National Nutrition Institute
General Organisation for Teaching Hospitals
16 Kasr El Aini St
WHO Focal Point
Dr Riadh Ben-Ismail
Abdul Razzak Al Sanhouri St
World Health Organization Regional Office for Eastern Mediterranean www.emro.who.int
EMRO has three main endemic countries: Sudan, Egypt and Yemen.
It was one of the first countries to start the MDA programme at 2000 where 2.6 million Egyptians were covered. Most of them are living in the Nile Delta of Egypt. MDA coverage in Egypt was always above 80% due to the good health infrastructure. All the 181 villages covered with MDA were evaluated by mf and ICT cards for the children. That is why although most of the villages were legible to stop the MDA, still some villages are to be covered for the seventh MDA round. Egypt is now in the mopping-up phase to get rid of filariasis. New villages discovered, as well as those not yet met the elimination criteria, will be covered with MDA during 2007. Egypt opted to cover the newly discovered villages (with ICT prevalence above 1%) twice a year.
It is the main challenge in the EMRO. More than 90% of the filariasis cases of the EMRO are living in Sudan. Sudan was unable to finish the mapping and to start the MDA programme for elimination of lymphatic filariasis because of the on-going unrest. Despite the war, mapping has been done in many areas in Sudan. None of the examined areas were negative. This would raise the suggestion that all Sudanese are living in filariasis endemic areas.
WHO is now supporting two offices in Sudan: one in the North in Khartoum and the other is in the Southern capital, Juba.
South Sudan consists of 10 states. 'County' is the implementation unit in the south, equivalent to 'locality' in North Sudan. There are still certain transitional areas under the presidency and not related to any of the South or North Sudan. 12 counties reviewed blood and serological surveys done by the Federal team and six counties were done by Questionnaire. South Sudan is planning to complete mapping through questionnaire during the year 2007. Mean while South Sudan is planning to have a pilot MDA survey in any of the oncho co-endemic areas.
North Sudan did not finish mapping as well. All the non-mapped areas be mapped during 2007 either with ICT or questionnaire. Pilot MDA in the North Sudan is still postponed for the lack of integration with other running health programmes.
Both North and South Sudan are in need for great support to finalise their programmes.
Other suspected countries in the region are: Saudi Arabia (especially the southern area), Djibouti, Somalia, Pakistan, Afghanistan.
All the endemic areas in Yemen (nine districts) were covered with MDA for the fifth annual round during 2006. The total population of these areas was 111,036. The mean coverage was 86%. All Yemen areas except Socotra Island (2 districts) became mf free. ICT cards for kids are also all negative except in Socotra island. Yemen is planning to keep monitoring the free areas. At the same time Socotra Island (mf prevalence 2.4%) will be covered with a sixth round of MDA during 2007.