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In June 2020 the Uganda Ministry of Health, with support from SCI Foundation, resumed its programme of treatment for people affected by neglected tropical diseases (NTDs) including schistosomiasis and soil transmitted helminthiasis (STH) during the COVID-19 pandemic.
Uganda is one of the first countries to do so, despite the logistical challenges posed by the pandemic and the difficulties of reaching some communities.
Dr Francis Mugume
Dr Francis Mugume is a Senior Medical Officer at the Ministry of Health in Uganda, and Programme Manager for the Bilharzia and Tropical Diseases Elimination Programme. He spoke to us about this latest Mass Drug Administration (MDA) campaign.
“The most common NTDs in Uganda include schistosomiasis (known as bilharzia), STH and trachoma”, explained Dr Mugume.
Throughout the country, 90 out of 134 districts are endemic for schistosomiasis and the prevalence varies – low in 39 districts, moderate in 14 districts and high in 37 districts.
“Since 2007, the Ugandan government has been running an integrated national NTD programme under one division in the Ministry of Health and specific programmes to address specific problems”, he added.
Worryingly, Dr Mugume also said: “A lack of treatment for these diseases causes chronic disability and a lot of suffering. We are seeing increased susceptibility to other illnesses and worsening co-morbidities to other conditions like hypertension, diabetes and cancer that can also affect people suffering from NTDs.”
He was emphatic about the socio-economic effects of these diseases, saying “There’s a vicious cycle of disease and poverty”.
Sanitising vehicles before supervisors moved to the communities
Talking about how the Ministry of Health made this MDA happen, Dr Mugume said “Uganda has been following all WHO [World Health Organization] guidelines, but despite a suspension of some the NTD activities, there was room for continuity of essential health services. Uganda views MDA as one of the essential health services and looking at the achievements gained in the area of NTD control and elimination, the country could not afford to lose some of these achievements.”
The Government of Uganda has put measures in place taking into consideration the risk of COVID-19 transmission, including the use of masks, social distancing and handwashing.
“As a programme, we are working closely with the central, district and local governments in the control of COVID-19. The MDA has been implemented considering the restrictions and knowing the risks. With Standard Operating Procedures (SOPs) in place and engagement of the local district taskforces and communities, Uganda has made the MDA possible,” Dr Mugume explained.
Dr Mugume also highlighted some of the challenges encountered in conducting the MDA.
In normal times, MDAs take place in schools but given school closures, restrictions in people’s movements and large gatherings, the campaign had to adapt.
Using a dose pole during COVID-19
“The MDA had to change from school-based to community-based, and this time [the distribution of drugs took place] door to door. Before, the teachers were the drug distributors, but with schools closed we had to use community drug distributors. We have also had high operational costs linked to access to communities, especially in the highlands, and the resources available.
We also had not planned before for the use of PPE (personal protective equipment), and making masks available to the village health teams and the community drug distributors has been a challenge given the resources that we have,” he said.
Dr Mugume is justifiably proud of the work they have been able to do. “Despite the challenges, this MDA has been possible.”
Take a look at our Flickr gallery of the MDA here