Title: INTERCOUNTRY WORKSHOP ON SCALING UP ITN IMPLEMENATION FOR CONTROL OF MALALIA AND OTHER VECTORBORNE D
1INTER-COUNTRY WORKSHOP ON SCALING UP ITN
IMPLEMENATION FOR CONTROL OF MALALIA AND OTHER
VECTOR-BORNE DISEASES IN EMR
- Plan of action for promotion and distribution of
insecticide treated nets in Djibouti
2COUNTRY PROFILE
- Population 600 000
- Surface area 23 000 square kilometers
- Climate hot with average daily
- temperature of 36
degree
- Celsius
- Humidity 60
- Pluviomerty 130 millimeters per year
- Two main seasons
- Hot season may to September
- Cold season November to April
3EPIDEMIOLOGICAL SITUATION OF MALARIA IN DJIBOUTI
- Malaria inexistent in Djibouti at the beginning
of the century
- Anopheles arabiensis mentioned between 1901 and
1906
- From 1906 to 1962, only imported cases declared
- In 1963 14 malaria cases diagnosed in
autochthon population
- In 1994 35 malaria cases declared
- In 1978 First malaria epidemic with 316
malaria cases
4EPIDEMIOLOGICAL SITUATION OF MALARIA IN DJIBOUTI
(introduction of malaria in the country)
5EPIDEMIOLOGICAL SITUATION OF MALARIA IN DJIBOUTI
(suite)
- In 1988 and 1994 Flooding with increase
bleeding sites
- Number of malaria cases confirmed declared each
year 4000 7000 case
- Population at risk 360 000 (60 of the total
population)
- Areas most affected by malaria
- - Djibouti city Ambouli and Balbala
- - Tadjurah district Sagalou, Kalaaf, Dorra et
Weima
- - Dikhil district As-Eyla, Hanlé
-
- Type of parasite Plasmodum falciparum (98 )
6MALARIA HIGH RISK AREAS IN DJIBOUTI
7MALARIA VECTOR CONTROL IN DJIBOUTI
- Malaria vector control introduced in 70s
- consisting in insecticide spraying
- At present, different vector control methods are
used
- - Inside and outside insecticide spraying
- with malathion
- - Bleeding sites Introduction of
- Abbate
-
8INSECTICIDE TREATED NETS (ITN)
- Before 1990 utilization of ITN individual
initiative
- In 1990, first involvement of MOH in promotion of
ITN with assistance from WHO
- - Training of NGOs
- - Involvement of NGOs in ITN
- distribution
- - Symbolic contribution of 0.06 cents by
- beneficiaries
- Priority were given to high risk areas, mainly to
nomadic people in rural area were others vector
control activities are not applicable
9INSECTICIDE TREATED NETS (ITN) (suite)
- In 1999, MOH initiated a campaign in all
districts to sensitize the population on ITN
- Contribution of different partners including WHO,
USA and one NGO
- Involvement of community in ITN promotion through
local associations, community health workers and
the community itself
- Population sleeping under ITN in high risk areas
- 10 - 20
-
- Mosquito nets available at local market
- at the cost between US 8 to US 10
10CONSTRAINTS
- Lack of follow-up
- Lack of collaboration and coordination with local
businessmen importing mosquito nets
- Lack of awareness of the population
- Insufficient financial resources
- Limit access to ITN for poor population
- Quality of nets imported through private sector
11PLAN OF ACTION FOR PROMOTION AND DISTRIBUTION OF
ITN IN DJIBOUTI
- Population targeted in ITN plan of action
-
- Population leaving in high risk areas (360
000) which are
- - Ambouli and Balbala in Djibouti
- city
- - As-Eyla in Dikhil District
- - Sagalou/Karaaf and Dorra in
- Tadjourah District
-
-
12OBJECTIVES
- General objective
- Reduction of mortality and morbidity due to
malaria
- Specific objectives
- - 60 of the population leaving in high
risk
- areas using ITN
- - 60 of pregnant women and children
leaving in
- high risk areas sleeping under ITN
13STRATEGIES
- Creating an enabling environment for the
promotion and distribution of ITN
- Creating demand
- Supplying and distribution
- Monitoring and evaluation
- Operational research
-
14CREATING AN ENVIRONMENT FOR THE PROMOTION AND
DISTRIBUTION OF ITN
- Meeting and coordination with partners
- Meeting with NGOs
- Meeting with community leaving in high risk ares
- Identification of local businessmen to be
implicated in ITN promotion and distribution
- Decision by the Ministry of Health for 0
taxation of nets
- Define procedure and modality of collaboration
with NGOs
15CREATING DEMAND
- Identification of NGOs to be involved in
promotion and distribution of ITN
- Training of NGOs members
- Involvement of communities trough community
health workers, local associations and NGOs
- Introducing ITN promotion in BDN sites
- Involvement of media including training of
journalists
- Elaboration of educational materials
- Monthly publication of articles in local
newspapers
16Facilitating supply and distribution of ITN
- Importation of ITN by the Ministry of Health in
collaboration with partners
- Importation of nets through private sector (local
businessmen)
- Training members of NGOs
- Establishment of district teams in charge of ITN
distribution
- Distribution of ITN through BDN
- Training of District team members
- Importation of insecticides for nets treatment
17MONITORING AND EVALUATION
- Define indicators for the evaluation of ITN plan
of action
- Survey on knowledge, attitude and practices in
high risk areas
- Follow-up of ITN importation, distribution and
utilization
18OPERATIONAL RESEACH
- Study on sensibility of anopheles to insecticide
(k-othrine)
19Principal indicators
- Number of nets imported through public and
private sectors
- Number of ITN distributed
- of household with one or more ITN
- of persons sleeping under ITN in high risk
areas
- pregnant women and children under five sleeping
under ITN in high risk areas
- Number of malaria cases confirmed and declared
every year