Mectizan delivery systems and cost recovery in the Central African Republic.
The Central African Republic (CAR) has a serious onchocerciasis problem.
The disease is endemic in three quarters of the country and there is considerable onchocercal blindness in the north-west.
The low population density and extreme poverty (the CAR being one of the 20 poorest countries in the world) combine to make mass treatment with Mectizan (ivermectin, MSD) a challenge.
Although planned, primary health care (PHC) is not widely developed in the country.
Mectizan distribution was carried out in 1993-1994 by mobile teams in order to address the most urgent need, particularly in the north-west.
Since then, the strategy has been one of community involvement, using village health workers, chosen by their own communities, to do the treatment.
The system has been a stimulus to the development of PHC in some areas, as the co-ordinators of the Mectizan programme are often the only health personnel to visit every village.
The long distances between health centres, with a mean of 45 km, are likely to be an obstacle to the population collecting their own Mectizan, within the self-treatment system otherwise in place.
Operational research is planned to examine ways in which the population can contribute to cost recovery without there being a reduction in treatment coverage.
Mots-clés Pascal : Onchocercose, Filariose, Nématodose, Helminthiase, Parasitose, Infection, Antiparasitaire, Chimiothérapie, Ivermectine, Traitement, Système distribution, Méthode, Programme sanitaire, Distribution, Centrafrique, Afrique, Coût, Lutte sanitaire, Dispensation médicament, Homme, Peau pathologie, Oeil pathologie, Organisation santé, Economie santé
Mots-clés Pascal anglais : Onchocerciasis, Filariosis, Nematode disease, Helminthiasis, Parasitosis, Infection, Parasiticid, Chemotherapy, Ivermectin, Treatment, Distribution system, Method, Sanitary program, Distribution, Central African Republic, Africa, Costs, Sanitary control, Drug dispensation, Human, Skin disease, Eye disease, Public health organization, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0314126
Code Inist : 002B05E03B4C. Création : 27/11/1998.