Impact of six years Community Directed Treatment with Ivermectin in the control of onchocerciasis, Western Ethiopia Abdi Samuel, Tariku Belay, Delenasaw Yehala, Mohammed Taha, Ahimed Zeynudin 1 INTRODUCTION  O. volvulus  Simulium black flies (McCarthy et.al.,1994)  Tropical Africa, Latin America, & Yemen  By Italian in 1939  Western part of the country (Zein et.al.,1993) 2  Ethiopia 7.3 million people  1.38 million affected (Zein et.al., 1993)  Blindness and dermal changes  One million DALYs  More than half due to skin diseases  Fertile hills, slopes and plains 3  Lack of sleep  Poor school performance  High dropout rate  Low productivity  Low income  High health related cost 4  APOC established in 1995  With Principal strategy of CDTI  15-18 years (WHO 1995)  In Ethiopia in 2000  In Anfilo in 2006 5  Aimed to evaluate the impact of CDTI on clinical and parasitological indices of onchocerciasis  Policy makers  Partners  Local authorities 6  Researchers Methods and Materials  Study period and setting  February – May,2012  792 km west of the capital  Shebel , Waba, Yeli & Dola villages of Anfilo District  Ega, Chamo, Agami, Gati, Sabu, Yawi,Ursa & Yaga 7  Irrigation, drinking and sanitation Methods and materials…ctd  Study Design : pre - post impact evaluation design  Minimum sample size (n): 1318  Sampling technique: Multi stage sampling technique 8 Methods and materials…ctd  Data collection techniques and instruments  Participants appointed in health post:  Socio-demographic characteristics  Clinical examination  Two bloodless skin snips 9  Skin snips were placed in eppendorf tubes for 24 hrs  Preserved with Formalin(4%)  Weighed  Centrifuged  Identified & Microfilaria Counted 10 Data analysis and processing  SPSS version 16.0  Medcalc 12.2.1.0  Chi-square (X2) test  Student’s t-test  P < 0.05 11 Change in parasitological indices of onchocerciasis 12 Change in CMFL in each Village 13 Prevalence VS Frequency of Treatment 14 Mean Intensity VS Frequency of Treatment 15 Impact of CDTI on Clinical Indices 16 Conclusions  Prevalence, AMI, CMFL and Clinical Indices significantly reduced  Endemicity level Fall from Hyper to Meso endemic  Still chance of Active transmission 17 Recommendations  Improve Annual Therapeutic Coverage  Sustainability  Biannual treatment schedule  Further study on:  Sustainability of CDTI  Entomologic study 18 Acknowledgements  My advisors: Mr. Ahimed Zeinudin, Mr. Tariku Belay, and Dr. Delenasaw Yewhala and mohammed Taha  Jimma University  Wollega university  Zonal and Woreda Health Department  My wife and daughter 19 END ONCHOCERCIASIS 20 THANK YOU ALL !