Inter-American Development Bank’s Documentary Highlights “Big Foot” in Guyana

 

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“I’ve had [lymphatic filariasis] for 18 years” said Bernadette Seenarine –a long time resident of Georgetown, Guyana who operates a small grocery shop from her home. In the short video titled “Tackling ‘Big Foot’: A Story of Sanitation and Health in Guyana”, the Inter-American Development Bank (IDB) shines light on how lymphatic filariasis (LF) is negatively affecting communities in Guyana, one of four countries in the Americas where transmission of LF still occurs. Seenarine is one of an estimated 68,000 people –approximately 9 percent of Guyana’s population—assumed to have been infected with LF. In Guyana, it is estimated that 310,000 people are at risk of contracting the disease.

Lymphatic filariasis (LF)—also known as “big foot” in Guyana—is a debilitating neglected tropical disease (NTD) caused by microfilaria, a tiny parasite that causes the disease. In Georgetown, Guyana, the disease is predominately spread by the culex mosquito, the vector for the parasitic worm that causes LF. Due to the frequent flooding that occurs in Georgetown and its lack of adequate drainage and sewer systems, large pools of contaminated and stagnant water are formed throughout the city. These pools of water act as breeding grounds for culex mostiqutoes who transmit the LF disease to humans.

LF is extremely painful and causes profound swelling of the legs that can lead to permanent disability. People living with this disease also suffer from financial and social loses and can become stigmatized. “Sometimes people don’t want to come and buy when I have this foot,” Seenarine said when explaining how her swollen leg has caused people from her community to stop buying food from her grocery store. “…It’s really difficult to live with this.”

To tackle this problem, the Latin American and the Caribbean Neglected Tropical Disease Initiative (LAC NTD Initiative)—a partnership that includes the Inter-American Development Bank (IDB), Pan American Health Organization (PAHO) and Sabin Vaccine Institute’s Global Network for Neglected Tropical Disease—are working to scale-up efforts to control and eliminate NTDs within the LAC regions, including Guyana. These efforts include implementing joint community-based deworming campaigns for LF in Guyana’s capital of Georgetown, in addition to integrating social mobilization campaigns to educate Guyana’s population about LF treatment, transmission and prevention. The LAC NTD Initiative is also working to improve the infrastructure of Georgetown’s sewage system to reduce risk factors of contracting LF.

The Sabin City Group, a collaborative partnership with corporate institutions in the United Kingdom and the UK charity Sabin Foundation Europe, is also contributing in the fight to eliminate LF in Guyana by recently launching the group’s ‘Guyana campaign’. The campaign’s goal is to raise funding to support NTD programs in Guyana in an effort to eliminate LF by 2016.

To learn more about NTD projects carried out in the LAC region, we invite you to read this published report titled “It Can be Done: An Integrated Approach for Controlling and Eliminating Neglected Tropical Diseases”. We also encourage you to watch IDB’s documentary on LF in Guyana and the work that is being done to control and eliminate the disease.

Intervention with Impact: Integrating Safe Drinking Water, Sanitation, and Hygiene to prevent Undernutrition and NTDs

 

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By: Jordan Teague, Program Associate at WASH Advocates

My niece turned two years old on Sunday. It was a joyful occasion, celebrating that she can now speak in full sentences, gives full-blown hugs and started pre-school in the fall. The entire family gathered this weekend with presents, cake and a birthday outing to a fire truck parade. During the festivities, it occurred to me that my niece is now past the first 1,000 days of her life, the most critical time with regard to her nutrition. We are fortunate that because we live in the United States, we have not had to worry about undernutrition or the illnesses related to that condition, but what if she had been born somewhere else?

In many places around the world, undernutrition is not the only worry that families have for their small children and themselves. Over 1.4 billion people in Africa, Asia, and Latin America and the Caribbean are affected by at least one of the neglected tropical diseases (NTDs). These diseases largely overlap in areas where undernutrition is prevalent and magnify its impact on childhood growth and micronutrient deficiencies. In fact, all of the 34 countries with the highest levels of malnutrition are endemic for NTDs. Several NTDs like schistosomiasis and soil-transmitted helminthiasis (STH) are underlying contributors to stunting and undernutrition. Not only do they affect child health and survival, but they also have detrimental impacts on cognitive development, educational outcomes and economic growth.

A lack of safe drinking water, adequate sanitation and proper water, sanitation and hygiene (WASH) contributes to both NTDs and undernutrition. Safe WASH is key to preventing, controlling and eliminating five NTDs: Soil transmitted helminthes (also known as intestinal worms), schistosomiasis, trachoma, lymphatic filariasis and Guinea worm. Similarly, poor sanitation and unsafe drinking water cause diarrheal disease and environmental enteropathy, which inhibit nutrient absorption and lead to stunting and undernutrition. Improved WASH allows for the absorption and use of vital nutrients and calories, leading to improved nutrition and health.

Given the myriad of linkages between WASH, NTDs and nutrition, joint policies and programming have significant potential to scale up the impact of the individual efforts. For example, in 2013 Dubai Cares launched an integrated Home Grown School Feeding Program that includes elements of all three sectors. This program includes in-school meals prepared from local foods and commodities in addition to deworming treatment and provision of WASH interventions in the schools. This program shows how different stakeholders can collectively use their diverse expertise to make a larger impact on the health of a community.

WASH interventions support the sustainability of progress made through NTD and nutrition programs on reducing disease and improving health. Real and sustainable impacts can be achieved when investments in NTDs and nutrition go hand-in-hand with efforts to provide WASH.

Jordan Teague is the Program Associate at WASH Advocates, where she focuses on sustainability within the WASH sector and the integration of WASH with other development efforts such as nutrition, NTDs and education.

Keeping Targets in Sight with New Diagnostics for NTDs

 

By Kerry Gallo, Communications Officer, PATH

In 2012, the private and public sectors pledged substantial resources to fight neglected tropical diseases (NTDs) through the signing of the London Declaration. Donations of drugs from the pharmaceutical industry, funding from donors, and supportive policy at the international and national levels are helping to expand the toolkit for combating NTDs.

But important tools are still missing—diagnostic tests to guide efforts to control and eliminate NTDs.

The lack of effective diagnostics has been identified as a critical gap in the ability to achieve the goals set forward by the London Declaration. The NTD community has taken notice of this gap, as evidenced by new support to PATH for the prioritization and development of novel NTD diagnostic tests, which once commercialized, will be critical in the global fight against NTDs.

In many parts of the world, diagnostics are often taken for granted. But in low-resource settings, these tests are a rarity. People living in remote communities may be far from hospitals and clinics where tests are available, trained health workers who know how to properly administer complex diagnostics are often in short supply and there are few facilities where samples can be processed.

These are some of the challenges that the next generation of diagnostics for NTDs will need to overcome.

Diagnostics for NTDs are especially important because they provide data for informed decision-making throughout the life cycle of a control or elimination program. At the start of an NTD control or elimination program, diagnostics are critical to mapping disease and identifying areas in need of treatment. Interventions like mass drug administration (MDA) are the arrows in the NTD program manager’s quiver and diagnostics bring the target into focus so programs know where to aim. Even if current diagnostics are sufficient for this purpose, the need for new tests comes as NTD programs make progress on the path toward disease control and elimination.

Later on during the program life cycle, as MDA programs and prevention efforts are scaled up, levels of infection will decrease. However, current diagnostics for NTDs are not sensitive enough to detect very low levels of infection. Data from insufficiently sensitive tests might result in decisions to reduce or stop MDA prematurely, which can lead to infection levels bouncing back. New, more sensitive diagnostics will be critical to guide control programs for diseases such as soil-transmitted helminthiasis as MDA is scaled up globally.

New diagnostics will also be critical to conducting surveillance for elimination programs for diseases like onchocerciasis, blinding trachoma, lymphatic filariasis, Chagas disease, human African trypanosomiasis (sleeping sickness), leprosy and visceral leishmaniasis. Identifying individual cases of infection will become more challenging as levels decrease, requiring many samples from target populations to be taken. For this reason, simple, effective and field-ready diagnostics that can be used by minimally-trained staff with limited resources will be essential.

In the coming months, PATH and our partners will be working to identify where the introduction and scale-up of new diagnostics will have the greatest impact, evaluate potential technologies and focus on the most promising new tests. Continued commitment from donors and partners will be essential to bring these tests to market so they will be available for NTD program managers worldwide. Some progress has already been made—we worked to develop a new test for onchocerciasis, which will be available in late 2014.

With new diagnostics to hone our vision and guide our decisions, we will move closer to a future free of NTDs.

For more information, contact dxinfo@path.org.

Introducing Lydia Silber, September’s END7 Student of the Month

 

Lydia_END7Each month, END7 honors one student who has made a significant contribution to our growing movement of student advocates dedicated to seeing the end of NTDs. We are very proud to introduce our September Student of the Month, Lydia Silber, a senior at Lake Forest High School in Lake Forest, Illinois. Lydia, who learned about END7 after her sister attended a presentation at Boston University, shares:

“In April, my sister showed me a disturbing YouTube video that said that roughly one out of every six people are infected with a neglected tropical disease (NTDs), and that all it took was $0.50 to treat one person for a whole year. Within weeks, I began fundraising for NTD treatment, and all throughout the summer, I was outside of restaurants and coffee shops raising money for END7. I sold bracelets and held pizza sales for a few weeks too. Though raising money was a huge part of this, to me raising awareness was even more important. I just wanted to supply as many people as I could find with access to information about NTD’s and insight into how treatable they are. I wear my bracelet every day, and each time I look at it, I am reminded that a lot of work still needs to be done for END7. I hope that all of the people that wear their bracelets think the same, and continue to spread the word. If my hopes are a reality, then I am confident that we will see the end of all seven of those NTDs by 2020.”

In all, Lydia raised an incredible $800 for END7 to support NTD treatment programs around the world. Her involvement is a great example of the power of people spreading the word about NTDs and END7 to their friends, family and community, and we are so grateful for her hard work!

We are are excited to see our community of student supporters like Lydia continue to grow. If you are ready to get your school involved in END7’s work, contact student coordinator Emily on Facebook or at Emily.Conron@sabin.org to learn how you can get started!