The facets of TDR research from drug discovery to implementation

First meeting in the Americas region

Presentation of study on community-directed interventions in Africa

TDR-supported implementation research in the remote Amazonas region of Brazil is evaluating the use and validity of syphilis diagnostics, so as to reduce the incidence of congenital syphilis in newborn infants.

One of the presentations at this year’s JCB described the results of the recently-completed multi-country study, Community-directed interventions for major health problems in Africa (TDR, 2008). The results were presented by Dr Elisabeth Elhassan of Sightsavers International, Kaduna, Nigeria. The study of nearly three dozen health districts in Nigeria, Cameroon and Uganda, documents how an integrated package of health interventions, including both antimalarial and ivermectin treatments, can be managed and delivered by community volunteers through a system of ‘community-directed interventions (CDI).’

CDI is based on the innovative programme for annual ivermectin delivery that was developed in the mid-1990s by TDR-supported research and is currently used to distribute ivermectin annually to over 55 million people, under the auspices of the African Programme for Onchocerciasis Control (APOC).

The recent research documents how other vital health tools can be delivered to remote communities in an integrated package. In the health districts of the three countries where the CDI strategy was tested over a three-year period, access and use of antimalarial drugs and bednets in districts using the CDI approach was approximately double that of control districts. The proportion of community members reached with ivermectin also was higher and distribution of Vitamin A supplements more successful in CDI study districts, as compared to districts where distribution was by conventional channels.