Posts Tagged dengue

Trinidad and Tobago. A Success Story in the Fight Against NTDs.

June 8th, 2012

This Caribbean country has succeeded in controlling or eliminated most NTDs. Dr. Dave Chadee, Professor of Environmental Health at the Neglected Tropical Diseases Initiative for LAC is implementing several projects.

Dr. Chadee, what is the situation regarding NTDs in Trinidad and Tobago?

The situation regarding NTDs in my country is quite different from that of our neighbor’s. The country has eliminated lymphatic filariasis (LF) as well as malaria, and leprosy has been reduced to less than 1 case in every 100,000 inhabitants so it is no longer considered a major public health problem. We have also reduced the incidence of hookworms and recent surveys have not found cases of this infection. Today, the NTDs that are still considered a real challenge are yellow fever, which still persists in some pockets in forested areas (a zoonosis), and dengue, the most extensive  and problematic vector-borne disease in Trinidad and Tobago and the Caribbean region.

Dr. Dave Chadee

In your opinion, what are the main factors that have helped control and eliminate these diseases in the country?

Well, first of all the fact that Trinidad and Tobago has an universal, free to all health care system that has helped in controlling or eliminating most of the local and imported diseases. This is an advantage compared to other countries in the Caribbean region, because offering free treatments to all for any NTD makes it easier for people to seek help when they need it, no matter their ability to pay for these services and whether they are nationals or non nationals.

I also think that having staff that have received specific training on NTDs is key, and not only do they need to acquire the knowledge: they need to keep informed of new developments in their field by receiving updates or refresher training.

Another success story for the country involves the strategy against NTDs – which involves continuing monitoring and evaluation activities. We know of programs that have implemented wonderful strategies but did not incorporate internal audits to check their effectiveness, strengths and weaknesses over time, significantly reducing the efficacy of the programs.

Last but not least, I believe that the political support of local authorities is key, both for the implementation of effective programs and to keep morale high among health workers. NTD work can be tedious because it is a battle that is never complete, so keeping the morale of the teams high, making workers feel appreciated, is very important.

What is the importance of vector management in the fight against NTDs?

Our experience has demonstrated that integrated vector management can help combat these diseases more effectively. At my university we have developed vector control strategies that are effective against Culex quinquefasciatus and other container breeding mosquitoes. Also, our research demonstrates that integrated vector management can be useful if used together with mass drug administration programs, and can help raise awareness about LF and other NTDs among communities.

Based on your latest research about transmission of LF, what are the changes you have observed in the habits of the Culex mosquito in the last years?

Based on my research, there is evidence that the blood feeding times of the Culex quinquefasciatus mosquito, the main vector for the transmission of LF, have shifted significantly. Previous studies showed the peak biting times in Trinidad and Tobago was between 10 pm and 3 am. Now we are finding a bimodal pattern with an early peak between 7 and 9 pm, as well as the 10-3am peak. This shift may be due to any of several factors like the use of air conditioning and fans in the household and the change of light regimens in cities such as the use of indoor lights and security lights from dusk to dawn. This means that the Culex mosquitoes  have access to people  between 7 and 11 pm, when they  are relaxing  at home and are likely to be casually dressed and  exposing larger skin surface area to foraging mosquitoes. In addition, our preliminary study shows more biting in areas around the legs and arms, thereby increasing the possibility of LF transmission at an earlier time during the night than previously thought. We think it is important to take these factors into account when designing programs to fight LF and other vector-born NTDs.



Dr. Dave D. Chadee is a Professor of Environmental Health in the Department of Life Sciences, UWI. His breakthrough research includes the development of the Xenomonitoring/PCR approach to Lymphatic filariasis, a new assay method for detecting mosquito preferences, the pupal index for dengue epidemiology and control, detected and eradicated two malaria outbreaks in Trinidad and the paper published in Science entitled, Genetics: a breakthrough for global public health.

Prof. Chadee has published over 200 papers and book chapters and has numerous collaborations in the USA and the UK. Prof. Chadee is a graduate of Naparima College, Trinidad, Dalhousie University (BSc Hons.), The University of the West Indies (MPhil) and the University of Dundee (PhD, M.PH, DSc).

Agustin Caceres is a Communications and Outreach Officer in the Inter-American Development Bank (IDB) in Washington DC.

You Give Me Fever….

December 5th, 2011

Today we feature a repost from from  the blog the seven most common neglected tropical diseases:

Two years ago, my co-worker traveled to Colombia. She was so excited to go and talked about it for weeks. Her plans entailed hiking on a hidden track through the jungle, touring the countryside and having amazing food. The day she was due to come back to work from her vacation, she was a no show. I was informed that she had contracted dengue while in Colombia and was out sick all week. My head was racing with questions: What? How was that even possible? What EXACTLY was dengue? I knew absolutely nothing about this disease, but it sounded worse than anything I could possibly imagine.

Aedes aegypti - vector for dengue fever

My research informed me that dengue is a mosquito borne infection that causes a severe flu-like illness and can potentially lead to deadly complication called dengue hemorrhagic fever. Mosquitoes became a huge concern for me especially because of my impending trip to Dominican Republic. Dengue was on a rise that year and I was prepared to fight that battle with bug repellant.  The entire vacation I reeked of bug repellent, but I didn’t get one mosquito bite.  Contracting dengue was my biggest fear and it still is. Dengue is officially on my radar!

The seven most common Neglected Tropical Diseases (NTDs) are ascariasis, hookworm, lymphatic filariasis, onchocerciasis, schstosomiasis, trachoma and trichuriasis. I thought dengue sounded scary, but the top seven sounded worse. Click here to continue reading.

Reading List 9/2/2011

September 2nd, 2011

Happy Friday readers! Check out the latest happenings in the world of neglected and infectious diseases on our reading list. Today were reading about:

Where Every Drop of Water Counts Mrs Nhamo Mutumba (22), a mother of one who lives in Muvhidza Village under chief Goronga in Mudzi District, is a woman who has watched the nearest Nyatikonde Dam that used to provide water for habitants of her area dry up. She has seen many meetings on how to solve the problem being attended by men while on her way to look for water.

DOH hopes to declare Oro as filariasis-free by 2012 The Department of Health (DOH) is hoping to declare Cagayan de Oro and Misamis Occidental as filariasis-free by next year. Dr. Jaime Bernadas, DOH Northern Mindanao director, said this is the fifth year that the Mass Drug Administration (MDA) has been done to persons living in endemic areas in Cagayan de Oro, Misamis Occidental and Misamis Oriental to prevent them from getting infected with filariasis.

Mass drug administration vs filariasis to include Iloilo City The city government here is joining the third round of the mass drug administration (MDA) against lymphatic filariasis slated in November. This was confirmed by Dr Ma. Jocelyn Te, coordinator of the emerging/re-emerging diseases prevention and control of the Department of Health-Center for Health Development 6 (DOH-CHD 6). The five-year MDA campaign against filariasis kicked off 2009 with the province of Iloilo as the first target and was later expanded to cover other provinces of Panay.

Indigenous elders to train up child doctors Elders in Alice Springs are selecting children aged under 10 to train them up to be so-called child doctors. Children will learn more about basic health and hygiene in the training sessions. The projects coordinators say a similar scheme in Indonesia helped prevent an outbreak of cholera after the 2004 tsunami.

Reading List 8/31/2011

August 31st, 2011

Be up to date on the latest happenings in the world of NTDs with our reading list! Today were reading about:

In Uganda, Elephantiasis Cases Are Up Cases of sleeping sickness, elephantiasis and hydrocele are increasing in Alebtong district. About 30 people have been diagnosed with the neglected tropical diseases and are receiving treatment from Alebtong Health Centre IV.

Houston Medical Center rising as a global health hub: New star doc & programs gain UN notice Whether its a cancer breakthrough or the rehabilitation of a congresswoman shot on the job, the Texas Medical Center has a high national profile across nearly every advanced medical discipline. But with prestigious new programs and doctors setting up here, Houston is also making a name for itself in the world of global health initiatives, according to the United Nations Dispatch.

Rural Areas at Higher Risk of Dengue Fever Than Cities In a study led by Wolf-Peter Schmidt from the Nagasaki Institute of Tropical Medicine, Japan, and recently published in PLoS Medicine, the authors analyzed a population in Kanh-Hoa Province in south-central Vietnam (~350,000 people) that was affected by two dengue epidemics between January 2005 and June 2008.