Zimbabwe prepares for ward based mass drug administration for bilharzia, intestinal worms and lymphatic filariasis

To tackle the prevalent neglected tropical diseases (NTDs), Zimbabwe is gearing up for a nationwide mass drug administration (MDA) campaign set to commence this September. Spearheaded by the Ministry of Health and Child Care, with crucial technical and financial support from the World Health Organization (WHO) and the Higher Life Foundation, this initiative targets the eradication of schistosomiasis (bilharzia), soil transmitted helminths (intestinal worms), and lymphatic filariasis (LF) across the country.

As part of the preparations, a training of trainers’ workshop was conducted in Bulawayo from 17-19 June 2024, targeting 90 health workers from all the country’s districts. These trainers will play a pivotal role in cascading their acquired expertise throughout their respective districts, ensuring a comprehensive and coordinated approach to disease management and treatment.

“This training is part of the planning process for the upcoming MDAs, which will be intense given that we already have the medication required,” said Dr Isaac Phiri, MoHCC Epidemiology and Disease Control Acting Director.

The integrated MDAs follows a meticulous population and community-based survey conducted in 2021. This survey identified districts with low treatment coverage for schistosomiasis, intestinal worms, and LF, thereby pinpointing areas where intervention is urgently required. The prevalence of schistosomiasis and soil transmitted helminthiasis in Zimbabwe were estimated at 22 % and 5.7 %. Fifty-three (53) districts were found to be endemic for SCH and 5 were found to be endemic for STH. In 2015, 39 districts were identified to have Lymphatic Filariasis. Only two (2) rounds of LF MDAs were implemented (2016, and 2017), with the country embarking on confirmatory mapping in 2021. The first phase identified 16 priority districts for mapping, among these selected districts only two (2) came out positive for LF endemicity. The programme plans to conduct further confirmatory mapping in the remaining 23 districts. With a targeted outreach to approximately 5 million children, the upcoming campaigns will significantly curb the spread of these diseases, improving overall public health outcomes nationwide.

“The training was very helpful, and the timing allows us to cascade these to our peers and also be ready for the campaign,” said Mordecai Chephiri, a Health Promotion Officer from Kariba District.

To ensure the campaign’s success, the MoHCC received a critical donation of medicines from the WHO. The donation included 3,631,000 Praziquantel tablets to cover 1,815,500 people, for albendazole 8,789 boxes of 200 tablets to cover 1,757,800 people and for Ivermectin 6,116 bottles of 500 tablets. WHO’s support extends beyond medication, encompassing vital roles in the planning stages, advocacy and communication efforts, and providing supervisory guidance throughout implementation.

Zimbabwe adopted the new WHO guidelines advocating for decentralized service delivery to combat these debilitating diseases directly at the ward level. This strategic shift not only improves access to treatment but also strengthens efforts in areas heavily affected by lymphatic filariasis (LF). With WHO’s recent support in developing a comprehensive Neglected Tropical Diseases Master Plan reflecting these changes, Zimbabwe is now pioneering the use of triple therapy (Ivermectin, Diethylcarbamazepine, and Albendazole – IDA) to eliminate LF as a public health threat. Additionally, informed by recent nationwide mapping of Soil Transmitted Helminths  and Schistosomiasis , Zimbabwe will implement the new WHO guidelines of administering medication at the ward level.

“The new WHO guidelines for triple therapy to eliminate LF and ward-level administration of medicines are positive steps towards decentralizing provision of services in line with universal health coverage goal and a great step towards eliminating these diseases,” said Dr Mkhokheli Ngwenya, WHO Zimbabwe Acting Team Lead, Communicable and Non-Communicable Diseases Cluster.

Distributed by APO Group on behalf of World Health Organzation (WHO) – Zimbabwe.