AID grant no. 624-0277-G-SS-1077-00 to the Helen Keller International for the prevention of the recurrence of onchocerciasis in Niger

The principal activities will be epidemiological surveillance and, where indicated, ivermectin distribution. HKI will work with the Ministry of Health and other national and community groups to: train a 9-person surveillance team and a 30-person cadre of nurses; identify communities where the rate of infection is above the acceptable threshold and distribute ivermectin on a preventive basis; identify and treat recent in-migrants who are infected; provide information and public outreach services; develop a network of referrals for blind and visually impaired persons; and implement a cost-recovery system. Although the ivermectin will be provided free of charge by the pharmaceutical firm Merck and Company (under its brand name, Mectizan), a cost recovery system will be put in place to ensure sustainability. The principal target of surveillance activities will be all children aged 5-15 and all adult males aged 20-60 living in the most at-risk communities along the tributaries of the Niger River. The districts of Tera and Say, in the department of Tillaberi, will be evaluated for possible disease recrudescence, with more limited scrutiny in the districts of Gaya and Bobye, in the department of Dosso, due to their proximity to hyperendemic conditions in Nigeria.