Better Together: Integrating Immunization and Deworming during World Immunization Week

 

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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.

Tackling NTDs to Help End the Cycle of Poverty and Disability

 

Hadiya Hussien's eyes are examined by a community worker credit: CBM

Hadiya Hussien’s eyes are examined by a community worker. credit: CBM UK

By CBM UK

This blog post is part of Global Network’s #G7forHealth series, which highlights the current and potential impact of G7 countries on those suffering from neglected tropical diseases. 

Hadiya is 9 years old. When CBM community workers met her in her village in Amhara, Ethiopia, her eyes had been itching and watering for three days. “It keeps her from being able to see others. She can’t see them clearly because of the tears,” explained her father Ali. But it wasn’t the first time Hadiya has experienced trachoma and she’s not alone in her village. 6 out of every 10 children in this region of Ethiopia suffer from an active trachoma infection.

Hadiya’s infection was treated with Zithromax, and her family now knows how face washing can help prevent the disease. CBM’s partner, Organisation for Rehabilitation and Development in Amhara (ORDA), has been working with the community to ensure that the village well is protected with the source capped and a retrieval unit fitted so that the water used for drinking and washing stays clean.

These interventions will make a huge difference to Hadiya. Not only will she be free from the itching and pain of the trachoma infection, but she is no longer at risk of losing her sight to the disease. And in a poor community like Hadiya’s the consequences of sight loss can be utterly devastating. Her chances of completing her education would be much reduced – only 1 in 10 children with disabilities in the global south goes to school. She would be at 2-3 times greater risk of violence or abuse. Her access to healthcare and opportunities to earn a livelihood would be far more limited. Like millions of people with disabilities worldwide, she could very easily find herself trapped in a cycle of poverty and disability.

Neglected tropical diseases (NTDs) such as trachoma are caused by poverty, flourishing under conditions characterised by poor housing and sanitation, unsafe water and limited access to basic health care. But by causing disability, they also lead to increased poverty for individuals and communities. This is why we believe investment in the fight against NTDs should be a priority for the world’s leading economies and why CBM UK — alongside 100+ international institutions and experts working on NTDs — is one of the signatories of an open letter to G7 leaders, asking them to sustain their current support for NTD control and elimination as well as to address current gaps.

Tackling disability is vital to ending extreme poverty, and eliminating NTDs like trachoma is a key way to prevent disability – 2.2 million people are visually impaired due to trachoma, and of them 1.2 million are irreversibly blind.

CBM has been working to prevent and treat blinding NTDs such as river blindness (onchocerciasis) and trachoma for over 20 years. CBM UK is currently involved in the Queen Elizabeth Diamond Jubilee Trust’s programme to tackle blinding trachoma in 10 out of 18 Commonwealth countries where trachoma is confirmed or estimated to be endemic.

Within the Trust’s programme, CBM UK is an implementing partner in Kenya, Uganda and Malawi, aiming to eliminate trachoma as a public health problem in each of these countries. This is done by implementing the ‘SAFE’ Strategy which consists of Surgery, Antibiotics, Facial Cleanliness and Environmental Improvements. The programme has recently completed its first year. During this time, CBM has held a number of community outreach camps to conduct trachoma surgery, which is used to treat the more advanced, blinding stage of the disease. The surgery element of the SAFE Strategy is used to address the backlog of trachoma cases, whilst the other elements are aimed at prevention and stopping (re)infection.

Funding programmes like the Trust’s initiative make a crucial contribution to the World Health Organisation’s (WHO) Alliance for the Global Elimination of trachoma by 2020 (GET 2020). The UK and the other G7 members must now ensure that this moment is sustained to permanently eliminate trachoma and other NTDs.

CBM is in international Christian disability and development organisation improving the quality of life of millions of people living with or at risk of disability in some of the world’s poorest communities. CBM UK programmes include a range of NTD programmes and other disability related programmes in Health, Livelihoods and Inclusive Education.

NTD Article Round-Up

 

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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.”

Introducing Lauren Crossman, March’s END7 Student of the Month

 

LaurenEND7Each month, END7 honors one student who has made a significant contribution to our growing movement of student advocates dedicated to seeing the end of neglected tropical diseases (NTDs). We are very proud to introduce our March 2015 Student of the Month, Lauren Crossman, the END7 Student Advisory Board representative for the University of Cincinnati. Lauren, a third year pre-med student studying Biology at UC, shares:

“A month prior to learning about the END7 campaign last summer, I was on a study abroad trip in Accra, Ghana learning about the prevalence of HIV, malaria, and tuberculosis, as well as the nation’s public health policies and infrastructures. Upon returning from Ghana, a few classmates from the trip and I decided to attend the 5th Annual Consortium of Universities for Global Health conference in Washington, D.C. There, we met Emily Conron, END7’s Student Outreach Coordinator, and we were highly impressed by the campaign’s advocacy efforts and network of passionate students. As a student with a desire to become more involved in global health in a sustainable way, I was more than excited to become a part of the END7 campaign. UC students Malini Ramudit, Paige Craig, Madeline Kincaid, Angelica Hardee and I are thrilled to have started END7 as an official student organization at the University of Cincinnati with the goal of educating the UC community about NTDs through the promotion of advocacy actions to ensure that NTDs remain a political priority, and fundraising to finance the mass distribution of drugs to treat and prevent NTDs.

“This semester, we have given presentations on NTDs and the END7 campaign to several classes and have collected more than one hundred signatures on END7’s petition to protect funding for the USAID NTD Program in the 2016 federal budget. At our meeting this week, we are excited to have a scientist from the Environmental Protection agency (EPA) come in to discuss his experience with water infrastructure in the Caribbean and his current research at the EPA. On World Health Day, we will be co-hosting a global health panel with other student organizations to discuss health inequity and student involvement in global health. I am enthusiastic to continue working with my peers to secure an increase in federal NTD funding and a decrease in NTD prevalence worldwide!”

We are so grateful for Lauren’s continued commitment to END7 and are excited to see our community of student supporters like her grow. If you are ready to get your school involved in END7’s work, contact the END7’s student outreach coordinator at Emily.Conron@sabin.org to learn how you can get started!