According to recent estimates, about 45 percent of Central America’s population is at risk for Chagas Disease –one of the 17 neglected tropical diseases recognized by the World Health Organization (WHO). However, the Japan International Cooperation Agency (JICA) has made large strides in controlling and halting the transmission of Chagas within several countries of the region.
On Thursday, May 29th, JICA members shared success stories and best practices from their 14 years of experience controlling Chagas Disease in Central America. During the event, Dr. Ken Hashimoto, JICA’s Central American Regional Advisor for Chagas, noted that the best practices developed by his team were designed to aid the broader global health community in their efforts to rid the Americas of this deadly disease.
Beginning with an overview, Dr. Hashimoto explained that Chagas disease is most-often transmitted by small insects (triatomine bugs) which frequently hide in the cracks of mud walls. This is problematic because the majority of Chagas victims are poor and live in mud houses.
Dr. Hashimoto noted that JICA’s Chagas control strategy involved a variety of activities – including surveying, training national officials and community health workers, securing financial support, raising awareness and establishing a surveillance system to prevent new outbreaks of the disease.
More specifically, Dr. Hashimoto said the control strategy consisted of an attack phase and a surveillance phase. As part of the attack phase, JICA conducted initial surveys on the scope of the problem, dispatching dozes of long-term and short-term experts and volunteers to the region. Once this initial task had been completed, the team sprayed houses in at-risk communities with insecticide. In addition, JICA members educated communities on ways to prevent the disease. Lastly, the JICA team evaluated the success of their efforts – often times needing to repeat the steps until finally halting transmission of the disease in several areas.
Why was JICA so successful? Their latest report, “Best Practices” from JICA’s Chagas Disease Control Efforts in Central America, provides insight into their best practices.
Through workshops, interviews and analysis, JICA developed 23 different best practices: 13 at the national level, 5 at the departmental level and 5 at the operational level. According to JICA, the term best practices is defined as “a set of coherent actions that generate favorable changes in sustainability, impact, and the ability to be replicated.”
Some examples of best practices at the national level include the following:
- Projecting a vision for a national plan to control Chagas
- The strategic design of national plan
- Creating a diploma course on vector borne diseases
- Applying GIS (Geographic Information Systems)
- Establishing connections between the Ministries of Health and the Ministries of Education
At the departmental level, Dr. Hashimoto notes that establishing community participation on the control efforts was important. In addition, deworming was provided at the same time that surveys were conducted to assess the burden of Chagas disease. This is because children found positive for Chagas are often not able to receive treatment for the disease because they are malnourished and will react poorly to the treatment. To help with this issue, the children are dewormed before treatment and their bodies are rid of the nutrient-sucking intestinal worms. In addition to deworming medicine, many children also need better nutrients depending on how malnourished they are.
Lastly, Dr. Hashimoto noted that strong commitment from governments were key to sustaining the program’s success long-term.
For more information and best practices from JICA’s Chagas control efforts, click here.