Shifting Priorities on Disinfection – The END Fund

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By Daniel Boakye For the past few months following the outbreak of the COVID-19 pandemic, the END Fund’s  programmatic priorities have shifted like many other organizations to supporting efforts to stop the spread of COVID-19. This also meant a shift of my role as a technical advisor to the countries supported by the Reaching the…

By Daniel Boakye

For the past few months following the outbreak of the COVID-19 pandemic, the END Fund’s  programmatic priorities have shifted like many other organizations to supporting efforts to stop the spread of COVID-19. This also meant a shift of my role as a technical advisor to the countries supported by the Reaching the Last Mile Fund (RLMF) — particularly on the elimination of river blindness — to advising the Ghana Ministry of Health on disinfection. Disinfection is one of the World Health Organization’s (WHO) recommended strategies to prevent COVID-19 from spreading.

COVID-19 in Ghana

The COVID-19 pandemic in Ghana poses a challenge not only to its health system but also to the economy and other sectors. The country reported its first cases in March from travelers who returned to the country. Shortly after, all borders were closed and travel ceased — air, sea, and land —  crippling airlines and all businesses and professions that depend on these industries. Preventive measures were put in place such as physical distancing, the pausing of public gathering in churches, funerals, and schools, and hand washing.  Increased hand washing as a result of COVID-19 may prove beneficial to the control of some parasitic infections — it is an infection prevention practice that the NTD community has been advocating for years. Testing of all suspected COVID-19 cases was done at the Noguchi Memorial Institute for Medical Research, University of Ghana (NMIMR), the Kumasi Center for Collaborative research, and Kwame Nkrumah University of Science and Technology (KCCR). Currently, , Ghana has almost 43k  confirmed cases, over 41k recovered with 263 deaths from over 357k tested,  according to the Africa CDC as of August 20th.

Switching roles from technical advisor on elimination of river blindness (onchocerciasis) to disinfection advisor

As a Technical advisor for NTDs, specifically river blindness and elephantiasis for the RLMF, I often travel to support African countries. Due to the current ban on international travel, my trips to support these countries have been suspended and I have been stationed in Accra, Ghana at the Department of Parasitology, NMIMR. Although I have been able to provide remote support through online discussions, data analysis, and planning for post-COVID-19 activities, being in Ghana provided me an opportunity to contribute to activities towards control and prevention of COVID-19 in my country. The opportunity to be of service to the country’s COVID-19 efforts came when Ghana decided to undertake one of the main WHO recommended preventive measures, which is disinfection of areas of high-risk for infection. This includes marketplaces, airports, and schools.

Daniel Boakye (right) in 2018 working in Senegal to capture black flies to test for river blindness.
What does this entail?

The Ministry of Local Government and Rural Development (MLGRD), Ghana contracted the vector control arm of a private company ZOOMLION Ghana Ltd, VectorPes to undertake the disinfection activities initially of local markets throughout Ghana. Three entomologists at the Parasitology Department, NMIMR – Prof Maxwell Appawu, Dr. Samuel Dadzie and myself —  were contacted to provide technical advice for these activities.  A planning meeting was organized to discuss the procedures and way forward for disinfection of markets within the Accra Metropolitan Assembly. The meeting resulted in strategies for disinfection activities including informing messages and traders in the markets and setting specific times for the disinfection.

Following the successful disinfection of the major markets, the company was asked to disinfect schools,  airports, military bases and  naval bases. Apart from my initial participation in the strategy meeting for the market disinfection, I was also one of the trainers for the sprayers, a member of the press briefing in Kumasi in the Ashanti Region, prepared important press briefing documents, and provided post-disinfection analysis of the whole process after each activity.

Recommendations:

The process for the disinfection includes:

(a) the planning stage at the offices of VectorPes Company;

(b) discussion with the management of the area to be disinfected to set a date and prepare for the activities;

(c) visiting the area and structures to be disinfected;

(d) a training session for the sprayers on the rationale for spraying, basic safety procedures and how to undertake the activities;

(e) actual disinfection; and

(f) post-disinfection information to the end-users.

An important message to end-users and the general public is that disinfection for COVID-19 prevention is not a one off activity. It is not a standalone preventive measure, but should be incorporated with other measures including regular hand washing with soap, wearing of masks, and social distancing practices.