Conclusions & Recommendations
18.3.1 - Surveillance for Recrudescence
Conclusion/Recommendation:
TEC recommends to ITI to continue supporting opportunities to conduct longitudinal surveillance of populations no longer warranting MDA in a variety of geographical and epidemiological settings.
Action:
ITI Management have discussed a variety of operational research options with researchers who have experience in this field, and where opportunities exist for building off of existing longitudinal studies. We will seek the input of the TEC in the closed door session as to whether this constitutes a topic of sufficient importance to allocate Scale Up funds to ensure this is done in a timely fashion.
TEC 18
2018
end game, research
18.4.1 - New Zithromax® Dosing
Conclusion/Recommendation:
Following roll-out of the new Zithromax® dosing recommendations, TEC recommends ITI monitor to ensure correct POS and tablet stock provision from Pfizer and gather feedback from implementing partners and National Programs.
Action:
ITI Supply Chain team is working in close coordination with each National Program to ensure adequate POS provision, recognizing that adjustments may be needed over time. Pfizer has committed to sending supplemental POS shipments to countries, should the need arise.
In addition, the Ethiopia program will carry out operational research to determine the actual mean dose of Zithromax® tablets for older children and adults and the mean dose of POS for children to facilitate accurate stock forecasting. The research will take place in November in three regions (Amhara, Oromia, and SNNP).
TEC 18
2018
dosing, supply chain, recommendations for ITI management
18.4.2 - New Zithromax® Dosing
Conclusion/Recommendation:
TEC recommends ITI share the new guidelines with National Programs with immediate effect to facilitate roll out.
Action:
ITI has communicated the dosing changes to all National Programs and partners in a letter in July, through presentations at the regional meetings in July and August, and the ICTC meeting in September. Countries have been requested to implement the changes as soon as practical.
TEC 18
2018
dosing
18.5.1 - Cameroon
Conclusion/Recommendation:
TEC recommends population-based prevalence surveys in Kolofata to determine whether the district has reached the elimination goals. If the district warrants treatment, TEC encourages the National Program to submit a mid-year request for Zithromax® to ITI as soon as the data become available.
Action:
The recommendation has been shared with the National Program.
TEC 18
2018
Africa - West
Cameroon
18.6.1 - Chad
Conclusion/Recommendation:
TEC encourages the Ministry of Health to submit a mid-year request for Zithromax® in Bol and Ngouri in Lac if they warrant treatment following their upcoming population-based prevalence surveys.
Action:
The recommendation has been shared with the National Program.
TEC 18
2018
Africa - West
Chad
18.7.1 - Guinea
Conclusion/Recommendation:
Because of a recent publication which indicates an EU prevalence of TF1-9 41.1% for all 5 request districts, Faranah in Faranah does not warrant a 7th round of MDA and should instead conduct a population-based prevalence impact survey in 2019 along with Dabola and Kissidigou in Faranah and Kouroussa in Kankan. Only Dinguiraye in Faranah warrants treatment (round 5 of 5) in 2019, pending confirmation of funding.
Action:
The recommendation has been shared with the National Program.
TEC 18
2018
Africa - West
Guinea
Zithromax® donation criteria
18.8.1 - Mauritania
Conclusion/Recommendation:
TEC recommends to ITI management to provide technical assistance for guidance on the last stages of program implementation, specifically in Nema and Timbedra in Hodh Ech Chargui, which had baseline TF1-9 5-9% in 2004, but no interventions or further surveys.
Action:
ITI is discussing with partners how best to support the National Program in identifying funding for the remaining surveys and providing technical support for dossier preparation, transition strategies, and post-elimination surveillance.
TEC 18
2018
Africa - West
Mauritania
end game, recommendations for ITI management
18.9.1 - Niger
Conclusion/Recommendation:
TEC recommends to the Ministry that:
– they consider conducting MDA coverage surveys in Maine Soroa (in Diffa), Tessaoua (in Maradi), and Miriah (in Zinder);
– they do not delay in-country transport of Zithromax® awaiting the arrival of other NTD drugs, which often delays implementation. The National Program should budget for separate transport for each NTD drug, but if the possibility for integration presents itself, then they should proceed accordingly;
– in accordance with WHO guidelines, districts with populations greater than 250,000 should be split into multiple evaluation units for surveys with boundaries that represent discrete implementation units.
Action:
ITI Supply Chain has worked intensively with partners and the Ministry of Health to improve supply chain management in Niger. This has resulted in the MOH appointing a supply chain manager and providing role clarity in drug management. Further details will be provided in a TEC 19 presentation.
TEC 18
2018
Africa - West
Niger
surveys, supply chain, coverage, evaluation units
17.1.1 - General Recommendations to ITI
Conclusion/Recommendation:
TEC suggests we include a note of praise at the beginning of every country-specific recommendation arising from TEC meetings, where appropriate.
Action:
Done
TEC 17
2017
TEC meeting management
17.1.2 - General Recommendations to ITI
Conclusion/Recommendation:
If future Zithromax® management anomalies arise, ITI should ensure that the relevant donors are also alerted, in addition to the direct implementing partner.
Action:
Implemented
TEC 17
2017
recommendations for ITI management