Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-9 (of 9 Records) |
Query Trace: Sodahlon Y[original query] |
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Transitioning from river blindness control to elimination: steps toward stopping treatment
Cantey PT , Roy SL , Boakye D , Mwingira U , Ottesen EA , Hopkins AD , Sodahlon YK . Int Health 2018 10 i7-i13 The transition from onchocerciasis control to elimination requires country programmes to rethink their approach to a variety of activities as they move from addressing morbidity to addressing transmission of the parasite. Although the 2016 WHO guidelines provide extensive recommendations, it was beyond the scope of the document to provide guidance on all aspects of the transition. This paper will discuss some of the important issues that programmes are grappling with as they transition to elimination and provide some potential approaches that programmes can use to address them. Although there are some data to support some aspects of the suggested approaches, operational research will be needed to generate data to support these approaches further and to determine how programmes could best tailor them to their own unique epidemiological challenges. Good communication between the national programmes and the broader global programme will facilitate the clear articulation of programmatic challenges and the development of the evidence to support programme decision-making. |
Final program evaluation methods and results of a National Lymphedema Management Program in Togo, West Africa
Ziperstein J , Dorkenoo M , Datagni M , Drexler N , Murphy M , Sodahlon Y , Mathieu E . J Epidemiol Glob Health 2014 4 (2) 125-33 In order to eliminate Lymphatic Filariasis (LF) as a public health problem, the World Health Assembly recommends an approach which includes interruption of transmission of infection and the alleviation of morbidity. In 2000, the Togolese National Program to Eliminate Lymphatic Filariasis (PNELF) started the annual mass drug administrations and in 2007, the program added a morbidity component for the management of lymphedema. This manuscript describes the methods of an evaluation aimed at assessing the strengths and weaknesses of the Togolese National Lymphedema Morbidity Program. The evaluation was conducted through in-depth interviews with stakeholders at each programmatic level. Interviews focused on message dissemination, health provider training, patient self-care practices, social dynamics, and program impact. The evaluation demonstrated that the program strengths include the standardization and in-depth training of health staff, dissemination of the program's treatment message, a positive change in the community's perception of lymphedema, and successful patient recruitment and training in care techniques. The lessons learned from this evaluation helped to improve Togo's program, but may also provide guidance and strategies for other countries desiring to develop a morbidity program. The methods of program evaluation described in this paper can serve as a model for monitoring components of other decentralized national health programs in low resource settings. |
Ongoing surveillance for lymphatic filariasis in Togo: assessment of alternatives and nationwide reassessment of transmission status
Budge PJ , Dorkenoo AM , Sodahlon YK , Fasuyi OB , Mathieu E . Am J Trop Med Hyg 2013 90 (1) 89-95 Tremendous progress has been made to the goal of global elimination of lymphatic filariasis (LF) transmission by 2020. The number of endemic countries reducing LF transmission through mass drug administration continues to increase, and therefore, the need for effective post-intervention surveillance also continues to increase. Togo is the first sub-Saharan African country to implement LF surveillance, and it has 6 years of experience with this passive surveillance system. We herein report the results of a recent evaluation of the Togolese LF surveillance system, including an evaluation of blood donors as a surveillance population, and provide updated results of ongoing surveillance, including expansion in remote areas. Since implementation of LF surveillance in 2006, only three cases of positive Wuchereria bancrofti filaremia have been detected, suggesting that interruption of transmission has been sustained. Given the impracticality of validating the surveillance system in the absence of ongoing transmission, we confirmed the lack of transmission through a nationwide reassessment survey. |
It is possible: availability of lymphedema case management in each health facility in Togo: program description, evaluation, and lessons learned
Mathieu E , Dorkenoo AM , Morgah K , Datagni M , Cantey PT , Morgah K , Harvey K , Ziperstein J , Drexler N , Chapleau G , Sodahlon Y . Am J Trop Med Hyg 2013 89 (1) 16-22 Lymphatic filariasis (LF) is a vector-borne parasitic disease that can clinically manifest as disabling lymphedema. Although the LF elimination program aims to reduce disability and to interrupt transmission, there has been a scarcity of disease morbidity management programs, particularly on a national scale. This report describes the implementation of the first nationwide LF lymphedema management program. The program, which was initiated in Togo in 2007, focuses on patient behavioral change. Its goal is two-fold: to achieve a sustainable program on a national-scale, and to serve as a model for other countries. The program has five major components: 1) train at least one health staff in lymphedema care in each health facility in Togo; 2) inform people with a swollen leg that care is available at their dispensary; 3) train patients on self-care; 4) provide a support system to motivate patients to continue self-care by training community health workers or family members and providing in home follow-up; and 5) integrate lymphedema management into the curriculum for medical staff. The program achieved the inclusion of lymphedema management in the routine healthcare package. The evaluation after three years estimated that 79% of persons with a swollen leg in Togo were enrolled in the program. The adherence rate to the proposed World Health Organization treatment of washing, exercise, and leg elevation was more than 70% after three years of the program, resulting in a stabilization of the lymphedema stage and a slight decrease in reported acute attacks among program participants. Health staff and patients consider the program successful in reaching and educating the patients. After the external funding ended, the morbidity management program is maintained through routine Ministry of Health activities. |
A success story: Togo is moving toward becoming the first sub-Saharan African nation to eliminate lymphatic filariasis through mass drug administration and countrywide morbidity alleviation
Sodahlon YK , Dorkenoo AM , Morgah K , Nabiliou K , Agbo K , Miller R , Datagni M , Seim A , Mathieu E . PLoS Negl Trop Dis 2013 7 (4) e2080 Lymphatic filariasis (LF) is a debilitating vector-borne disease predominantly caused by the helminths Wuchereria bancrofti and Brugia malayi [1], [2]. Endemic in 72 countries, LF is responsible for 5.9 million DALYs lost and is implicated as the second leading cause of disability worldwide by the World Health Organization (WHO) [3]–[5]. Although 70% of those infected do not exhibit symptoms, almost all persons infected have subclinical damage to the lymphatic vessels [6], [7]. An estimated 40 million people are symptomatic with the predominant morbidities associated with LF: lymphedema and/or hydrocele [8]. | In recognition of the worldwide burden of LF, in 1997, the World Health Assembly passed the resolution WHA 50.29 calling for collaborative efforts by member states to eliminate the disease as a public health problem [9]. In 2000, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) was formed in response to the WHA resolution and aimed to eliminate the disease by 2020. The program adopted a two-pronged strategy: (1) to interrupt transmission of the causal parasite and (2) to alleviate morbidities associated with the disease [10]. The two pillars of the GPELF's strategy form the basic framework for any successful LF program. | Togo is one of the 34 African countries endemic for lymphatic filariasis and is surrounded by the endemic countries of Benin, Ghana, and Burkina Faso [11]. The National Program to Eliminate Lymphatic Filariasis (NPELF) was founded in 2000 and is one of the few LF programs that address the dual goals of the global elimination program on a national scale. Togo is the first sub-Saharan country to achieve probable interruption of transmission and to move to the post-MDA surveillance phase as defined by the WHO [12]. Here we describe the elements that proved successful in the national strategy to address LF in Togo. |
Nationwide integrated mapping of three neglected tropical diseases in Togo: countrywide implementation of a novel approach
Dorkenoo AM , Bronzan RN , Ayena KD , Anthony G , Agbo YM , Sognikin KS , Dogbe KS , Amza A , Sodahlon Y , Mathieu E . Trop Med Int Health 2012 17 (7) 896-903 OBJECTIVE: To conduct a nationwide integrated neglected tropical disease (NTD) prevalence survey to define the need for public health interventions using an innovative mapping protocol. METHODS: Two villages were selected in every peripheral health unit in endemic districts: 29 districts for schistosomiasis and STH, 15 of them for trachoma. In each village, 15 children aged 6-9 years at a randomly selected school were tested. An additional convenience sample of 35 children aged 1-5 years underwent an eye examination for trachoma. This integrated mapping was followed by a 20-cluster trachoma survey in each district that surpassed the WHO-defined threshold of 10% prevalence of trachomatous inflammation-follicular (TF). RESULTS: A total of 1096 villages were surveyed in <6 weeks. The district prevalence of schistosomiasis ranged from 2 to 49% and of STH from 5 to 70%, with prevalence at the village level ranging from 0 to 100% for both diseases. Two districts passed the threshold of 10% for active trachoma, but the cluster survey indicated this was because of misclassification bias and that the real prevalence was <1%. CONCLUSION: Results of this mapping were used by the MoH and partners to plan integrated mass drug administration (MDA). Mass drug administration for trachoma was not implemented as no district passed the threshold requiring public health intervention. |
A laboratory-based surveillance system for Wuchereria bancrofti in Togo: a practical model for resource-poor settings
Mathieu E , Dorkenoo A , Otogbe FK , Budge PJ , Sodahlon YK . Am J Trop Med Hyg 2011 84 (6) 988-93 One goal of the Global Program to Eliminate Lymphatic Filariasis (GAELF) is interruption of disease transmission through annual mass drug administration (MDA) in areas where LF prevalence is greater than 1%. After MDAs are completed, the World Health Organization (WHO) recommends a period of passive surveillance before final certification of LF elimination is achieved. Guidelines for such a surveillance system have yet to be developed. This paper describes a surveillance system launched in Togo in 2006. The system uses existing laboratories with technicians on call at night who, among other activities, prepare nocturnal thick blood smears for malaria diagnosis that can also be used for LF diagnosis. During its first 2 years (2006-2007), the system provided geographically disperse sampling nationwide, and 1 of 750 people residing in Togo was tested. Over the same period, the system detected two cases of LF, both from areas previously considered non-endemic. This system could be a cost-effective, sustainable model for WHO-mandated passive surveillance after cessation of MDA. |
Rapid scale-up of long-lasting insecticide-treated bed nets through integration into the national immunization program during Child Health Week in Togo, 2004
Wolkon A , Vanden Eng JL , Morgah K , Eliades MJ , Thwing J , Terlouw DJ , Takpa V , Dare A , Sodahlon YK , Doumanou Y , Hightower AW , Lama M , Thawani N , Slutsker L , Hawley WA . Am J Trop Med Hyg 2010 83 (5) 1014-9 In December 2004, Togo was the first country to conduct a nationwide free insecticide-treated net (ITN) distribution as part of its National Integrated Child Health Campaign. Community-based cross-sectional surveys were conducted one and nine months post-campaign as part of a multidisciplinary evaluation of the nationwide distribution of ITNs to children 9-59 months of age to evaluate ITN ownership, equity, and use. Our results demonstrated that at one month post-campaign, 93.1% of all eligible children received an ITN. Household ITN ownership and equity increased significantly post-campaign. Nine months post-campaign, 78.6% of households with a child eligible to participate in the campaign retained at least one campaign net. Use by eligible children was 43.5% at one month post-campaign (during the dry season) and 52.9% at nine months post-campaign (during the rainy season). Household ownership of at least one ITN increased from 8.0% pre-campaign to 62.5% one month post-campaign. Together, these findings demonstrate that in this setting, increased household ITN ownership, equity, and retention can be achieved on a national scale through free ITN distribution during an integrated campaign. |
Impact of mass distribution of free long-lasting insecticidal nets on childhood malaria morbidity: the Togo National Integrated Child Health Campaign
Terlouw DJ , Morgah K , Wolkon A , Dare A , Dorkenoo A , Eliades MJ , Vanden Eng J , Sodahlon YK , ter Kuile FO , Hawley WA . Malar J 2010 9 199 BACKGROUND: An evaluation of the short-term impact on childhood malaria morbidity of mass distribution of free long-lasting insecticidal nets (LLINs) to households with children aged 9-59 months as part of the Togo National Integrated Child Health Campaign. METHODS: The prevalence of anaemia and malaria in children aged zero to 59 months was measured during two cross-sectional household cluster-sample surveys conducted during the peak malaria transmission, three months before (Sept 2004, n=2521) and nine months after the campaign (Sept 2005, n=2813) in three districts representative of Togo's three epidemiological malaria transmission regions: southern tropical coastal plains (Yoto), central fertile highlands (Ogou) and northern semi-arid savannah (Tone). RESULTS: In households with children<5 years of age, insecticide-treated net (ITN) ownership increased from <1% to >65% in all 3 districts. Reported ITN use by children during the previous night was 35.9%, 43.8% and 80.6% in Yoto, Ogou and Tone, respectively. Rainfall patterns were comparable in both years. The overall prevalence of moderate to severe anaemia (Hb<8.0 g/dL) was reduced by 28% (prevalence ratio [PR] 0.72, 95% CI 0.62-0.84) and mean haemoglobin was increased by 0.35 g/dL (95% CI 0.25-0.45).The effect was predominantly seen in children aged 18-59 months and in the two southern districts: PR (95% CI) for moderate to severe anaemia and clinical malaria: Yoto 0.62 (0.44-0.88) and 0.49 (0.35-0.75); Ogou 0.54 (0.37-0.79) and 0.85 (0.57-1.27), respectively. Similar reductions occurred in children<18 months in Ogou, but not in Yoto. No effect was seen in the semi-arid northern district despite a high malaria burden and ITN coverage. CONCLUSIONS: A marked reduction in childhood malaria associated morbidity was observed in the year following mass distribution of free LLINs in two of the three districts in Togo. Sub-national level impact evaluations will contribute to a better understanding of the impact of expanding national malaria control efforts. |
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