By: Alanna Shaikh
It was recently pointed out to me that I’ve never covered leishmaniasis in my posts. I’d hate to make an NTD extra-neglected, so I’ll look at it today. As a quick refresher, you may recall that I named it “giant sores and organ damage disease” in my very first post on this blog. It’s also known as kala-azar.
For a somewhat more formal description of leishmaniasis, we can turn to the World Health Organization (WHO). They’re just issued an information page on the disease. (Which, by the way, is good news. It will help raise the profile of this NTD and all the others as well.) The WHO would like you to know that:
Leishmaniasis is caused by protozoan parasites belonging to the genus Leishmania. The parasites are transmitted by the bite of a tiny – only 2–3 mm long – insect vector, the phlebotomine sandfly.
Photo Credit: CDC
I think they’re kind of burying the lede there. I don’t honestly care about the length of the sandfly that transmits the parasite that causes the huge sores. (Though, on a personal note, sandflies bit the heck out of me last summer and I spent many insomniac hours worrying about leishmaniasis. Working in global health is not always good for the psyche. And I googled; we do have leishmaniasis in Tajikistan, although not in terrible amounts. It’s genetically unique.) They also suggest you watch the trailer of a film on the disease.
If you scroll down the page a little more, here’s the numbers that made an impact on me:
Leishmaniasis threatens about 350 million men, women and children in 88 countries around the world. As many as 12 million people are believed to be currently infected, with about 1–2 million estimated new cases occurring every year.
88 countries (including Tajikistan) is an awful lot of territory. And the WHO page doesn’t get into leishmaniasis control at all. Once you tell me 12 million people have the disease, and 2 million more every year, I want to know how to stop the thing. The WHO does have a leishmaniasis control page, with their chosen five points for fighting the disease (my thoughts in parentheses):
- Facilitation of early diagnosis and prompt treatment (Helps both the people who get treated and keeps them from being a reservoir for the disease.)
- Support for control of sandfly populations through residual insecticide spraying of houses and use of insecticide-impregnated bednets (I wonder if they use the same insecticides used for mosquito spraying? I am going to assume yes, otherwise the bednets situation would be ridiculous.)
- Provision of health education and production of training materials; (What are people being educated on? I guess bednets and spraying and why sandflies are bad.)
- Detection and containment of epidemics in the early stages (Not quite sure how this is different from the first point. I guess it’s based on looking at data at the population level and requires support to government bodies on data collection, as opposed to training individual health care providers.)
- Early diagnosis and effective management of leishmaniasis/HIV co-infections. (That had never even occurred to me – leishmaniasis and HIV. Makes sense though.)
I think the WHO is missing one more tool to fighting leishmaniasis, and all NTDs: poverty reduction. The NTDs are still fundamentally diseases of the poor. Less poverty will mean fewer infections. It’s not exactly the WHO’s field, I admit, but it’s worth pointing out.
Alanna Shaikh is an expert in health consulting, writing about global health for UN Dispatch and about international relief and development at Blood & Milk. She also serves as a frequently contributing blogger to ‘End the Neglect.’ The views and opinions expressed by guest bloggers are not neccesarily the views and opinions of the Global Network.
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