02475nas a2200313   4500000000100000008004100001653003900042653001900081653001000100653001400110653001600124100002000140700001300160700001700173700001300190700001300203700001600216700001400232700001300246700001300259700001400272700001800286700001400304245010800318300001000426490000700436520170400443022001402147       2015                            d10aNeglected tropical diseases (NTDs)10aonchocerciasis10aCongo10aTreatment10aCommunities1 aMakenga Bof J-C1 aMaketa V1 aBakajika D K1 aNtumba F1 aMpunga D1 aMurdoch M E1 aHopkins A1 aNoma M M1 aZouré H1 aTekle A H1 aKatabarwa M N1 aLutumba P00aOnchocerciasis control in the Democratic Republic of Congo (DRC): challenges in a post-war environment.  a48-620 v203 a<p><strong>OBJECTIVE: </strong>To evaluate onchocerciasis control activities in the Democratic Republic of Congo (DRC) in the first 12&nbsp;years of community-directed treatment with ivermectin (CDTI).</p>

<p><strong>METHODS: </strong>Data from the National Programme for Onchocerciasis (NPO) provided by the National Onchocerciasis Task Force (NOTF) through the annual reports of the 21 CDTI projects for the years 2001-2012 were reviewed retrospectively. A hypothetical-inputs-process-outputs-outcomes table was constructed.</p>

<p><strong>RESULTS: </strong>Community-directed treatment with ivermectin expanded from 1968 communities in 2001 to 39&nbsp;100 communities by 2012 while the number of community-directed distributors (CDD) and health workers (HW) multiplied. By 2012, there were ratios of 1 CDD per 262 persons and 1 HW per 2318 persons at risk. More than 80% of the funding came from the fiduciary funds of the African Programme for Onchocerciasis Control. The cost of treatment per person treated fell from US$ 1.1 in 2001 to US$ 0.1 in 2012. The therapeutic coverage increased from 2.7% (2001) to 74.2% (2012); the geographical coverage, from 4.7% (2001) to 93.9% (2012). Geographical coverage fell in 2005 due to deaths in loiasis co-endemic areas, and the therapeutic coverage fell in 2008 due to insecurity.</p>

<p><strong>CONCLUSIONS: </strong>Challenges to CDTI in DRC have been serious adverse reactions to ivermectin in loiasis co-endemic areas and political conflict. Targets for personnel or therapeutic and geographical coverages were not met. Longer term funding and renewed efforts are required to achieve control and elimination of onchocerciasis in DRC.</p>
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