All posts by Hanna Schwing

West Wing Characters Learn Seven Facts about NTDs

In honor of NTD Awareness Week, and to rally for Thursdays NTD Advocacy Day, we present the below listicle for your enjoyment.

1. Neglected tropical diseases (NTDs) are a group of parasitic and bacterial diseases that affect the world’s poorest people. Without treatment, they can lead to lifelong disabilities and suffering. But NTD treatment programs struggle to find funding.

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2. The seven most common NTDs infect over one billion people, including half a billion kids, but it’s not all bad. It only costs 50 cents to treat and protect one person from seven NTDs for a whole year.

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3. The United States government — through the U.S. Agency for International Development’s (USAID) NTD Program — is a leader in the effort to control and eliminate NTDs worldwide.

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4. Since the USAID NTD Program was launched in 2006, more than 1 billion NTD treatments have been delivered to 460 million people across 25 countries.

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5. Every $1 invested in the program has leveraged $26 in drug donations from pharmaceutical companies — a best buy in global health! Ainsley

6. The program’s budget is less than 1% of total U.S. spending on global health. But for the last three years, President Obama has suggested a $13.5 million cut to the program.

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7. END7 student supporters spent last spring urging Congress to protect and increase funding for NTD treatment. But the fight is not over. Send a message to President Bartlett Obama to show your support for the NTD budget!

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Advocate, fundraise, and spread the word to be part of the solution!

Sabin Vaccine Institute. END7 is working to raise the awareness and funding necessary to control and eliminate the seven most common neglected tropical diseases (NTDs) by 2020.

Tune in for a Live Chat on River Blindness

Global Network for Neglected Tropical Diseases. The chat follows two stories about river blindness from NPR correspondent Jason Beaubien.tweetchat

Listen to the stories below, tweet your questions to #RiverBlindness, and tune in on January 22nd to participate in the discussion.

60-year-old Emmanuel Kwame first started to get sick with onchocerciasis, commonly known as river blindness, when he was in his 20s. His hometown of Asubende in central Ghana was hard hit by the disease. Of Kwames 12 siblings, six lost their eyesight. Read more.

Bondi Sanbark, the chief in Beposo 2, Ghana, says his village used to be full of blind men led around by boys — but that began to change after the Nobel prize-winning drug, Ivermectin, started being distributed.

Mass ivermectin campaigns are now treating roughly 4 million Ghanaians a year, or more than 15 percent of the population. And the strategy is paying off. No one has gone blind in Beposo 2 for years, says Sanbark. Read more.

NTD Article Round-Up

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

1. Associations between School- and Household-Level Water, Sanitation and Hygiene Conditions and Soil-Transmitted Helminth Infection among Kenyan School Children

Parasites and Vectors – Published August 7, 2015 Freeman MC, Chard AN, Nikolay B, Garn JV, Okoyo C, Kihara J, Njenga SM, Pullan RL, Brooker SJ, Mwandawiro CS

Soil-transmitted helminths, a class of parasitic intestinal worms, are pervasive in many low-income settings. Mass treatment, typically administered through schools, with yearly or biannual drugs is inexpensive and can reduce worm burden, but reinfection can occur rapidly. Access to and use of sanitation facilities and proper hygiene can reduce infection, but rigorous data are scarce. Among school-age children, infection can occur at home or at school, but little is known about the relative importance of WASH in transmission in these two settings.  We explored the relationships between school and household water, sanitation, and hygiene conditions and behaviors during the baseline of a large-scale mass drug administration programme in Kenya. We assessed several WASH measures to quantify the exposure of school children, and developed theory and empirically-based parsimonious models.  Results suggest mixed impacts of household and school WASH on prevalence and intensity of infection. WASH risk factors differed across individual worm species, which is expected given the different mechanisms of infection.  No trend of the relative importance of school versus household-level WASH emerged, though some factors, like water supply were more strongly related to lower infection, which suggests it is important in supporting other school practices, such as hand-washing and keeping school toilets clean.

2. Should the Goal for the Treatment of Soil Transmitted Helminth (STH) Infections Be Changed from Morbidity Control in Children to Community-Wide Transmission Elimination?

PLoS Neglected Tropical Diseases – Published August 20, 2015 Roy M. Anderson, Hugo C. Turner, James E. Truscott, T. Déirdre Hollingsworth, Simon J. Brooker

This article examines the feasibility of reaching the World Health Organization goal of mass drug administration coverage for 75% of those at-risk of soil-transmitted helminths. It weighs alternative goals to achieve morbidity control and the elimination of transmission.

We are still a long way from the 2020 target of 75%. Even if this target is reached, will it be enough to eliminate transmission and the disease arising from heavy infections with STH? If not, how should the guidelines be changed to push towards morbidity control, and ideally, the eventual elimination of transmission?

3. Impact of Community Mass Treatment with Azithromycin for Trachoma Elimination on the Prevalence of Yaws

PLoS Negelcted Tropical Diseases – Published August 4, 2015 Marks M, Vahi V, Sokana O, Chi KH, Puiahi E, Kilua G, Pillay A, Dalipanda T, Bottomley C, Solomon AW, Mabey DC

Yaws is a bacterial infection closely related to syphilis. The WHO has launched a worldwide campaign to eradicate yaws by 2020. This strategy relies on mass treatment of the whole community with the antibiotic azithromycin. Mass treatment with the same antibiotic is also recommended by WHO to treat the eye condition trachoma, but with a lower dose. This study assesses the impact of a trachoma control programme in the Solomon Islands on yaws. Following a single round of mass treatment the number of yaws cases fell significantly compared to before treatment. The findings suggest that mass treatment with the lower dose of azithromycin is also effective as a treatment for yaws. In countries where both yaws and trachoma are found it may be possible to develop an integrated strategy for both conditions.

4. Nodding Syndrome May Be Only the Ears of the Hippo

PLoS Neglected Tropical Diseases – Published August 13, 2015 Joseph Francis Wamala, Mugagga Malimbo, Floribert Tepage, Luswa Lukwago, Charles Lukoya Okot, Robert O. Cannon, Anne Laudisoit, Robert Colebunders

Epidemiological studies suggest a strong association between NS and onchocerciasis.  In this paper, the authors argue in favor of expanding the research on NS to include the study of all forms of epilepsy in onchocerciasis-endemic regions and to investigate in well-designed intervention studies whether ivermectin, with or without larviciding rivers, is able to decrease the incidence of epilepsy in onchocerciasis-endemic regions. APOC estimates there are currently 36 million people with onchocerciasis. Therefore, if 1% (equivalent to the approximate excess prevalence over non-endemic areas) were to develop epilepsy, the number of excess cases of epilepsy due to onchocerciasis would be on the order of 360,000. The authors hypothesize that most of this excess in prevalence of epilepsy is potentially preventable by increasing the coverage of ivermectin treatment and by maintaining it over many years. If it is confirmed that OV increases the risk of epilepsy, this will be an additional argument to strengthen onchocerciasis elimination plans.

5. Historical Perspective and Risk of Multiple Neglected Tropical Diseases in Coastal Tanzania: Compositional and Contextual Determinants of Disease Risk

PLoS Neglected Tropical Diseases – Published August 4, 2015 Frederick Ato Armah, Reginald Quansah, Isaac Luginaah, Ratana Chuenpagdee, Herbert Hambati, Gwyn Campbell

In the past decade, research on neglected tropical diseases (NTDs) has intensified in response to the need to enhance community participation in health delivery, establish monitoring and surveillance systems, and integrate existing disease-specific treatment programs to control overlapping NTD burdens and detrimental effects. In this paper, we evaluated the geographical distribution of NTDs in coastal Tanzania. We also assessed the collective (compositional and contextual) factors that currently determine risks to multiple NTDs using a cross sectional survey of 1253 individuals in coastal Tanzania. The results show that the effect size in decreasing order of magnitude for non-binary predictors of NTD risks is as follows: NTD comorbidities > poverty > educational attainment > self-reported household quality of life > ethnicity. Compositional (biosocial and sociocultural) factors explained more variance at the neighborhood level than at the regional level, whereas contextual factors, such as access to health services and household quality, in districts explained a large proportion of variance at the regional level but individually had modest statistical significance, demonstrating the complex interactions between compositional and contextual factors in generating NTD risks. NTD risks were inequitably distributed over geographic space, which has several important policy implications. First, it suggests that localities of high burden of NTDs are likely to diminish within statistical averages at higher (regional or national) levels. Second, it indicates that curative or preventive interventions will become more efficient provided they can be focused on the localities, particularly as populations in these localities are likely to be burdened by several NTDs simultaneously, further increasing the imperative of multi-disease interventions.

The Global NGO Deworming Inventory: Taking Stock of Progress against NTDs

According to the World Health Organization (WHO), an estimated 873 million children are at risk of soil-transmitted helminths (STH), including roundworm, hookworm and whipworm. In children, STH infections can lead to malnutrition, anemia and stunting. In both adults and children, they can cause fatigue, intense abdominal pain and chronic diarrhea. In severe cases they can even cause bowel obstruction, rectal prolapse and appendicitis.

To improve health and development in infected communities and reduce the prevalence of neglected tropical diseases (NTDs), WHO aims to control STH and schistosomiasis by 2020. Meeting this goal requires regularly deworming at minimum 75 percent of the preschool-age and school-age children who are at risk of STH or schistosomiasis. To ensure such an ambitious global goal is met, it is paramount that ministries of health, WHO and non-governmental organizations (NGOs) coordinate and share data.

WHO operates the Preventive Chemotherapy and Transmission Control (PCT) Databank, which tracks the number of children given PCT for STH, schistosomiasis and three other NTDs. The databank is populated largely by information reported by ministries of health and helps policymakers and implementers understand where deworming programs are active and where more interventions are needed to meet the WHO target of controlling STH and schistosomiasis by 2020.

However, gaps in the PCT Databank have become apparent. The 2013 STH preschool treatment data was recently revised when supplementary data was submitted by UNICEF. This data caused a 104 percent increase in the recorded number of preschool-age children treated for STH. Clearly, better coordination is needed to ensure the global community meets 2020 goals.

To facilitate better coordination among WHO, ministries of health and NGOs, the Children Without Worms (CWW).

After the data are compiled, WHO will merge the CWW database with national program data provided by ministries of health to the PCT Databank. This effort will make deworming dollars go even further by strengthening program monitoring and leading to an efficient use of resources. Ultimately, it will be an important step in controlling STH and schistosomiasis.

You can learn more about the Global NGO Deworming Inventory — and implementers can submit their data — at