Category Archives: Latin America and the Caribbean

A Comprehensive Analysis of Soil-Transmitted Helminths in Honduras

 

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Honduras became the first country in Latin America and the Caribbean to launch its national and integrated plan addressing neglected tropical diseases (NTDs) in April 2012; however, information gaps regarding the prevalence and intensity of soil-transmitted helminth (STH or intestinal worm) infections remained. The first comprehensive historic review of soil-STH prevalence and research studies done in Honduras was recently published – the information analyzed and presented in the new article will be instrumental in the successful implementation of the country’s national plan on NTDs.

The article, titled “A Scoping Review and Prevalence Analysis of Soil-Transmitted Helminth Infections in Honduras,” was published in PLOS Neglected Tropical Diseases. Sabin Vaccine Institute’s Dr. Maria Elena Bottazzi, herself a Honduran and Deputy Director of Sabin’s Product Development Partnership, is one of the authors.

As part of their efforts, the researchers conducted a review of hundreds of studies dating back to May 1930, some of which had not been published. Using studies published between 2001 and 2012 that included epidemiological data from Honduras’ 18 departments, the researchers were able to produce STH prevalence maps. The researchers included the most recent information available after consulting with various groups involved in STH control activities, including the Ministry of Health, the Healthy Schools Program, the Parasitology Department of the School of Microbiology (part of the National Autonomous University of Honduras, UNAH), the World Food Program and the Pan American Health Organization (PAHO).

The results from their review are astounding – the researchers found that the prevalence of STH in 40.6 percent of the municipalities in Honduras is greater than 50 percent. The World Health Organization (WHO) recommends mass drug administration (MDA) campaigns to take place, without previous diagnosis, once a year in communities with STH prevalence over 20 percent, and twice a year in communities with STH prevalence over 50 percent. This strategy not only reduces the morbidity and the intensity of infection on those already infected with this NTD, but it also helps protect the entire community from further infection.

The researchers also found that the STH prevalence was higher in municipalities with a lower socioeconomic status – those characterized by having a lower human development index and less access to safe drinking water or improved sanitation.

The Sabin Vaccine Institute’s Global Network for Neglected Tropical Diseases recently traveled to Honduras and witnessed the effects of intestinal worms on some of Honduras’ poorest communities, including those in the department of Choluteca. After speaking with a head teacher at Escuela Urbana Mixta Pedro Nufio (1st to 6th grade), we learned that 880 students attending the school were at risk for intestinal worms.

View photos from the trip below:

Children in Choluteca and across Honduras are being treated annually for intestinal worms thanks to Honduras’ national plan of action against NTDs. However, many children are still heavily infected. For example, some students in Choluteca expelled worms through their mouth and nose after receiving treatment – a sign of heavy infection.

However, progress is being made and the deworming of preschool children has been institutionalized as part of national vaccination week activities in the country.  Honduras is continuing to lead in one of the fundamental components in the fight against NTDs: integration with infrastructure improvements in water and sanitation, supported by community education campaigns. This type of cross-sectoral integration will bring us closer to achieving the NTD 2020 control and elimination goals set by the WHO Roadmap.

We look forward to sharing stories of how the government of Honduras and its partners use the findings from this study to successfully implement their national plan on NTDs! We invite you to follow Dr. Bottazzi (@mebottazzi) and the PLOS NTDs journal (@PLOSNTDs) on Twitter, to keep up with new developments in the NTD field.

2014 FIFA World Cup Round of 16: Celebrating World Cup Teams Fighting NTDs

 

For one month, countries around the world are gathering to watch arguably the greatest sporting event in the world—the World Cup. Every four years, people from around the world come together to celebrate this epic event that transcends political turmoil, and even wars and conflict. In this time of celebration, we’re taking the time to recognize the World Cup teams advancing to the prestigious Round of 16! In particular, we’re highlighting the progress their countries have made in controlling and eliminating neglected tropical diseases (NTDs).

Brazil

brazilThe hosting nation of Brazil is being tagged as the favorite to win it all. If they do, the Brazilian National Soccer team would have a mind-blowing six World Cup trophies! While Brazil is famous for its passion and love for soccer, Brazil is also gaining public health recognition by taking concrete steps towards eliminating NTDs in their country.  In Brazil, nearly 6.8 million people are infected with schistosomiasis and millions are at risk for other common NTDs. To address this problem, Brazil has launched an integrated National Plan of Action for NTDs to combat all seven of the most common NTDs. Last year, the Brazilian Ministry of Health led a campaign to diagnose and treat leprosy and intestinal worms in 9.2 million public schools.

argentinaArgentina

With Argentina having arguably the best player in the world, Lionel Messi, the country’s hopes of winning the World Cup are high. Over the last four years, Argentina made tremendous progress towards preventing NTDs such as Chagas disease and intestinal parasites in at risk populations. In 2011, the Government of Argentina launched the National Institute for Tropical Medicine in an effort to advance NTD research and finding new solutions for lowering the prevalence of NTDs in at risk regions in Argentina.

colombiaColombia

The Colombian National Soccer team had been M.I.A. (missing in action) in World Cup action for the past 15 years. This year, Los Cafeteros has ended its long hiatus and is finally back on the World Cup stage. While the national team was working hard towards getting to this year’s World Cup, their country was busy accomplishing major NTD elimination goals. In 2011, Colombia became the first country in the Latin America region to eliminate onchocerciasis—a great milestone for Latin America and the Caribbean.

Nigeria

nigeriaNigeria’s Supereagles has always had high expectations when entering the World Cup—and rightfully so. The Nigerian National Soccer Team is one of the very few African teams that has ever reached the second round of the knockout stage (Ghana, Senegal, Cameroon, Morocco are the only other teams). Nigeria is known for meeting expectations when it comes to controlling NTDs. This year, Nigeria achieved a major milestone in its fight against NTDs by launching Africa’s first integrated malaria and lymphatic filariasis (LF) elimination plan. Nigeria’s Ministry of Health has also reached 96 percent of communities with onchocerciasis mass drug administrations and is currently scaling up school-based deworming campaigns.

mexicoMexico

Mexico’s prized forward—Javier “Chicharito” Hernandez from Manchester United—hopes to transform the Mexican National Soccer Team into a serious contender in this year’s World Cup. Mexico has also taken serious strides in preventing NTDs by nearly eliminating onchocerciaisis and trachoma in their country. In 2011, Mexico launched a campaign to treat the last trachoma endemic state—Chiapas. Soon, Mexico hopes to become one of four countries in the region to eliminate trachoma.

costa ricaCosta Rica

In 1990, Costa Rica shocked the world by advancing into the knockout stage. This year, Costa Rica has surprised the world again by advancing into the Round of 16! Costa Rica has already put the global health world on notice by working to receive a certification by the World Health Organization (WHO) stating that they’ve successfully stopped transmission of lymphatic filariasis (LF).

On behalf of END7, we’d like to thank these countries on their continued effort towards eliminating NTDs and wish them the best of luck in this year’s World Cup!

Sharing Best Practices from JICA’s Chagas Disease Control Efforts in Central America

 

Photo courtesy of JICA

Photo courtesy of JICA

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.

Update from Vaccination Week: Highlighting Honduras’ Integrated Approach to Health

 

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By Karen Palacio and Alex Gordon

This afternoon, hordes of journalists and TV newscasters huddled around one small toddler, creating a semi-circle two rows deep as they waited in anticipation. Moments later, the toddler opened her mouth and received deworming medicine — a simple but life changing act that on any other day may go unnoticed.

But today was different. In honor of Vaccination Week in the Americas (VWA), Members from the Pan American Health Organization (PAHO), the Ministry of Health of Honduras, and representatives from the Office of the President of Honduras, hosted a high-profile ceremony, highlighting the importance of vaccination, deworming and the integrated delivery of other health interventions.

Panelists at Honduras’ 2014 Vaccination campaign launch in Tegucigalpa, Honduras. From left to right: Dr. Karina Silva, local health department, Dr. Ida Molina, EPI Program Manager, Ministry of Health Honduras, Mr. Ricardo Alvarez, Representative from President Hernandez’s office, Dr. Yolani Batres, Minister of Health, Dr. Jon Andrus, PAHO Deputy Director, Dr. Alma Fabiola Morales, PAHO Honduras, and Dr. German Laborel, Representative from the faith-based community

Panelists at Honduras’ 2014 Vaccination campaign launch in Tegucigalpa, Honduras. From left to right: Dr. Karina Silva, local health department, Dr. Ida Molina, EPI Program Manager, Ministry of Health Honduras, Mr. Ricardo Alvarez, Representative from President Hernandez’s office, Dr. Yolani Batres, Minister of Health, Dr. Jon Andrus, PAHO Deputy Director, Dr. Alma Fabiola Morales, PAHO Honduras, and Dr. German Laborel, Representative from the faith-based community.

As Dr. Mirta Roses Periago mentioned in her previous blog post, VWA provides a much-needed platform to celebrate, showcase and implement the public health interventions that save lives and keep children and families thriving.

In Honduras, the ceremony that launched the two week campaign began with a prayer led by Padre Pablo Hernandez and the country’s national anthem.

Next, Dr. Ida Berenice Molina, head of Honduras’ Extended Program for Immunization (EPI) program, delivered remarks on the 12th anniversary of Vaccination Week of the Americas and Honduras’ consistent and impressive coverage rate of over 90 perecent for vaccinations since 1991.

Following Dr. Molina, Dr. Jon Andrus, Deputy Director of PAHO, highlighted the importance of the integration of vaccination and other health interventions such as deworming. This year’s slogan, “Vaccination, Your Best Shot” was selected as the call to action in the context of this year’s upcoming World Cup in Brazil. It is estimated that more than 63 million people in 180 countries and territories in the Americas will be vaccinated over the next two weeks.

Dr. Andrus also highlighted the opportunity that Vaccination Week offers to deliver other critical interventions such as deworming, Vitamin A, health education and lactation consultation, among others.

Historically, Honduras has been one of Latin America’s leaders in health and integration. In addition to holding high vaccination rates, Honduras was also the first country in the Americas to launch a national plan of action against neglected tropical diseases (NTDs) in 2012. After the plan’s launch, Honduras quickly began a demonstration project that expanded deworming to preschool children as part of vaccination week in six municipalities.

Now, two years later, the deworming of preschool children has been institutionalized as part of national vaccination week activities. This compliments the national campaign for school age children which is implemented in coordination with World Food Programme, UNICEF, Operation Blessing and other stakeholders.

Continuing with the presentations, Dr. Ricardo Alvarez, a representative from President Juan Orlando Hernandez’s office gave remarks on the political commitment to saving lives through vaccine preventable diseases and essential medicines that prevent and control NTDs.

And lastly, Dr. Edna Yolani Batres from the ministry of health remarked that VWA offers some of the best investments in public health. She called on partners to continue to join the Ministry of Health of Honduras in assuring the quality of life of millions of Honduran children and families continue to be improved through the services provided during Vaccination Week.

The speeches and presentations were followed by a series of vaccinations and the provision of deworming medicine and vitamin A supplementation. Members from PAHO and the Ministry of Health ceremoniously aided in the delivery of the health interventions as crowds gathered to watch babies, toddles, and pregnant mothers receive vaccines, deworming medicine and vitamins.

We were extremely happy to see these cost-effective health interventions and the nurses and doctors delivering them, receiving the attention they deserve. Through an integrated approach to public health, Honduras is providing smart opportunities for its population to remain healthy and thriving.