed, analyzedand finally integrated with theexisting epidemiological data. At.the *i.ortrrl *o[rr,"p,lr,. refined map of GDTI areasin Nigeria (based on the current REMO data then) *.r J[r.rrped and agreed upon by allthe participating members of NorF as a true representative of the disease,s distributionas at June 10, 1998 (Fig. 2)
Furthermore the workshop observed that with the available data, there were areas/zonesin the country where nrMo was not conducteJ,;;;;;s which needed to be refinedand/or areavzones where trre data were inconrirt.ri *itr-, k;;*"epidemiologicauentomological information Th;;;rkffiin.r.rore recommended thatfor effective coverag-e, plTl1.s ana imptementation;i;il ongoing CDTI in the country,there was need to refine REMd in Nig.iia - to create a "t.., picture of the disease. Itwas in recognition of this necd that cricouraged Afoc ur,i1,o,t,.,.,-in tlie cllT.t srrategyto sponsor this mission. So the objectives oiry *irrion u,.1'
To train Nigerian N0TF scientists/consultants in ^Rapid
Epidemiological Mapping ofonchocerciasis (REMo) - to enable them successfully carry out independent REM9exercise.To assist the national team conduct nation - wide REMO refinement in the country - todelineate the main onchocerciasis endemi" u..* ,t *;.il; definite CDTI approacrr, andwhere clinic - based strategy are to be adopted
- --r-" -
3.0 MATERIALS AND METHODS3.1 Study Area
Fig.2 shows the areas/zones in the country for the REMO refinement
3.2 Training
The first objective of this mission was capacity b_uilding Two different groupswere trained: (l) National Scientists ana rvoci, stunuio tzilcn Sraff Thedetailed REMO training-war eir.nio th. Natiornar Scientisil and Nocp staffwho#ffi::"ed
the rcn hearth"uunin ihe fiera whire.orau.ting the REM,
It is a statement of fact that alr the National scientists and Nocp staffareexperienced and have at one time or the other been invqlved in onchocerciasiscontrol in the country. This fact not withstanding, th..r*u, need for this trainingsinib REMo is a new and rr...ni Jiusnostic toor. Again, it is significant that theglobal standard of the procedure is ma]ntained for oulio* epidemiorogicarreasons. The eight - man national ,"i.ntirt, un;;ffi'iloH staffred by theNational coordinator (see appendix) weretherefor" "*porra
to a 3 - day intensiveand detailed training aithe ionat ;6r;ln Kaduna. rr,ilir"iiirg covered a1 theaspects of the wHoiREMo documents 6Ngoumou t w;r;h, rg93; wHO, I995)Inaddition,thebiologyandecologvoi.r,.Vector,theepidemiology,
5Tt 61
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clininopathological manifestations and socioeconomic impact of the disease, aswell as the need and current control strategy, thb CDTI stiategy *er. disrursJ.'
3.3 Implementation
At theend "{t.!..
training it was clear that every member had acquired theappropriate pkill and procedure necessary to carry out successfuliy independentREMO exercise, Each national scientist *ur usig*a an area or states for REMOrefinement' B.!1. leavirig for the field exercis.,"sarple villages were seiectedand the states, NGDos and LGAs were inflormed and senstized for the exercise -to enable them be ready with staffand logistic suirport. with the time - table,adequate logistic and material support and efficient conrmunication, the nationalscierttists wcrtt.altead lbr the field bxercisc. Thc wiro adviser particrpated rn t5eexercise and also plaved both supervisory and facilitating role. At the end of the.exercise, jhe REMO results generated were impressive and consistent. Notwithstanding the inherent difficulties and risks'associated with extensive andintensive vilrage studies, the REMo refinement i, trrc country was a hugesuccess.
4.0 RESULTS AND DISCUSSION
4.1 TARABA STATE (Tabte 2 )
a) LGAs mapped as Definite CDTI by 1998
l. Part of Yorro2. Zing3 Bali4. Gashaka
5. Sarduana6. Kurmi7 Ussa8. Tukum
b) LGAs mapped as NO CDTI area
l. Wukari 2 partoflbi
c) LGAs where REMO refine was conducted
l. Part of Ibi2. Gassol3. Part of fudokola4. Jalingo
9. Donga10. Part of Karirn LamidoI 1 . Part of fudokola
5. Lau6. Part of Karim Lamido7. Part of Yorro8. Southern Sarduana to validate the199311994 RAM exercise
A total of 83 commu.nilie; from the -eight
LGfu in Taraba were refined (Table 2)The results showed rTl[" zones of I6i, Gassor, r,*, i..i, Lamido, Jaringo,andYorro LGAs are not .DTI. Two areas in ardokora L'cA ;;; definite GDTI. TheREMo exercise in Southern part of Sarduana LGA showed that the low land
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yeas.(wr]h a lot of breeding sites), especially within the Donga river basin aredefinite CDTI as recorded in the 1993194 REMO exercise. fhis is not uncommonbecapse the same river, Donga river, and enviromental factors which arefavoi[able to the breeding oIthe r""torc and transmission of the disease in Dongaand Kurmi LGAs are also prevalent in this part of Sarduana LGA. On the other-hand, the present result showed that the highland communities around the Gembuzone which hitherto were mapped definite CDTI by lgg3lg4 are not cDTI zone.This result is consistent-with known epidemiologicll and entomological facts.Aq1in, Gembu highland, or rather the Mambila Flateau, is perhaps 6ne of thecoldest areas in Nigeria. And such very cord weather conditions are known toinhibit breeding of flies and development of parasite in the flies. Similar resultshave been observed at gther very cold highlands such as on the Nyika highlandsof Malawi (Nwoke et al, 1995)
4.2 KIYARA STATE (Iahte 3)
a. LGAs mapped as Definite CDTI by 1998
l. Baruten Z.pategi
b. LGAS mapped as NO CDTI area
None
c. LGAs where REMO refine was conducted
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5 Moro6. Ekiti7. Oke - ero8. Ilorin East
9 Irepodunl0 OsinI l.Asa
f(wara state is one of the foremost states in the country where distribution ofivermectin was carried out by Africarel A lot of oth.r'pr.vui"nce surveys havebeen carried out in this area. By the present exercise nBMo, was refined in 29communities in the state(Tablb 3). While we await the intejration of this resultinto.the Atlas GIS, we wish to observe that onchocerciasis is endemic in theLGAs examined to warrant definite CDTI stiategy, .*."pi in trr" area of EduLGA.
4.3 KEBBI STATE'(Table g'
a. LGi{s mapped as Definite CDTI by l99g
l. Part of Danko Wasagun2. Part of Zuru
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b. LGAs mapped as NO CDTI area
1. Birnin Kebbi 2. Argungu
c. LGfu where REMO refine was conducted
3. Gwandu
13. Part of Danko Wasagun14.'Yauri15. Suru16. Koko Besse
I, Aliero2. Arewa3. Bunza4. Bagudo
5 Dandi6. Kalgo7. Maiyama8. Shanga
9. Ngaski10. Part of ZuruI L Fakai12. Sakaba
REMO refine was conducted in 60 communities of 16 LGAs of Kebbi state(Table 4) and the results showed that onchocerciasis is not a major public healthproblem in the state- Except at Danko wasagun LGA o;.ring.ni.*ic areas orZamfara) which is drained by Culbin river, i-he othdr ti LGAs studied were notCDTI definite areas. These other less endemic areas are drained mainly by thesandy, fl9od - plain -like, sluggish Sokoto river (whictr empties into wigLr iiverat Gwamba). The Kebbi REMo result is not uncommon because this major river.tysl:.* in.the state (sokoto river) like most other river systems in this type ofbioclimatic zone of the coun_try and indeed continent *. t"tnporury, and haveshallow, lmdy valleys
3na !9w through the saherian zone. As a result they do notfavourably support the breeding of vec-tor flies - t.n.. "".y
limited diseasetransmission' The same similairesults have been recordedin rh;;;;;i.ii.uti"zone of nearby Niger, Chad and Cameroon.
4.4 KOGI STATE (Iabte S)
LGAs where REMO refine was conducted
l. Omala2. Bassa3. Okehi4. Ijumu5. Kalla - Buru
6. Mopa - Muro7. Yagba East8. Lokoja9. Kogi
lhere was difticulty.in getting at th9 appropriate maps of Kogi state. Thisobscures our discussion on thi results notn. uo*rvei a total of 30 communitieswere examined in the study. of the 9 LGAS studied, onif o^uta area showeddefinite CDTI communities_(Table 5). The'results will be made clearer whenintegrated into the Atlas GIS. ' -
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4.5 GOMBE STATE (Tahte 6)
a. LGAs mapped as Definite CDTI by l99g
l. Shongom2. Eastern Yamaltu - beba
b. LGAs mapped as NO CDTI area
l. Western Yamaltu - Deba2. Western Funakaye3. Kwami
3. Eastern Nafada4. Eastern Funakaye
4. Eastern i{kko5. Kaltungo
5. Eastern Damboa6. Gwoza7. Chibok
c. LGAs where REMO refine was conducted
5. Western Nafada6. Western Funakaye
The results on Table 6 showed that six LGAS were refined in Gombe state in thisexercise' This covered 43 communities. It is clear from these results that westernNafada, western Funakaye, Billiri and Balanga as well u. rrr. north eastern area ofDukku LGAs are definite CDTI zones. ekkJlcn i, noi"na.ri, to attractdefinite CDTI strategy.
4.6 BORNO STATE (tabte 7)
a. LGAs mapped as Definite CDTI by l99g
L Balanga2. Billiri
1. Eastern Biu2. Shani3. Hawul4. Askira Uba
l. Abadam2. Mobbar3. Kukawa4. Guzamala5. Gubio6. Nganzai7. Monguno
3 Akko4. Dukku
8. Marte9. Mafa10. NgalaLl. Kala - Balge12. Dikwa13. Bama14. Magumeri
15. Jere16. Konduga17. Kaga18. Western Damboa19. Western Bui20. Kwaya Kusar21. Bayo
b. For obvious roasons, apart ftom the above LGAs, REMO was conducted in theremaining LGA'. This was designed to create u ,t"* "orprehensive.
picture of_onchocerciasis
preevalence./endJmicity in the state. rhe l6ns studied were 21,vtz.
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A total of 4l communities were examined from 2l LGAS in Borno state in thist1!E Except the zones of Kala - Barge and Bama LGAs which are definiteCDTI areas the areas in the other tg iGas are not endemic io **runt CDTIstrategy (Table 7). This result confirms. that the sandy folld plain - like andtemporary rivers in these less endemic and sahelian LCas rl" not favourable tozupPo-rt the breeding of vectors of onchocerciasis. Similar results have beenrecorded in the bordering Niger and Chad Republics.
4.7 SOKOTO STATE (Iabte s)
a. LGI\.s mapped as Delrnite CD f I by l99g
None
b. LGfu where REMO was reflrned
tL Balle2. Gidan Madi3. Binji4. Silame5. Yabo6. Shagari
7. Illela8. Gada9. Sabon Birni10. IsaI l. Goronyo12. Gwadabawa
13. Wurno14. Rabah15. Dange16. Bodinga17. Tureta18. Tambawel
A total of 41 communities were selected from 19 LGAs in sokoto state for thisexercise' The refinement was actually carried out in zo lititlcommunities whileLz (29%) were inaccessible at the time of this studt. ir,i ..rurt showed thatonchocerciasis was apparently absent in26 (90%ttrtrr. communities examinedand onlv three comrnunities (ro%)had onchtc;i;;;ilof b.,*."n ro/o and9%. onchocerciasis_is therefore not a seriour puuri. t.u[r, i.our.m in Sokotostate to warrant CDTI strategy. This result "onfir*, tt" i"ritrr"t the more or lesssahelian zone of Africa withlits characteristic harsh *.ui["i during most periodsofthe year rarely supports breeding ofvector species.
4.8 ZAMFARA STATE (Tabte e)
a. LGAs mapped as Definite CDTI by 1998
l. Gummi 2. Bukkuytrm
b. LGAs where REMO wasrefined
3. Anka
fi
fi
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3.
4.
MaruGasauTsafeBungudu
4.9 RAUCHLST,4TI| (Tahte r 0 )
a. LGAs mapped as Definite CDTI by l99g
l. Ningi 2. .Warji 3 Misau
b. LGAS where CDTI was not recommended
1. Damba2. Shira3. Katagum4. Jama'are
B/IvlagajiK./NamodaT/IvIafaraBakura
4. Bogoro5. Tafawa Balewa6. Dass
4. Gulak5. Michika6. North Hong
9. Maraduml0 Shinkafill. Zurmi
4. Gade
5.
6.
7.
8.
The REMO result showed that onchocerciasis is apparently absent in I I (4g%) ofthe 23 communities examined in this exercise. rhe community onchocercalnodular rates in the 12 (s2%) who were positive were r - g yo The zones in these1l LGAs are therefore not CDTI definite.
5. Itas Gidau6 Garnawa7 Zaki8. Western Toro
c. LGAs where REMO was refrned
I Alkaleri2. Kirfi3. Bauchi
7
8
9
ToroGanjuwaDarazo
of all the 35 communities examined from the 9 LGA' in this exercise, 460/o ofthem (16) had no onchocercal nodures while 19 of the communities (54%) werepositive. However, except the Toro zone which may be Jrn"i,, CDTI,onchocerciasis was not i public health problem in all the other g LGAs.
4,10 ADAMAWA STATE (Tabte tI)
a. LGAs mapped as Definite CDTI by l99g
l. Ganye2. Jada3. South lvllBelwa
7. North Gombi8. North Shelleng9. North Guyuk
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l.2.
3.
4.
IVI/Belwa 5. Lamurde6. South Guyuk7 South Shelleng8. Gire
9. Song10. South HongI l. Maiha
12. Mubi (North & South)
7 Bursari8 Karasuwa9. Yunusari
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4.11 YOBE STATE (Iabte t2)
a. LGAs where REMO was refined
By the 1998 REMO results there was need to clarifu some areas where the datawere inconsistent with epidemiologioal and entomological information in thefollowing LGAs.
FuforeDemsaNuman
l. Geidam2. Bade3. Jakusko
4. Tarmuwa5. Nguru6. Yusufari
Iy:llv-!t"ee (23) communities were selected for this exercise in yobe stare but 4(17%) of them were floodecl and inaccessible at the ti*" oiirr. study. A total of19 (80%) communiries were examined frg, ?
LGA;. E;r.pt in one commu,nity,Dagona in Bade LGA, the REMO results in the other rg colmunities showed thatthe disease prevalenbe does not W*i*i-CnTI strategy.
4.12 PI-ATEAU STATE (Tabte tJ) ..
a. LCRs mapped as Definite CDTI by I99g
l. BtLadi2. Jos North3. Jos South
4.5.
6.
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During the rg%rg4nr^ao exerciie there Ip mix - up of ratitude and rongitudeat Panlcshin add Kanam lGAs Thir"*,o the extent that tlendemio resurts orpankshin il;;rdted at K;;;#ifffil. ,Tllpj.. -tntegrated into Atlas GJS,.I, th;;;.*"t exercise, REMo;u, refined at bothPankshin and Kanam LGAs ;w.elffii; other 8 rctsI total of 3I commTl,:r.yr.: g*rine.d 1!3nly communities in the zone ofBassq ros East and pankshilidA#.1. cnn i.ilffi;; other 7 LGtu arewlhin the lowland zone with ,.,y8;i.eeding sites.
b. LGAs where REMO was refined
l. Bassa2. Jos East3. Pankshin4. Kanke5. Langfung North
4.13 ' KATSINA STATE (Tabte 14)
a. LGfu where REMO was refined
l. Safana2. Dan Musa3. Kankara4. Northern Faskari
I Northern Malumfashi6. Musawa
6. Kanam7. Wase'8, Shedam9. Langtang South10. Quan - pan
7.
8.
9.
l0lt12.
MataztDutsin - MaKurfiCherenchiBindawaKankiya
A total of 1r2 communities were examined \gn tzLGAs in Katsina state.onchocerciasis was apparentry "dili; 50 (u.6%)ofttre communities andhypoendemic disease was recorded in the remaininj ii-(isinBy this resurt.ffi#Stri?ffi;y;; ffi* idL*
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4.14 JIGAWA STATE (table 15)
REMO was required to be clarified in the Hadeja River Basin of Jigawa SlateThe LGAs involved are:
L2.
3.
4.
5.
AnyoTauraCuriRinS,mJahnn
lUhausaK./kasama
KanganaMigalWmadom
BimiwaDutse.
6.
7.
8
9.
l0
lll2
t
The exercise was conducted in 30 communities from 12 LGAs. Onchocercal module was
absent in I8(60%) of the comrnuruties exarruned. Ihe result further showed tirat the ciisease
control prografirme in the Hadejia River Basin area of Jigawa does not require CDT, strategy.
4.ls KANO STATE (Table 16)
(a) REMO was required to be refined in'the Zone of Hadeji fuver Basin of six LGfu
in Kano. Viz,
l. Ajngr 4 D/l(udu
2. Warawa 5 Wudil
3. Gabasawa 6 Abasawa
. In course if this REMO refinement exercise a total of I I communities were examined frorn
the 6 LGAs in Kanb State, Onchocerciasis was apparently 'absent n 5(45%) of the communities
while the sisease was pr6sent in the other 6(55%) communities. However, the endemicity was met
..serious enough to warrant CDTI approach
4.16 IIVIO STATE (Table 17)
(a) LGAS where REMO was refined
l. Obowo 3. Ezinihitte 5. Ngor Okpala
2. Ahiazu 4, Abor
REMO was refined in l8 communities in the Zone of lower Imo River Basin of lmo State.
The present rezult showed that of the 5 LGAs examined, only the zone ofNiger Okpala LGA had
disease situation that warrants CDTI strategy.
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4.17 NASARAWA STATE (Table ts)(a) REMO refinement was conducted in the lowland zone of western Doma, Southern
Nasarawa and Southern Toto LGAs of Nasarawa State.
The result from 12 communities examined showed that onchocerciasis endematy in the
lowland zone of these LGAs are not serious public health problem to warrant CDTI stategy
4.18 EDO STATE (Table 19)
REMO was refined in Ovia South West and Ovia North West.
Atotal oI'10 cotrururuties were examined from these 2 LGA. The endenucrty levels ofOchocerciasis in the northern zone of these LGAs (bordering endemic areas of Ondo State) are
serious to watrant CDTI approach. Onchcerciasis in the Southern Delta zone of these LGfu ishypoedemic.
4.19 ONDO STATE (Table 20)
(a) REMO was refined in ldanre, Irele, Okitipupa and Odigbo LGAs on the South
Eastern zone.of Ondo State. This exercise was concluded in l2 communited and only the zone ofIdanre LGA was a CDTI area.
4.2O EKITI STATE (Tabte 2l)
Two LGAs (Ikole and Oye) bordering Ekiti State with Kwara and Kogi States were
refined in the exercise. Six communities were examined and the result showed that the area ofthese two LGAs is CDTI zone.
4.21 KN)UNA STATE (Tebte 22)\- ---- --, .
T\e 1993/94 REMO rezult from Chikun Lga were clarified in this study while that of lerelgA was refined' Atotal of l'6 commuriities were examined and results showed that these twoLGAS in Kaduna State are hypondemic
4.22 OSUN STATE (Tabte)
(a) REMO was refined in 8 LGAS
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1. South 4. IrePodun 7 ' Olurunde
2. Ife North 5. Egbefe 8' Odo ofin
3. Ayeda ade 6. Ede
In this exercise 15 communities were examined from these 8 LGAS and the result shoqed
that the zone atAyeda Ade, Irepodum and Egdeofe are qualified for CDTI strategy' The
areas/zone in the other 5 LGAs are less endemic
4.23 OYO STATE (table 2.4)
(a) REMO was refined in 6 LGAs of Oyo State:
l. Orire 4. OreloPe
2. Olorunsogo 5. OluYole
3. Orepo
Twenty (20) communities were refined in these 6 LGDAs The result showed that the
Northern LGAs of lrepo, Olorunsogo and Orire as well as Ido LGA definite CDTI zone. The
other LGAs are hypoendemic for Onchocerciasis.
4.u OGUN STATE (table 25)
(a) REMO was refined in 4 Southern LGAs of Ogun State:
l. tjebu East 3. Ijebu N/East
2. Ijebu Ode 4. Odogbolu
REMO was refined in 13 communities in course of this exercise. Onchocerciasis in this
zone is not a serious public health problem to warrant CDTI strategy.
6.0 ACKNOWLEDGEMENT
I am grateful to WHO.APOC for given this opportunity to serve and contribute in our
collective effort to eliminate human onchocerciasis as a public problem in AfriCan sub-region. My
thanks are due to WR Lagos, NOCP National coordinator, Dr J.Y. Jiya and his team REMO
national scietists; and NGDO coalition in Nigeria for their logistic and technical support,
understanding and hospitality in this study. The success of this nationwide exercise'was
madecomparatively easier by the committement and good will of the zonal OFFICES, SOCTS,
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5.0 REFERENCES
Gemade, EII; Jiya, J Y; Nwoke, B E B; Ogumba, E O; Edegere, H; Akoh, J IE omojola, A (1993). Human onchocerciasis: currJnt assessment of
the disease burden in Nigeria by rapid epidemiologicar mapping"Ann. Trop. Med. parasitol', (92c1): s79 _ 5g3.
Nguomou, P E walsh, J F. (r993). A manual for rapid epidemiorogicarmapping of onchocerciasis (REMO)"TDR/TDE/ONCHO/94.3 WHO Geneva
++
Nwokc, B E, B 1i96ua.1 ilapro assessntent ol'onchocercrasrs tn N lgena'Nigerian J. Biotech." ll.Zl3 -216
Nwoke, B E B (1990b) The economic aspects of human onchocerciasis inAfrica: Present Appraisal." .34..37_44
Nwoke, B E B; Tambala, R E White (1995) Nation_wide raoidepidemological mapping of o,crrocerciasis (REMO) in MarawiWHO/APOC unpublished document. Burkina Faso.
villages of West Africa exposured to onchocerciasis "T s Rov SocTrop. Hgv" 80 522 - 527
Nwoke, B EB,Dozie, INS, Jiya, J yEGemade, E I I. (1999) onchocerciasisin Southeastern Nigeria using rapid epidemiologicar mapping"Nigerian J. parasirol. l9 (1999)
Prost, A (1986). The burden of blindness in adult males in the savanna
fr -.rg'HIE
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III
Taylor, H R; Duke, B o L E Munoz, B(rggz) The serection of communitiesfor treatment of onchocerciasis with ivermectin. ..Trop.
MedParasitol" (43.267 - 270).
wHo (1992). Methods for_community Diagnosis of onchocerciasis to guideivermectin -based control in Africa. ',@.WHO Geneva.
wHo (1995). onchocerciasis and its contror. "wHo Expert ca.nmillgg_rr!- gZ5 WAO Geneva
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J'O APPE,uqx-7.A, SCHBDULE OF RBMO REFINEMBNT IN NIGERIA
(ocToBER 3r - DBCBMBER 13,2000)
October 3l Travel to Kaduna
November I - 3
Novenrber 4
November 4 -6
November 7
Novernber 8 - l9
November 20
Noverriber 2l
November 22
Novenrber 23 - 29
Novenrber 30
December I - 2
December'3
December 4 - 7
December 8
December 9 - 12
December l3
Dr. J. Y JiyaNOCP nal Coordinator
Planning & Training of national Scientists
Natiorral Scientists tiavel to prepare for field work
REMO Adviser & NOCP contirlue with planning ofthe e.xercise
Scientists and REMO Adviser travel to field
Phase I REMO excrcise
Travel to Kaduna for appraisal of phase I REMO
Appraisal of Phase I REMO and planning of phasc2
Travcl to field for REMO phase II
Conrpletion of Phase II
Retunt to Base (Jos)
Collation of results
Departure of National Scientists
Validation of REMO continues by REMO Adviser
REMO Adviser rerurn to base (Jos)
Data ently, reporting and briefing
Departure of REMO Adviser
Prof. B. E. B. NWHO/APOC Temporary Aflviser on REMO2/t I/20002/I t/2000
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6.0 ACKNOWLEDGEMENT
I am grateful to WHO/APOC for grving this opportunity to serve and contribute in ourcollective effort to eliminate human onchocerbiasis as a public problem in African sub -region. My thanks are due to WR Lagos; NOCP National Coordinator, Dr. J. Y. Jiya, andhis team; REMO national scientists; and NGDO Coalition in Nigeria for their logistic andtechnical support, understanding and hospitality in this study.
The success of this nationwide exercise was made comparatively easier by theconlrllittncltt atrd goodr.r'ill of the zcnal ofl-iocs, SOC'l's, LOLi's, UDij>.rrri riiiagurs. Iuall that helped in this exercise I say, Thank you.
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LIST OF PARTICIPANTS
NOCP SECRETARIAT
l. Dr J.Y. Jiya - NOCP National Coordinator
2. Dr. Y. Saka
3. chK,u okoronkrvo - Tel: (234) I - 269 6013. National
. Scientists/Consultant.
1. I.N.S. Dozie
MedicaVpublic Health parasitology
School of Biological Sciences
Imo State universty owerri p.M.B. 2000 owerri Nigeria
Tel (234) 83230 698
Dr. C.F. Mafiana
Deparfinent of Biological Sciences
University of Agricultue
P,M.B. 2240 Abeokuta, Ogun State Nigeria
E-Mail: Mafiana @ unaab. edu.ng
Ukaur Oyene
Onchocerciasis Control Programms
Minisfiy of Health Calabar Nigeria
Tel: (234) 87 23651?
E-Mail: onchocal @ skannet.com
Dr. O. Amali
Departnent of Bioligcal Sciences
University of Agriculture
P.M.B. 2373 Makurdi Benue State Niseria.
7.2
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7.0 APPENDD(
SCHEDULE OF'REMO REFINEMENT IN NIGERIA(ocToBER 3I-DECEMBER 13,2fi)0)
October 3l Travel to Kaduna
November l-3 Planning & Training of national scientists
Nbvember 4 National scientists travel to prepare for field work
November 4-6 REMO Adviser & NOCP continue with planning ofthe exercise
Scientists and REMO Adviser travel to field
Phase 1 REMO exercise
Travelto Kaduna for appraisal of phase I REMO
Appraisal of phase I REMO and planning of phase 2
Travel to field for REMO phase II
Completion of phase IIReturn to Base (Jos)
Collation of results
Departure of National Scientists
Validation of REMO continues by REMO Adviser
REMO Adviser return to base (Jos)
Data entry, returning and briefing
Departure of REMO Adviser
Da J.Y. Jiya
NOCP National, Coordinator
utvm00
Prof. B.E.B. Nwoke
WHO/APOC Temporary Adviser on REMO
21rU2000
ii
November 7
November 8-19
November 20
November 2l
November 22
November 23-29
November 30
December l-2
December 3
December 4-7
December 8
December 9-12
Decernber 13
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Abubalar Tafawa Belewa University (ATBII)
P.M.B 0291 Bauchi Nigeria.
E-mail: jaogidi @ abtu.edu.ng
Patricia Ogbu-Pearce
National Onchocerciasis control programme
zone'c' Jahun road Bauchi
P.M.B 0291 Bauchi Nigeria.
Dr. W.A. Istifanus
Biological Sciences programme
A.T.B.U Bauchi
P.M.B. 0248 Bauchi Nigeria
T el: (234) 7 7 5 43500 (ext. 202)
E-mail: iwillali @ atbu.edu.ng
Gabriel Audu
c/o Sight Savers International
I Golf course Road kaduna
Kadrura State, Nigeria.
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