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Venezuela - PAHO

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USAID/PAHO Project for the Prevention and Control of Antimalarial Resistance in the Amazon

Work Plan for the Period October 2001 through September 2002

Country Work Plan VENEZUELA

Intermediate Result 1 - Reliable and standardized malaria drug efficacy information available. Indicators: 1) Number of target countries that have selected an adequate

number of sentinel surveillance sites, including a reference laboratory, and initiated training activities. 2) Number of target countries where the WHO/PAHO protocol has been

adapted. 3) Number of target countries that initiated anti-malarial drug resistance studies based on the WHO/PAHO protocol.



Activities Tasks Staff , other human resources, Product Month/ Remarks

and other inputs Year

A1.1. Establish a 1. Participate in the first regional PAHO focal point, Project plan and common agenda March 02 Cost included in task A3.1

regional network for technical meeting for reaching Project country coordinator 2002 consensus whit other partners.

surveillance of drug consensus about project work

resistance and plan, and common agenda

monitoring of 2002.

2. Participate in intercountry PAHO focal point, Informed working groups March -02 Cost included in task A3.1

activities under

coordinating committee to: National project coordinator -Regional centers with potential to to

coordination of

Monitor progress in PAHO/WHO integrate the regional network for September

PAHO.

protocol adaptation. surveillance of drug resistance 2002

Obtain consensus regarding the identified.

resistance testing methods, and -Progress reports on protocol

in monitoring, evaluation and implementation

quality control indicators. -Management indicators and protocols

for quality control established.





A.1.2. Establish 1. Conformation of a National - National technical advisory * National technical advisory committee Dec - 01 In preliminary meetings, the

National sentinel Technical Advisory Committee committee integrated by operational following academic institutions

surveillance by the Ministry of Health (MSDS) representative of: * Coordinator designated, were:

networks with and national research centers. * Central level (PAHO, MSDS, * Agenda established, * C.A.I. C.E.T

quality control in IESPA, IVIC) * Antimalarial drug resistance * UCV (Tropical Medicine

each target country * Regional Service Director from surveillance network established Institute)

to assess the the states of Sucre, Amazonas and * IVIC ( Microbiology Center)

efficacy of Bolívar, and * MSDS (Epidemiological

antimalarial drugs. * National Research centers. Surveillance Department)



2. Identify and select five (5) National technical advisory Five sentinel sites selected in the Jan-Sep Three sentinels sites will be

sentinel sites in Atures y committee states of Amazonas (2), Bolivar (2) 2002 operated by personnel

Manapiare (municipalities of the and Sucre (1) contracted under AMI funds;

state of Amazonas); two sentinel sites will be run

Maripa y Tumeremo ( state of with personnel from

Bolívar) and Cajigal (state of governmental institutions

Sucre) according to (MSDS, National Commission

epidemiological parameters. of Scientific Research and

Technical and NGOs.







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3. Begin operations of sentinel Physicians (3) = 62.400 Microscopy '- Human resources will have been Jan-Sep The project will cover

sites technologist (3) = 23.400 contracted. 2002 personnel expenses for first

Nursing auxiliaries (3) = 19.500 (*) - Sentinel sites structured in year to guarantee its success.

accordance with the established RAVREDA project, with AMI

criteria. funds will complement the Roll

- Studies of sensitivity and resistance Back Malaria Strategy

completed in at least 5 municipalities providing coverage in remote

- Laboratory diagnosis quality control areas with high incidence of

implemented. malaria. The teams will be

mobile to reach scattered rural

population. The studies will

include from 42 to 50 cases

per month per cohort, in

around 10 nearby localities.



Three vehicles repaired Vehicles will have been repaired and The project will operate in

in operation. areas of difficult access year

round, which make it

necessary to use land and/or

water transportation



Maintenance of three vehicles and

minor repairs to three vehicles.

=10.000

Maintenance and repairs of

microscopes =1.500



Equipment, materials and inputs

provision for sentinel sites

laboratories. Microscopes (3),

lancets, stains, balances,

thermometers and slides

Requirements for quality control:

monitoring, meetings every 2

months of sentinel site technical

coordinators, national technical

coordinator and PAHO focal point.



Antimalarial drugs provision for

study purposes



(*) The physician will direct all activities: patient selection (according to the protocol clinical parameters), patient medical examinations (both admission and

house calls), direct administration of the treatment, monitoring and recording any collateral drug effects, collecting hematic samples for parasitological requirements

(day 0, 1, 2, 3, 4, 7, 14 and 28), give training to guarantee the sustainability of the project. The microscopy technologist will take the blood samples for malarial

exams of suspected cases and selected positive cases for the studies in "vivo" (continuous work includes holidays and weekends). Nursing auxiliary will also act as

guide, and will drive and pilot boats on the rivers, and malaria case detection.

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3. Definition of therapeutic -Therapeutic regimens in use

regimens to be evaluated in the evaluated, and antimalarial drugs to be

sentinel sites. evaluated in sentinels sites selected.





4. Selection of a (1) staff Staff member include as participants in The staff member will be an

member in charge of periodic the RAVREADA activities experienced physician

monitoring of activities in epidemiologist in the MSDS.

sentinel sites.



A.1.3. Provide 1. Workshop to explain all 1. Members of the network and all All selected personnel with Jan-02 Activities to be carried out

training to improve surveillance network activities. personnel hired for the study commitment to carry out the during 8 working days.

national capability surveillance network.

to conduct the

2. Workshop on antimalarial 2. The physicians hired for the Personnel participating in the

surveillance

therapies study and analysis of sentinel sites, at least three PAHO/WHO protocol development for

network of malaria

the (WHO/PAHO) protocol for persons in charge of regional execute the surveillance of antimalarial

drug resistance in

the supervised administration of services, and at least two drugs efficacy on Venezuela field

all target countries.

antimalarial drugs, use of the members from the surveillance trained.

forms for specific data. network coordination.



3. Workshop for microscopists 3. Participants include # of microscopists trained

training in malaria diagnosis, microscopists assigned to sentinel

including parasitemia sites; trainer of trainers, and at

quantification. least one member from

surveillance network coordination



A.1.4. Study 1. Data tabulation and analysis. Participants include National New treatment identified and endorsed Sep 02

findings reviewed Technical Advisory committee by the national technical advisory

alternative Surveillance network members and committee.

treatments sentinel site health workers

evaluated, and medical.

consensus on

appropriate 2.Surveillance network meeting

protocols reached. for analysis of results and

discussion from sentinel site

data.



3.Assesment of therapeutic

regimens administered

4.Asses strategy for alternative

schemes.









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Intermediate Result 2. Tools and approaches developed, adapted, tested and disseminated. Indicator: Number of sites identified in Brazil with trials of rapid tests for

malaria diagnosis initiated.

A2.1 Rapid tests for

malaria diagnosis

evaluated in

selected sites and

appraisal of their

cost-effectiveness

evaluated.





Intermediate Result 3. Partnerships to improve malaria control in the sub-region enhance. Indicator: Number of surveillance network of anti-malarial drug resistance activities

carried out with technical assistance or exchanges between target countries.

A3.1. Sub-regional Participate in regional/sub- Meeting reports. March-02

dialogue and regional meetings to discuss Sept-02

planning for work plans, agendas, evaluation

prevention and progress of the national

containment anti- networks and applied

malaria drug methodologies in technical

resistance assistance. (Include a mid term

facilitated. inter- country meeting)



A3.2. Centers of

excellence for

regional training

identified and

supported.



A3.3. South-to- Meetings with Guyana and Surveillance network staff Agreements and schedule Sep-02

south technical Suriname surveillance network

assistance and members to exchange

training activities information and establish

executed. agreements for technical

cooperation









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