Category Archives: elephantiasis

END7 Funds NTD Projects Around the World

This spring, we awarded nearly $400,000 in new grants for neglected tropical disease (NTD) control and elimination activities in 2016.

This funding is made possible by generous donations to Sabin Foundation Europe, a partner of the U.S.-based Sabin Vaccine Institute and the Global Network also helped make these grants possible.

The grants will make a significant impact in supporting integrated NTD programs in six countries. All projects are coordinated with Ministries of Health and/or the World Health Organization in each country. Many of the projects include mass drug administration (MDA) for the most common NTDs and training of health care workers. These projects are expected to benefit nearly six million individuals at risk from NTDs and train tens of thousands of health workers and volunteers to lead the NTD control and elimination effort into the future.

Awarded to existing efforts that faced a funding gap, these projects will have a lasting impact on improving and expanding existing programs to reach ambitious NTD control and elimination goals in Africa, Asia and Latin America – the regions with the largest NTD burden:

Nigeria $50,000 to support integrated MDA for seven NTDs, administered by Sightsavers with the support of the Federal and Kebbi State Ministries of Health. Nearly 5.9 million people will receive donated medicine in Kebbi state, in northwest Nigeria, where all seven NTDs are widespread. Sightsavers will continue their successful MDA in the region and expand to new areas.

Somalia $66,200 to support the first integrated MDA in five regions of southwestern Somalia by the new NTD Program of the Ministry of Health and Human Services. The MDA will target schistosomiasis (snail fever), ascariasis (roundworm), hookworm and trichuriasis (whipworm) among school-age children and adults in areas of high prevalence. The NTD Programme was established in 2015; success this year will help scale up the delivery of donated medicine to the rest of the country.

Cote d’Ivoire $28,789 to support water, sanitation and hygiene education to prevent NTDs in Cote d’Ivoire, administered by Helen Keller International. More than 7,000 health workers, school teachers and community health volunteers will be trained to reach more than 2.5 million people.

Guyana $111,146 to support MDA to eliminate lymphatic filariasis in the most populous region of the country, administered by the Pan American Health Organization and the Ministry of Public Health. Guyana is on track to eliminate lymphatic filariasis (also known as elephantiasis) by 2020. These funds were raised for END7 by the Sabin City Group in London.

India $60,546 to assist a local NGO, Churches Auxiliary for Social Action (CASA), to expand their successful efforts to treat and prevent lymphatic filariasis to West Bengal. This grant will enable CASA to train community members to manage the swelling and disability that often results from later stages of lymphatic filariasis. Each infected patient will receive a hygiene kit with soap, a towel and antifungal ointment and be shown how to care for themselves to reduce swelling. CASA will also promote the government’s annual MDA targeting 500,000 people for lymphatic filariasis treatment in West Bengal.

Myanmar $75,645 to assist the Department of Public Health to determine where MDA for lymphatic filariasis has succeeded and can be concluded. Nine districts with a population of nearly 7 million have already conducted more than five rounds of MDA for lymphatic filariasis. Officials will determine whether transmission has been interrupted.

The Global Network team reviewed 37 proposals from a range of partners tackling NTDs around the world and selected projects with the potential to have the most lasting impact, leverage further investment and bolster country-led efforts to eliminate NTDs.

To date the Global Network has awarded more than US$1 million in grants to 19 partners. From individual donors contributing $5 a month to student groups raising $10,000 over the course of a school year, the END7 campaign has mobilized a diverse and growing community of supporters from countries around the world dedicated to supporting the fight against NTDs. Together, these contributions are moving the NTD elimination effort forward by helping communities set up treatment programs they can run themselves. END7 supporters fill funding gaps in successful NTD treatment programs, highlighting the tremendous impact of this inexpensive treatment and the power of partnership in the fight against NTDs.

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Best Foot Forward: Eliminating a Neglected Tropical Disease

An unknown among unknown diseases, podoconiosis (podo for short) is a devastating type of elephantiasis spread by long-term exposure to minerals found in volcanic soil. Unlike lymphatic filariasis, podo is not infectious. Podo has been reported in more than 15 countries across Africa, Southeast Asia and Latin America, and affects more than 4 million people in highland tropical Africa.

A three-minute animated video, “Best Foot Forward,” depicts the source, treatment and prevention of podo. The video was created by Footwork: The International Podoconiosis Initiative, in partnership with Ripple Effect Images, a group of National Geographic contributing photojournalists, to raise awareness of this neglected disease.

As the video movingly illustrates, subsistence farmers in remote rural areas contract this devastating disease while working barefoot. Podo causes progressive swelling of the lower legs and makes it difficult to walk. In addition to physical suffering, superstitions about the causes of podo lead to shaming and even banishing of podo sufferers, particularly women.

Yet, podo is treatable. Podo’s severe swelling can be significantly reduced with simple hygiene. Low-cost foot care and shoes can ameliorate symptoms and prevent the occurrence of podo. Funding is urgently needed to support these treatments and educate local populations about prevention.

To learn more about Footwork and podo, visit www.podo.org.

Best Foot Forward from \nbest foot forward< a> from Ripple Effect Images on Vimeo.

About Footwork Footwork: The International Podoconiosis Initiative is a project of New Venture Fund, a 501(c) 3 public charity. Our vision is a world free of podoconiosis in our lifetime. Our mission is to bring together public and private partners to support prevention and treatment of, and advocacy for, podoconiosis. Footwork is active in Ethiopia, Cameroon and Uganda. It encourages integration of podoconiosis control into efforts to eliminate other NTDs, and works with organizations active in other related diseases of the foot and leg.

Upholding Germany’s Historic Commitment to Poverty-Related and Neglected Diseases

by Peter J. Hotez and Neeraj Mistry

The German Bundestag has an opportunity to make unprecedented commitments toward the treatment and prevention of the world’s most common poverty-related diseases — a group of debilitating infections known as the neglected tropical diseases (NTDs). They include ancient scourges linked to poverty such as elephantiasis, river blindness, blinding trachoma, schistosomiasis, roundworm, whipworm and hookworm. Today, these NTDs are among the most common afflictions of the poor, and almost every person living in abject poverty suffers from at least one NTD. New research has shown that these NTDs, because of their long-standing effects on the mental and physical health of children and adults but especially girls and women, now rank among the most important reasons why people cannot escape poverty in the “global south,” including Africa and the Middle East, Asia and Latin America.

Prince Marah takes ivermectin and albendazole at Levuma community health center in Levuma, Sierra Leone.

For more than 150 years, German science has provided leadership in tropical medicine that makes it possible today to discuss the eventual global elimination of the NTDs. Theodor Bilharz discovered the cause of schistosomiasis (also known as bilharziasis) while working in Egypt in the 1850s; Otto Henry Wucherer conducted studies in Brazil in the 1860s that helped discover Wuchereria bancroftico-discovered the cause of hookworm, also in Egypt.

Then, in 2005, the Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) and the World Health Organization organized a landmark conference in Berlin to integrate the control and elimination of the most common NTDs by combining mass treatments for these diseases in a simple “rapid impact package” of medicines. Today those low-cost (less than one Euro per person annually) packages have reached at least 450 million people. As a result, we are now seeing major reductions in the global prevalence of elephantiasis, river blindness and blinding trachoma. Thus, a decade following that historic Berlin meeting, we have the opportunity to eliminate at least these three NTDs.

The Berlin conference also promoted the importance of research and development so that today new interventions are underway including a human hookworm vaccine now in clinical trials in Gabon through a European HOOKVAC Consortium that includes both the Sabin Vaccine Institute’s product development partnership and the Institut für Tropenmedizin, Universitätsklinikum Tübingen. In the 19th century, both Bilharz and Wucherer trained in Tübingen.

The German Bundestag now has a significant opportunity to build on these successes. New legislation to support non-profit product development partnerships to produce new drugs, diagnostics, and vaccines could create a new generation of ground breaking technologies for the world’s poverty related diseases. In parallel, Germany can join the governments of the United States and United Kingdom in supporting the delivery of low-cost rapid impact packages, now recognized as one of the most cost effective global health interventions known.

Earlier this year, Chancellor Angela Merkel also delivered a historic address to the World Health Assembly about the important role the Group of 7 (G7) nations could have in eliminating NTDs. Her call to the G7 to take on NTDs can now be backed with time-sensitive action. The German Bundestag should reassert its historic commitment to these diseases, in the research and development space and for mass treatment. In so doing, Germany can lead efforts to finish the job it began more than a century ago.

Peter Hotez, M.D., Ph.D., is president of the Sabin Vaccine Institute (Sabin), Texas Children’s Hospital Endowed Chair for Tropical Pediatrics and dean of the National School of Tropical Medicine at Baylor College of Medicine. He also serves as U.S. Science Envoy for the White House and State Department.

Neeraj Mistry, M.D., M.P.H., is managing director of the Global Network for Neglected Tropical Diseases, an initiative of Sabin.

Eliminating Lymphatic Filariasis in Odisha

ASHAs in Ganjam District, Odisha, India. Photo: Naveen Pun / Sabin Vaccine Institute

by Dr. Madan Mohan Pradhan

During the late 1990s, I was infected with lymphatic filariasis (LF), or elephantiasis, a neglected tropical disease (NTD) that can cause extreme pain, crippling disability and disfigurement. LF is one of 17 NTDs recognized by the World Health Organization (WHO) as a group of parasitic and bacterial infections, which primarily affect people living in extreme poverty.

The incident occurred after I completed my medical degree. I was eager to work in Odisha and help some of its most vulnerable and under-served communities. It was during this time that I began working on an LF project, making nightly visits to endemic villages to collect blood samples from fevered patients. I knew how LF was transmitted, but had limited knowledge on the preventive aspect. As is typical in most cases, I didn’t present symptoms until years later. When I saw my right foot swelling with redness and pain four years later, I immediately diagnosed the disease and took the full course of diethylcarbamazine (DEC) tablets. I was cured and never had a recurrence again. Though I was fortunate enough to stop the disease at an early stage, many are not as lucky.

During my tenure as a medical officer in rural Odisha, I saw a number of patients with LF. Many of them lived in the poorest communities, with limited resources and support from their families. Social stigma and discrimination, along with misconceptions about transmission of the disease, often made matters worse.

As we observe National Filaria Week from December 14 to 20, it is important to raise greater awareness about this disease, which threatens nearly 352 million people in India. It is particularly important to know the source of transmission of LF. It is not caused by a curse or deeds from a past life. And it is not hereditary.

Lymphatic filariasis is caused by a tiny parasite, which is transmitted by Culex mosquitoes. Globally, more than 120 million people are affected by this disease. People living in poor environmental and unhygienic conditions are vulnerable to the infection as the Culex mosquito breeds in these places. Most LF infected people may not have any symptoms and are found apparently healthy. But the LF parasite can be transmitted from these asymptomatic people to healthy people through mosquitoes. LF affects the lymphatic channels of the body due to which there occurs swelling of breast, lymph nodes, genital organs, and at later stage these swellings can result in disfiguration.

Although LF isn’t fatal, it can lead to disfigurement, disability and chronic pain. As a result, many people with LF are unable to make a living for themselves and their families. Social stigma and discrimination also limit the quality of life for those affected by LF. It is not uncommon for parents to be unable to marry off children with LF.

To facilitate greater progress in combating the disease, the WHO launched a global program to eliminate LF by 2020. They adopted the intervention known as mass drug administrations (MDA), in which two drugs — DEC and albendazole tablets — are co-administered in a single dose. These drugs are cost-effective and safe, and can be administered by trained community volunteers.

If more than 85 percent of the eligible population of at-risk communities consume the drugs once annually for five to seven years, the risk of LF infection will be minimal to zero. That is why the Indian government has prioritized efforts to eliminate LF through the National Vector Borne Disease Control Programme.

Besides the MDA, there are other components for LF elimination and morbidity management, including hydrocele operations. Government and non-profits are working to increase the knowledge and skill of LF-affected persons and family members on home care. For the success of both MDA and morbidity management, community involvement, participation from other government departments and active involvement of civil society organisations is essential. This requires high level political and administrative commitment and raising awareness through community participation

In Odisha, the MDA will be conducted on December 19, followed by two days of mop up rounds. Following 10 districts: Deogada, Boudh, Angul, Dhenkanal, Bhadrak, Jajpur, Jagatsinghpur, Nayagarh, Ganjam and Jharsuguda will be covered under 2015 MDA. During this time, drug administrators such as ASHA workers and other community volunteers, will make door-to-door household visits to administer the two drugs used in MDA. They will explain the safety and importance of taking the drugs and ensure that people consume drugs after eating; and monitor any adverse effects. If we continue our momentum and efforts in Odisha, we can eliminate LF within the next few years. Together, we can help create a filaria-free reality in Odisha and India.

Dr. Madan Mohan Pradhan is the joint director of health services for the National Vector Borne Disease Control Programme in Odisha, India.

This story originally appeared in the Political and Business Daily.