Integrating an NTD with One of “The Big Three”: Combined Malaria and Trachoma Survey in Amhara Region of Ethiopia

The “big three” killer diseases are malaria, HIV/AIDS, and tuberculosis; control programs for these diseases are usually well developed and financed. The neglected tropical diseases (NTDs) are a group of ancient afflictions that are frequently sidelined by planners and are under-resourced. Opportunities of integrating the big three with NTDs have been talked about but not widely acted upon. There is potential synergy for an integrated trachoma and malaria control program since control of both diseases is community-based. The first step in accessing these synergies has been an integrated malaria prevalence and indicator and trachoma prevalence and risk factor survey. This has been achieved at the incremental cost of one additional staff member per field team. The results give unprecedented precision for the calculation of intervention targets for the integrated program and demonstrate that it is possible to integrate NTDs with the “big three.

The sample population.

<p>The sample population.</p

Key trachoma prevalence indicators: trachomatous inflammation–follicular (TF) and trachomatous trichiasis (TT)

<p>CI, confidence interval</p

Prevalence of malaria by blood slide microscopy

<p>CI, confidence interval; Pf, <i>Plasmodium falciparum</i>; Pv, <i>Plasmodium vivax</i></p>*<p>Total parasite prevalence do not equal the sum of the species prevalence in some rows due to rounding</p

The WHO simplified grading scheme for assessment of trachoma.

<p>Reproduced from Thylefors, 1987 <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0000197#pntd.0000197-Thylefors1" target="_blank">[18]</a>.</p

Characteristics of study households

*<p>Bureau of Finance and Economic Development for the year 2006/2007</p><p>HH, household; LLIN, Long lasting insecticidal net</p

Map of Amhara Region of Ethiopia showing the survey sites.

<p>Map of Amhara Region of Ethiopia showing the survey sites.</p

Characteristics of study participants and net usage

<p>LLIN, Long lasting insecticidal net</p