Vol 55, No 4 (2017): Special issue

Background: Trachoma is slated for global elimination as a public health problem by 2020.  Ethiopia carries 1/3rd of the global burden of trachoma.  This paper aims to explore whether Ethiopia is on track to achieve the stated goal.

Methods: A qualitative research method was applied.  Review of relevant literature and in-depth interviews with 15 key informants was carried out involving experts and program managers drawn from governmental and non-governmental organizations at national and sub-national levels in the four big regions of the country. Open-ended interview guide was used and interviews were tape-recorded. 

Results: The Global and national burden of trachoma was reviewed and analyzed. If all goes as planned, a minimum of 161 districts will receive their final round of MDA in 2020.  The status of the country program in scaling up trachoma interventions since 2013 was assessed. There were mixed views expressed by study participants whether Ethiopia is on track to achieve the global goal of elimination of blinding trachoma as a public health problem by 2020. The Minister’s TT (trachomatous trichiasis) backlog clearing initiative has been identified as a precursor for attaining the target set for TT elimination in the country even before 2020. 

Conclusion: If the new scale up plans are implemented as stipulated in the national trachoma action plan and the Health Sector Transformation Plan (HSTP), Ethiopia could be so close to achieving elimination of trachoma as a public health problem by 2020 at least in those moderately endemic (TF<30%) districts. Additional financial resources should be sought for a complete scale up of SAFE interventions in all known remaining endemic districts by 2016/17. 

Key words: trachoma, elimination, Ethiopia, GET2020, SAFE strategy

Lymphatic filariasis (LF) is one of the most debilitating and disfiguring diseases common in Ethiopia and is caused by Wuchereria bancrofti.  Mapping for LF has shown that 70 woredas (districts) are endemic and 5.9 million people are estimated to be at risk. The national government’s LF elimination programme commenced in 2009 in 5 districts integrated with the onchocerciasis programme. The programme developed gradually and has shown significant progress over the past 6 years, reaching 100% geographical coverage for mass drug administration (MDA) by 2016. To comply with the global LF elimination goals an integrated morbidity management and disability prevention (MMDP) guideline and a burden assessment programme has also been developed; MMDP protocols and a hydrocoele surgical handbook produced for country-wide use. In Ethiopia, almost all LF endemic districts are co-endemic with malaria and vector control aspects of the activities are conducted in the context of malaria programme as the vectors for both diseases are mosquitoes. In order to monitor the elimination, 11 sentinel and spot-check sites have been established and baseline information has been collected. Although significant achievements have been achieved in the scale up of the LF elimination programme, there is still a need to strengthen operational research to generate programme-relevant evidence, to increase access to morbidity management services, and to improve monitoring and evaluation of the LF programme. However, the current status of implementation of the LF national programme indicates that Ethiopia is poised to achieve the 2020 goal of elimination of LF. Nevertheless, to achieve this goal, high and sustained treatment coverage and strong monitoring and evaluation of the programme are essential.

Keywords: Lymphatic filariasis, Wuchereria bancrofti, Ethiopia

Onchocerciasis is a severe parasitic infection which causes disabling skin and subcutaneous tissue changes. The disease is endemic in many African countries including Ethiopia. In 2013, Ethiopia launched Onchocerciasis elimination program with the goal of attaining interruption of onchocerciasis transmission nationwide by 2020. The country has successfully scaled up interventions and achieved 100% geographic coverage in all known endemic districts. The main strategy for interrupting the disease is mass drug administration (MDA) delivered two times per year. The treatment coverage for the last five years has been maintained at more than 80%. Despite many years of ivermectin MDA the transmission of onchocerciasis in many districts remained unabated. To achieve the 2020 goal, sustained high geographic and therapeutic coverage is required which is validated by coverage surveys. The programme should aim to improve the knowledge and attitude of the community towards the programme in order to improve drug compliance. The partnership between the relevant stakeholders should be strengthened to facilitate open discussions regarding the programme implementation and any challenges that may arise in the control and elimination of the disease.  It is also important to consider intensified vector control.

Key Words: NTDs, Onchocerciasis, Ethiopia

Podoconiosis is a geochemical disease occurring in individuals exposed to red clay soil of volcanic origin. This Neglected Tropical Disease (NTD) is highly prevalent in Ethiopia. According to the nationwide mapping in 2013, the disease is endemic in 345 districts, where an estimated 35 million people live. The government of Ethiopia prioritized podoconiosis as one of eight priority NTDs and included it in the national integrated masterplan for NTDs. An integrated lymphedema management guideline has been developed.  Service expansion has continued in the last few years and lymphoedema management services have been expanded to over one hundred endemic districts. The last few years have been critical in generating evidence about the distribution, burden and effective interventions for podoconiosis in Ethiopia. Although the extent of the problem within Ethiopia is considerable, the country is well positioned to now scale-up elimination efforts. Given the extraordinary progress of the past ten years and the current commitment of government, private and third sectors, Ethiopia seems to be on course for the elimination of podoconiosis in our lifetime. We need continued strong partner commitment, evidence-building, and scale-up of activities to accomplish this.

Key words:  NTDs, Podoconiosis, Ethiopia.

Schistosomiasis  and soil-transmitted helminthes are among seventeen WHO prioritized neglected tropical diseases that infect humans. These parasitic infections can be treated using single-dose and safe  drugs. Ethiopia successfully mapped the distribution of these infections nationwide.  According to the mapping there are an estimated 37.3 million people living in schistosomiasis endemic areas, and 79 million in schistosomiasis and soil-transmitted helminthes endemic areas. The Federal Ministry of Health successfully scaled up Schistosomiasis and schistosomiasis and soil-transmitted helminthes intervention in endemic areas and treated over 19 million individuals in 2015. The Ministry of Health has made a huge effort to establish neglected tropical diseases, including schistosomiasis and soil-transmitted helminthes program in the health system which helped to map majority of the woredas and initiate nationwide intervention. The National control programme is designed to achieve elimination for those diseases as a major public health problem by 2020 and aim to attain transmission break by 2025. The programme focuses on reaching those school-aged children who are not attending school, integration between neglected tropical diseases programme, and further collaboration with the WASH actors.

 Key Words: NTDs, Schistosomiasis, Ethiopia.