Conclusions & Recommendations

Highlight in country applications areas that are suspected endemic

Highlight districts with no partner and no funding source (either in maps, narrative, or applications)

TEC recommends to ITI that the districts in Tahoua and Maradi that are part of the AVENIR trial be noted in future Zithromax® Applications. TEC further recommends strong coordination between the study team, ITI, and the PNSO.

TEC expressed gratitude at the cooperation shown by the PNSO in the program assessment recommended at TEC 20. The results indicate that the country has taken large steps towards their elimination goals. TEC recommends that the assessment findings be shared with the PNSO and PNSO stakeholders that participated in this process.

TEC noted that there was no request for 2021 for the Protection of Civilians (POC) camp located in Juba. The national program has indicated that this is because the camp is due for closure. If the camp is not closed, TEC invites the Ministry to submit a mid-year request after conducting a prevalence survey.

The Ministry of Health of Tanzania submitted a concept note for an operational research project to determine the impact of nomadic populations on persistent disease in specific districts and to develop strategies for more effectively reaching these groups as distinct populations. The TEC Research Subcommittee will review the concept note and provide feedback to the MOH.

The TEC expressed concerns for the internally displaced persons from conflict in Cabo Delgado into trachoma-endemic districts of Nampula. TEC requests more details from the national program about the situation; based on this, the population for these districts may need to be adjusted following the guidelines of the Refugee/IDP algorithm.

TEC recommends continued adherence to the “enhanced” greenlight checklist while the pandemic continues. ITI Supply Chain will re-confirm availability of funds with the donor and timing of MDA with the MOH prior to all shipments.

Current modelling data predicts that for the majority of trachoma-endemic districts, skipping a round of MDA (i.e., up to 24 months between treatment rounds) will not have a significant negative effect on disease elimination. However, in hyper-endemic districts (defined in the models as TF1-9 ≥40% at baseline), the models predict that skipping a round of MDA could add 2-3 years to the elimination timeline. Further, annual MDA has usually not been successful in controlling trachoma in these areas.

The results of some past clinical trials demonstrate that multiple rounds of MDA targeting children may be more successful in controlling trachoma in hyper-endemic areas than standard annual treatment (though this was not studied in the context of mitigation).