Reaching semi-nomadic groups using a test and treat (with doxycycline) strategy in a challenging onchocerciasis focus in the west region of Cameroon -

Main objectives

To establish the effectiveness of mobile outreach with a doxycycline test and treat strategy (TnT) in reducing onchocerciasis prevalence and intensity of infection among hard-to-reach nomadic groups in the Massangam health area of Cameroon

Summary

Alternative treatment strategies (ATS) implemented in Massangam Health District (HD) including test and treat with doxycycline and ivermectin mass drug administration (MDA) could only reach 20% of the nomadic population considered to be at higher risk of infection and reservoir for transmission.

As well as the implicit equity concerns with the exclusion of this group from both treatment strategies, there is a risk that they constitute a roaming reservoir of transmission and will impede elimination efforts. A recent qualitative assessment of the ATS in the Massangam health area (HA) revealed the barriers in reaching this hard-to-reach nomadic population.

The barriers included remote, dispersed and small settlements, high mobility, communication barriers, CDD-linked challenges, limited information on them, low awareness of mass drug administration and education/literacy rates.

This study trialled and evaluated a mobile outreach strategy with test and treat with doxycycline, to better serve the semi-nomadic population. In doing so, it explored the movement and turnover of the population and also determined the level (rate) of onchocerciasis infection in them.