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Togo: One-stop Shopping Against Malaria and Other Diseases

Picture: Togolese Red Cross volunteers playing drums drum home a message about the importance of vaccination.
Togolese Red Cross volunteers drum home a message about the importance of vaccination.
(Courtesy: Marko Kokic, Canadian Red Cross)

During one week in December 2004, an integrated public health campaign protected more than 900,000 Togolese children.

Infectious Diseases Deadly to African Children

Infectious diseases are a leading but preventable cause of disease and death in African children:

  • Malaria kills an estimated 800,000 African children every year. Its harmful effects can be decreased when young children and pregnant women sleep under insecticide-treated bednets (ITN). (There is no malaria vaccine, to date.)
  • Measles killed an estimated 220,000 African children in 2004, and is a leading cause of blindness in that population group. Measles can be prevented by a vaccine that costs less than one dollar per child.
  • Poliomyelitis (polio) can cause meningitis, paralysis, and death. A global campaign to eradicate polio using an oral vaccine has been very successful, decreasing the number of cases by more than 99% since 1988. However, polio is still found, or has reappeared, in several countries of Africa and Asia.
  • Intestinal worms (soil-transmitted helminths) can cause malnutrition and slow down physical growth and learning, especially in pre-school children. Infestation can be reduced by oral administration of drugs such as mebendazole.
Picture: Togolese Red Cross volunteers demonstrate how to properly use an insecticide-treated bednet to prevent malaria, a leading cause of disease and death in Togolese children.
Togolese Red Cross volunteers demonstrate how to properly use an insecticide-treated bednet (ITN) to prevent malaria, a leading cause of disease and death in Togolese children.
(Courtesy: Marko Kokic, Canadian Red Cross)

Integrated Prevention Campaigns

“Vertical” campaigns against separate diseases have been conducted successfully. However, “integrated” campaigns that target several diseases together save time, money, and are more attractive to the potential beneficiaries. In particular, adding ITN to the health package:

  • Provides the beneficiaries with a valuable household item.
  • Offers a proven mean of protection against a deadly disease.
  • Allows public health workers to reach faster the 60% usage rate that is a goal of the Abuja declaration on malaria.
Picture: The measles vaccine will protect this child from the consequences of measles such as pneumonia, malnutrition, blindness and brain disease.
The measles vaccine will protect this child from the consequences of measles such as pneumonia, malnutrition, blindness and brain disease.
(Courtesy: Marko Kokic, Canadian Red Cross)
Such efforts at pubic health multitasking have been conducted by the Measles Initiative, a partnership led by the American Red Cross supported by African National Red Cross/Red Crescent Societies, and also including the:

The partnership, created in 2001, aims to eliminate measles in Africa by vaccinating 200 million children, thus preventing 1.2 million deaths over five years. So far, the Measles Initiative has vaccinated more than 150 million children.

Success in Togo

The Measles Initiative’s most recent achievement consists of a successful countrywide campaign in Togo against measles, polio, intestinal worms and malaria. In this West African country (5 million inhabitants), over a one-week period, from December 13-19, 2004, a National Integrated Child Health Campaign was conducted which:

  • Covered all 6 regions of the country
  • Involved 50 hospitals, 1,000 vaccination/distribution points, and 20,000 workers and volunteers
  • Reached more than 900,000 children between 9 months and 5 years of age (representing 96% of eligible children, as shown by a post-campaign assessment)*
  • Provided, free of charge, to practically all (93%) of the children reached:*
    • measles vaccine
    • oral polio vaccine
    • mebendazole for presumptive treatment of intestinal worms
    • insecticide-treated bednet (thus providing an ITN to 730,000 households)

 

Picture: Mebendazole is given to treat infestation with intestinal worms, which can cause malnutrition and slow physical growth and learning.
Mebendazole is given to treat infestation with intestinal worms, which can cause malnutrition and slow physical growth and learning.
(Courtesy: Marko Kokic, Canadian Red Cross)

The estimated cost per child was 6.00 US$ (4.16 US$ for the ITN, 0.84 US$ for the vaccines and mebendazole, and 1.00 US$ for operational costs).

This successful effort in Togo saw the first pairing, on a national scale, of ITN distribution with a vaccination campaign. This integrated approach allowed Togo to achieve rapidly, in all six regions of the country, high levels of ITN coverage.

The ITN coverage rate in children jumped from 8% to 62.5%, thus putting Togo in an excellent position to reach and maintain the Abuja targets.* Lessons learned from this first nationwide integrated campaign will guide similar future efforts.

 

Prepared in collaboration with the American Red Cross

*Data updated June 8, 2006

 

Page last modified : June 8, 2006
Content source: Division of Parasitic Diseases
National Center for Zoonotic, Vector-Borne, and Enteric Diseases (ZVED)

 

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