Capitalization of the NTDs in Tchad with AMASOT

Context

Neglected tropical diseases (NTDs) are a group of infectious diseases that occur in tropical and subtropical regions, affecting poor populations living in poor sanitation conditions and in close contact with infectious vectors and livestock; these communities also have very limited access to adequate health care. It is estimated that more than one billion people in 149 countries are affected.

The WHO recognizes 10 endemic NTDs in Chad, including onchocerciasis, lymphatic filariasis, soil-transmitted helminthiasis, schistosomiasis (bilharziasis), blinding trachoma, leprosy, dracunculiasis, human African trypasomiasis (HAT), leishmaniasis and loiasis. Snakebite envenomations are added to this list. Other diseases such as rabies, Buruli ulcer, scabiosis, mycetoma, Chikungunya and yaws are strongly suspected but there are no data in this direction.

As for leprosy, Chad has reached the elimination threshold was reached in 1997 with a prevalence rate of less than 1 case per 10,000 people. However, many cases with category 2 disability continue to be detected throughout the country. According to data from the Ministry of Public Health and Prevention, 23.1% of new cases of leprosy were detected with degree 2 disability.

For its part, leishmaniasis is a parasitic disease caused by flagellated protozoan (Leishmanias). It is transmitted by insects called sandflies.

In Chad, the first cases of leishmaniasis were notified since 1966 in the cutaneous form and in 1968 it was mucocutaneous.

After a retrospective study carried out with the support of the WHO in 2008 counting 2122 cutaneous cases, the Ministry of Public Health and Prevention retained Leishmaniasis as a public health problem.

Furthermore, in most endemic regions and districts, leishmaniasis and leprosy are evolving into co-endemicity. The socio-economic consequences of these two diseases are enormous among populations, especially the poorest. In 2019, the government through the National Leprosy Control Program (PNLL) and the NGO AMASOT requested funding from OCEAC to strengthen the fight against these two diseases.

Scope of the Work

Contribute to the elimination of Leprosy in residual pockets that are difficult to access and to the control of Leishmaniasis through the establishment of integrated surveillance and the management of cases in the border regions with the Central African Republic (CAR ) in the period from 2019 to 2021.

General objective

Treat the 2,122 cases of leishmaniasis detected and strengthen the integrated surveillance of leprosy and leishmaniasis in the border regions of Chad with the CAR

Specific objectives

Treat cases of cutaneous leishmaniasis already detected
Strengthen community-based surveillance using a telephone fleet in areas that are difficult to access (island and desert areas).
Reinforce Leishmaniasis surveillance at the border with the CAR
Strengthen the administrative and financial governance of the Project

Intervention site

The Project covers 9 Health Districts of the 5 Provinces. These are the Health Districts of the Province of Ouaddaï: (Adré, , Abéché, Abdi), the Province of Logone Oriental (Baibokoum, the Province of Salamat (Aboudéa, Haraze- Mangueigne and Am-Timan), the Province of Guera (Mongo), and the Province of Batha (Ati).

The Province of Logone Oriental (District Baibokoum) shares the border with both Cameroon and CAR. As for the Province of Salamat (District of Haraze-Mangueigne, Amtiman and Aboudéa), it is bordered with the CAR on the south-eastern side bordering the CAR. The Province of Ouaddai (Districts of Adré, Abdi, Abéché) borders Sudan. The Health District of Mongo is located in the Region of Guéra while that of Ati is in the Province of Batha. These last two Regions are in the center of Chad.

The implementers of the 9 health districts of the project were involved. To avoid a phenomenon of saturation, we proceeded to the choice of a limited number of actors.