Analytical summary - Neglected tropical diseases
Onchocerciasis is prevalent in 14 out of 15 counties in Liberia, with more than 1.1 million Liberians at risk. The Essential Package of Health Services will utilize the existing community-directed treatment with ivermectin approach for annual mass drug administration by community health volunteers.
Lymphatic filariasis is prevalent in 13 out of 15 counties (Immuno-Chromatic Test Survey, 2010). The community-directed treatment with ivermectin strategy will be utilized to administer annual mass drug administration of albendazole and ivermectin to the target population in 13 counties. Elimination is targeted for 2020.
Schistosomiasis has a prevalence of 20% or greater in Bong, Lofa and Nimba. In endemic communities, with prevalence rates above 50%, mass drug administration with praziquantel will target all resident children ≥5 years old.
Soil-transmitted helminthes, including Ascaris lumbricoides, hookworms and trichurias, are common intestinal parasites, prevalent in all 15 counties. The highest prevalence of 50–100% is found in Maryland, Grand Kru, Sinoe and Rivercess. Mass drug administration with mebendazole will target children 12–59 months, schoolchildren, adolescents and women of childbearing age.
Leprosy continues to be a public health problem in Liberia. WHO set an elimination target prevalence rate of less than 1 case in 10 000. Liberia had a prevalence rate of 3.61 cases per 10 000 and an incidence rate of 11.8 cases per 100 000 in 2009.
The trend of cases is steadily increasing with 410, 414 and 415 cases in 2007, 2008 and 2009 (National Leprosy and Tuberculosis Control Programme, 2009). The response to the leprosy situation has previously been provision of care in the leprosarium. However, the provision of care is now through integrated leprosy services at all facilities in all counties.
Activation of mechanisms for early detection, treatment and referrals is being addressed in the Essential Package of Health Services through increased training of health workers and improved capacity to manage complications. Increased sensitization and awareness about leprosy, through community education by community health volunteers, will reduce stigma associated with the disease. The Essential Package of Health Services hopes to eliminate leprosy during phase one of implementation.