This year many countries applied to be recipients of the mebendazole donated by Johnson & Johnson and the albendazole donated by GlaxoSmithKline. As a result, CWW is now working with new government representatives from the countries that successfully applied for the donations. One of these countries was Nigeria. Dr. Nebe Obiageli of Nigeria’s National Schistosomiasis and STH Control Programme explains why the programme applied for the mebendazole donation and how it intends to use the deworming medication to further Nigeria’s STH control efforts.
Nigeria, one of the largest countries in Sub-Saharan Africa, recently applied for and was approved to receive 1.76 million doses of mebendazole from Johnson & Johnson through Children Without Worms (CWW). Based on a partially completed STH and schistosomiasis mapping, nine states, and 42 districts within those states, are highly endemic for STH. In the three most endemic districts, infection rates range from 75 percent up to 84 percent. In the three most endemic states, infection rates range from 31 percent to 40 percent.
Dr. Obiageli Nebe is the Assistant Director and National Coordinator for the National Schistosomiasis and Soil Transmitted Helminths (STH) Control Programme in Nigeria. She will manage the efforts to ensure that the school-age children most at risk for STH infection receive the donated mebendazole.
In Nigeria, the National Schistosomiasis and STH Control Programme is part of the Department of Public Health in the Federal Ministry of Health. In her role, Dr. Nebe collaborates with other stakeholders such as the Ministry of Education and non-governmental development organizations (NGDOs) to design and support implementation of the STH control activities. She also ensures that STH control efforts are coordinated with the country’s overall neglected tropical disease control activities.
Dr. Nebe first learned about the Johnson & Johnson donations while attending the December 2010 Regional Meeting on Neglected Tropical Diseases in Accra, Ghana. There she met Kim Koporc, CWW Director of Program Implementation, and learned more about the requirements for and benefits of receiving donated mebendazole. Dr. Nebe worked with Ms. Koporc and the World Health Organization (WHO) to complete the application and qualification process, which included preparing the detailed master plan for integrated NTD control in Nigeria. This plan provides a roadmap for bringing together partners and resources to reduce morbidity caused by NTDs.
For Dr. Nebe, one of the most pressing needs is for data that informs the programme where to best direct its resources. She says, “If you don’t have the data on where the burden of disease lies and the number of people you are targeting, you can’t carry out effective STH control.” Assuming funding is available, the programme should complete its STH mapping in Nigeria in 2012. Currently they have mapped all or portions of 14 of the 37 states.
Dr. Nebe notes that the programme faces many challenges. These include competition for funds with other programmes for diseases such as malaria, difficulties reaching some areas of the country due to the terrain, and the need to build more capacity amongst teachers and healthcare workers to distribute the medication. However, she says that Nigeria already has a proven model for distributing deworming medications through integrated efforts with schistosomiasis control. As a result, many teachers are already trained in mass drug administration and health educational materials are available.
The donation will enable the National Schistosomiasis and STH Control Programme to treat many more school-age children. The expanded programme will need to include plans to train additional teachers to distribute the medication. Although much of the medication will be administered through school-based deworming events, they are also working with communities to administer the medication to the many un-enrolled school-age children.
“Nigeria is one of the countries with the greatest need for deworming, and it will take the support and commitment from many partners for the National Programme to make the impact that is needed,” explains Dr. Nebe. She points out that the programme “already has much of that support from Nigeria’s government officials, CWW, Johnson & Johnson, and our team of professionals working in the field.” She states, “Our progress toward STH control is steady and our efforts are on course. We are confident that worm control can be achieved.”