Global Programme to Eliminate Lymphatic Filariasis ... - libdoc.who.int

GUYANA63Endemicity statusEndemicNon-endemicUncertainAnnual Report on Lymphatic Filariasis 2003LF is a major public health problem in Guyana. Mappingwas completed in 2001. The estimated at-risk populationis 639 000 people — 90% of the entire population. Theproportion of infected population is 9.3%.The country is divided into 10 administrative regions. Theregion was designated as the IU. Nine of the 10 regions(IUs) are considered endemic for LF. Surveys conductedin 2002 revealed that approximately 0.5% of the total populationhas lymphoedema and 0.1% hydrocele. Two fixedsentinel sites and two spot check sites were establishedin 2003. Baseline ICT prevalence was 35% in the sentinelsite of Georgetown and 18% in that of New Amsterdam.The ministry of health authorities decided to adopt thediethylcarbamazine-fortified salt (DEC-fortified salt)treatment regimen and the importation of DEC-fortifiedsalt was therefore approved by the National Cabinet andthe Food and Drug Department in 2002. Importation ofthe DEC-fortified salt, which is supplied by three companies(from Cuba, Jamaica and Trinidad) commencedin June 2003. The supplies from Cuba and Trinidad andTobago were not guaranteed; only Jamaica has beenexporting fortified salt and some problems occurreddue to the change of staining of the product. The officialprogramme launch was in July 2003 and was limited toGeorgetown. It is expected to cover the entire countrywithin the next year. A monitoring and evaluation planhas been developed to evaluate salt use at the householdlevel. Implementation of this plan will take place in 2004.A quality control system to monitor the salt fortificationprocess was in place prior to the 2003 launch. Allimported salt is tested by the Food and Drug Departmentwith confirmatory testing by CDC.Chapter 3 Programme implementationTable 3.13 Goal: to eliminate LF from Guyana by 2006Objectives• To implement DEC-fortified salt MDAregimen in conjunction with disabilitymanagement activities• To decrease suffering from, andworsening of, LF-related disability• To integrate the LF elimination programmeinto ongoing communityhealth worker activitiesStrategies• Establish salt association to strengthen private sector partnership• Promote and sustain population support through social marketing andmobilization• Establish disability clinics in all regions, in coordination with existingdermatology/leprosy mobile clinics• Continue health worker training