All posts by Alex Gordon

Government of Nigeria Releases New Data on the Prevalence of Schistosomiasis and Intestinal Worms

On Thursday June 4, Nigeria’s Federal Ministry of Health released, for the first time, comprehensive data on the national distribution of two major neglected tropical diseases (NTDs) — schistosomiasis and intestinal worms. This new information, gathered by the government of Nigeria and a network of partners, found that across 19 states and the Federal Capital Territory (FCT) approximately 24 million Nigerians were at risk for schistosomiasis and 21 million were at risk for intestinal worms. Children between the ages of 5 10 had the highest prevalence of infection. The results also showed that men were more likely than females to have one of the diseases.

Nigeria is said to have the highest burden of NTDs in sub-Saharan Africa. While the government and NGO partners have already taken several steps to address the burden of disease, comprehensive epidemiological mapping had not been available until recently. Moving forward, the data gathered from this mapping project will aid the Federal Ministry of Health in planning effective intervention measures for both schistosomiasis and intestinal worms.

People infected with NTDs like schistosomiasis and intestinal worms are often unable to work or attend school – resulting in an endless cycle of economic hardship. Treating these diseases is critical to reducing poverty and boosting economic prosperity. Given the strong association between NTDs and economic development, NTD control and elimination should be considered an important factor in achieving the Sustainable Development Goals (SDGs) in Nigeria. Nigeria’s quest to be one of the 20 major economic players globally by 2020 as captured in it Vision 20: 2020 will depend on a healthy and productive society that does not neglect the less fortunate.

The prevalence mapping survey was completed by analyzing 50 55 children from five randomly selected schools in the 19 states and FCT. The Task Force for Global Health which uses smart phones for data collection and cloud based data reporting and management.

Map of Nigeria displaying study area

The results showed an overall prevalence rate of 9.5 percent for schistosomiasis and 27 percent for intestinal worms.

The data gathered from the mapping survey will enable Nigeria to receive the appropriate amount of donated medicines to treat schistosomiasis and intestinal worms, so that they can deliver the medicine to where it is most needed. In addition to providing actionable data, the mapping project helped build and improve the capacity of health workers across Nigeria for the country’s NTD programme. The project also fostered a platform for cross-sector learning and skills sharing, which ultimately improved programme coordination.

Moving forward, the Federal Ministry of Health has recommended that all levels of government (Federal, State and LGAs), NTD partners and other stakeholders — with the cooperation of the communities — scale up uninterrupted provision and administration of appropriate medicines alongside other environmental improvement interventions such as clean water and sanitation provisions. Plans should also be put in place for impact assessment after the third year of consistent Mass Administration of Medicines.

While there is much work to be done, the successful completion of epidemiological mapping for schistosomiasis and intestinal worms is a promising sign. Armed with this information, Nigeria can strategically and effectively scale up their efforts to control and eliminate these debilitating diseases for a more prosperous Nigeria.  Nigeria’s new government, led by President Buhari, should take advantage of this cost effective and relatively simple intervention in order to make a tremendous impact on the country’s most vulnerable populations.

Photos provided by Nigerias Federal Ministry of Health. 

Better Together: Integrating Immunization and Deworming during World Immunization Week

Beginning tomorrow, global health partners around the world will be celebrating World Immunization Week. While the week’s events primarily focus on achieving equitable access to immunization, the Global Network for Neglected Tropical Diseases is particularly excited about the opportunities World Immunization Week presents for integrating deworming and immunization campaigns.

In Honduras, for example, the Ministry of Health has used World Immunization Week as a platform to deworm hundreds of thousands of children throughout the country.

Read our Honduras case study here: HONDURAS: LEADING THE WAY IN THE AMERICAS THROUGH INTEGRATED EFFORTS TO TREAT NEGLECTED TROPICAL DISEASES (NTDS)

Integrating deworming with immunization campaigns under the umbrella of World Immunization Week is an extremely cost-effective way to prevent many diseases at the same time. By providing deworming medicine alongside immunizations, Honduras is maximizing the impact of its health interventions.

Honduras has also integrated water, sanitation and hygiene (WASH) practices, as well as vitamin A supplementation into World Immunization Week. Since poor WASH contributes to increased intestinal worm infections, and intestinal worms can worsen and intensify malnutrition, integrating these three health interventions is essential for maximizing the health of children.

Honduras’ unique and successfully-integrated approach to fighting intestinal worms should be celebrated and replicated. To learn more about the country’s efforts, read our case study here.

NTD Article Round-Up

Starting this month, the Global Network will be presenting a round-up of articles on neglected tropical diseases (NTDs). Check back every month for the latest. To suggest an article, you may post a comment below.

1. Unprogrammed Deworming in the Kibera Slum, Nairobi: Implications for Control of Soil-Transmitted Helminthiases

PLoS Neglected Tropical Diseases – Published to PubMed 3/12/15 Julie R. Harris, Caitlin M. Worrell, Stephanie M. Davis, Kennedy Odero, Ondari D. Mogeni, Michael S. Deming, Aden Mohammed, Joel M. Montgomery, Sammy M. Njenga, LeAnne M. Fox, David G. Addiss

“In countries with endemic soil-transmitted helminth infections, deworming medications are widely available from multiple sources, including over the counter. However, in many countries, national programs already provide deworming medications in mass drug administrations to primary school students, as part of World Health Organization recommendations. Evaluations of the effectiveness of such medications at reducing worm burden in children is based solely on the national program’s distribution schedules, primarily because little is known about how frequently deworming medications are obtained from other sources. We investigated sources of deworming medications received by children in a Kenyan slum, finding that more than half of school-aged and preschool-aged children received deworming medications outside of a national school-based deworming program. These drugs were received from multiple sources, including chemists, healthcare centers, and at schools, via the efforts of non-governmental organizations. These data strongly indicate a need to collect data on all sources of deworming medications when evaluating the effectiveness of national school-based deworming programs.”

2. Mass Drug Administration for Trachoma: How Long Is Not Long Enough?

PLoS Neglected Tropical Diseases – Published to PubMed 3/23/15 Violeta Jimenez, Huub C. Gelderblom, Rebecca Mann Flueckiger, Paul M. Emerson, Danny Haddad

“Trachoma, the world’s leading infectious cause of blindness, is scheduled for elimination by 2020. Reaching this elimination target depends on successful implementation of the SAFE strategy (Surgery, Antibiotics, Facial cleanliness, and Environmental improvements). Annual mass antibiotic distributions are key to breaking the cycle of transmission in a community. However, it is not clear how many annual mass treatments need to be carried out in order to achieve elimination. Our study analyzes the effect of mass antibiotic distribution on different baseline prevalence levels of trachoma, in order to assess factors that affect the success of reaching elimination goals. We find that the prevailing belief, which suggests that 3 annual mass treatments can achieve local elimination of trachoma at prevalences between 10–30%, and 5 annual mass treatments for districts above this benchmark, is probably incorrect. In fact, much longer intervals may be required with “business as usual” programmatic strategies, which often include skipped years of treatment. Districts with high prevalence levels may require more intense treatment strategies to eliminate trachoma. Intensified recommendations must be implemented without delay in order to reach the 2020 elimination deadline.”

3. Neglected Tropical Disease Control and Elimination: Is Human Displacement an Achilles Heel?

PLoS Neglected Tropical Diseases – Published to PubMed 3/19/15 Kaylee Myhre Errecaborde, William Stauffer, Martin Cetron

“The United Nations High Commission for Refugees (UNHCR) has estimated that over 40 million people are currently displaced and have variable access to health care in the country in which they reside. Populations displaced by conflict are largely disenfranchised, and high prevalence of neglected tropical diseases (NTDs) has been documented. NTDs generally affect the least advantaged people in poor societies—populations with little voice or representation. These already susceptible people become even more vulnerable when forced from their communities as internally displaced persons (IDPs), refugees, or forced migrants. To further complicate matters, many of these people of concern are under 18 years old. Children experience the greatest risk and suffer the most consequences of NTDs. As marginalized populations flee from conflict or environmental catastrophe, they are often burdened with insidious NTDs ranging from asymptomatic to overt and debilitating disease. Many suffer from chronic consequences such as malnutrition, growth stunting and developmental delays, inhibiting chances for sustainable livelihoods and making it less likely that they will successfully overcome the adversity.”

4. Gut Instincts: Knowledge, Attitudes, and Practices regarding Soil-Transmitted Helminths in Rural China

PLoS Neglected Tropical Diseases – Published to PubMed 3/25/15 Louise Lu, Chengfang Liu, Linxiu Zhang, Alexis Medina, Scott Smith, Scott Rozelle

“Soil-transmitted helminths (STHs) are parasitic intestinal worms that infect more than two out of every five schoolchildren in rural China, an alarmingly high prevalence given the low cost and wide availability of safe and effective deworming treatment. Understanding of local knowledge, attitudes, and practices regarding STHs in rural China has until now, been sparse, although such information is critical for prevention and control initiatives. This study elucidates the structural and sociocultural factors that explain why deworming treatment is rarely sought for schoolchildren in poor villages of rural China with persistently high intestinal worm infection rates. In-depth, qualitative interviews were conducted in six rural villages in Guizhou Province; participants included schoolchildren, children’s parents and grandparents, and village doctors. We found evidence of three predominant reasons for high STH prevalence: lack of awareness and skepticism about STHs, local myths about STHs and deworming treatment, and poor quality of village health care. The findings have significant relevance for the development of an effective deworming program in China as well as improvement of the quality of health care at the village level.”

Success in Vietnam: More than 700,000 School Children Treated!

Over the span of two months, Vietnam’s Ministry of Health, together with World Vision Australia, treated more than 700,000 school children for intestinal worms. Generous donations from END7 supporters helped support this massive effort to reach every primary school in the nine target provinces across the country.

Vietnam’s mass drug administration (MDA) was critical to improving the country’s health. Intestinal worms pose a significant threat to children in Vietnam; more than 8 million children are at risk. If infected, these children are more likely to suffer from malnutrition and anemia. Intestinal worm infections also lead to school absenteeism and decreased cognitive function. In order to reach their full potential, all at-risk children must be treated regularly.

To help address Vietnam’s burden of intestinal worms, END7 donations supported the delivery of abendazole tablets, and the training of teachers and healthcare workers. Now, END7 funds will be supporting the country’s efforts to monitor and evaluate the success of the MDA campaign.

Thanks to our END7 supporters for playing a meaningful role in the fight against neglected tropical diseases!