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.
Honduras is one of Latin America’s leaders in health and integration; their nation-wide effort to control and eliminate neglected tropical diseases (NTDs) draws upon the institutionalized infrastructure of the country’s national vaccination week activities, and works across multiple sectors to deworm as many children as possible throughout the country.
Honduras’ unique and successfully-integrated approach to fighting NTDs is highlighted in a recently published success story, click here to read in Spanish).The success story highlights one of the country’s pilot programs which dewormed children aged one four as part of the country’s vaccination week activities and scaled up to reach all preschool children at-risk, as well as Honduras’ efforts to deworm all school-aged children across the country.
In Honduras, 870,816 preschool children and 2 million school-age children are at risk for soil transmitted helminth infections (also known as intestinal worms). Intestinal worm infections are wide-spread and have a 50 percent prevalence rate in nearly half the country’s municipalities. These infections can cause severe anemia and contribute to pregnancy complications in women and severe malnutrition in children. NTDs also pose a threat to the development for endemic countries like Honduras by trapping the most vulnerable populations in cycles of poverty.
To address the heavy NTD burden within the country, Honduras’ NTD program leverages two platforms: Vaccination Week in the Americas and the Escuelas Saludables program. During Vaccination Week in the Americas, the deworming of children aged one-four occurs alongside a variety of other health interventions like vitamin A supplementation and vaccinations. And concurrently, Honduras’ Ministry of Health works with the Ministry of Education and Social Development, the World Food Programme and others to deworm school children across the country. Just last year, the Global Network partnered with these groups, the Pan American Health Organization (PAHO), Operation Blessing and the MAMA Project to deworm more than one million school children.
And beyond just deworming, Honduras is integrating water, hygiene and sanitation (WASH) practices into its NTD prevention efforts. Because NTDs are easily spread by contaminated water sources and a lack of hygiene and sanitation practices, health workers and teachers promote hygiene education among children through the Escuelas Saludables program. Additionally, four safe water systems (hydrochlorinators) were installed in the municipalities of Marcovia and El Triunfo.
Honduras’ deworming program has been successful not only because of its integrated nature, but also because of its political and public support. For example, in 2010 Honduras formed a National NTD Committee, called the Mesa Tecnica, which includes NTD experts from the Ministry of Health, PAHO country office and various other partners including academia and nongovernmental organizations. The Mesa Tecnica has led efforts to map the prevalence of intestinal worms and develop the national NTD plan.
Honduras also has the support of Global Network NTD Special Envoys including Dr. Mirta Roses Periago, former PAHO Director, His Excellency, President Ricardo Lagos Escobar of Chile and His Excellency, President Alvaro Arzú Iriogoyen of Guatemala.
This combination of political and public support, and a well-designed and integrated NTD program have solidified Honduras’ position as a leader in NTD control and elimination efforts in the region. To learn more about Honduras’ efforts and to read the full success story, click here.
By: Mia Wise and Raquel Corona-Parra
On Friday August 30, 2013, the Ministry of Health of Guatemala launched its multi-year, integrated, national plan addressing neglected tropical diseases (NTDs) with support from the Pan American Health Organization (PAHO) and the Inter-American Development Bank (IDB). The ambitious plan targets the control and elimination of six NTDs by providing deworming medication to children in prioritized municipalities and improving access to clean water in communities affected by NTDs. Even more, Guatemala’s national NTD plan will be linked the country’s Zero Hunger Plan which tackles hunger and malnutrition in the country.
More specifically, this integrated plan will target the control and elimination of onchocerciasis, soil-transmitted helminths (STHs, or intestinal parasites), Chagas disease, leishmaniasis, trachoma, and leprosy from 2013 to 2015. The Guatemalan Minister of Health Jorge Villavicencio said the increased attention placed on these diseases is essential for reducing malnutrition and poverty in Guatemala as these diseases represent an incredible health burden on communities in the country, trapping already marginalized populations in the cycle of poverty.
Even More Good News…
Guatemala was not the only country focused on NTD treatment and control this summer. The Council of Ministers of Health of Central America and the Dominican Republic ( regional meeting on June 27 and 28 in San José, Costa Rica. The Global Network team was happy to collaborate with COMISCA at this meeting – where they shared information on upcoming challenges and solutions in NTD treatment efforts, and global and regional policy activities.
COMISCA is a political faction of the System for Central American Integration (SICA) comprised of the Ministers and Secretariats of Health of eight Member Countries. The Council strives to ensure the right to health care services to the people of Central America and the Dominican Republic, and is influential in determining health care priorities within the region.
The Global Network was delighted that COMISCA recognized the importance of NTD control and elimination with regards to the 2015 Millennium Development Goals (MDGs) and the 2020 Sustainable Development Goals. The Ministers of Health also approved the addition of NTDs in their closing report – a result that has paved the way for NTD control and elimination action items to be included in the next COMISCA Regional Health Plan.
And More Collaboration…
The Global Network was also invited to participate at the Forum of the Health Sector in Central America and the Dominican Republic (RESSCAD), during its annual meeting held in Guatemala on July 17. RESSCAD meetings serve as another opportunity for integration among the ministers of health of the region.
During the meeting, PAHO Director Dr. Carissa Etienne stressed that NTDs are the clearest example of preventable health inequities. She added that prioritizing these diseases, which affect the most vulnerable and marginalized populations, is a public health, political, and moral imperative. RESSCAD will now be placing a stronger emphasis on intersectoral collaboration and NTD control and will review progress made at the next meeting in 2014.
The launch of Guatemala’s national plan on NTDs and the increased attention to NTDs made by COMISCA and RESSCAD are all great news for the NTD community!
Over the past few months, we’ve been working together with our partners in Honduras to promote and accelerate their leadership in preventing and treating neglected tropical diseases (NTDs).
In Honduras, where over two million preschool and school-age children are at-risk for infection with intestinal worms, a working group of three government ministries is mounting an impressive effort to put an end to these parasitic infections.
That includes reaching mothers like Cleotilde Acosta and her four children who were so sick with intestinal worms that they could barely eat or sleep.
In 2012, Honduras was the first country in Latin America and the Caribbean to launch a national integrated plan for NTD control and elimination. Since then, treatment for intestinal worms has increased by 55 percent, and families like Cleotilde’s have received the care they need.
Our partners in Honduras want to expand this successful initiative to help many more families and have asked END7 to help fill a funding gap for their school-based deworming program, Escuelas Saludables. Later this summer, the Honduras Ministry of Health and its partners are hoping to reach 1.4 million kids – ages 5 to 14 – in more than 20,000 schools.
The pills to treat against intestinal worms are already available, thanks to the terrific support and partnership of the World Food Programme and Operation Blessing. But, it will take further efforts to ensure these pills reach those in need. In particular, teachers, other community members and school children who will receive health education materials and necessary training.
The next campaign will take place over just five days in August. More than 1 million kids in five days! It’s a big opportunity for Honduras to shine.
Read more about the last Honduras deworming campaign on PAHO/WHO’s website.