Tag Archives: IDB

Can Health Education be Fun?

 

This blog post by Agustín Cáceres was originally posted on Inter-American Development Bank’s blog

When I was a child, my school days were sometimes fairly boring. Long classes, presentations, homework… Probably that is why, when I travelled to Chiapas (Mexico) to coordinate a number activities to educate almost 4,000 kids about healthy habits to prevent Neglected Tropical Diseases (NTDs), I only had one thing in mind: Let’s try to make it as fun as possible.

We arrived in the village of Huixtán, in an isolated area in the mountains of Chiapas, and we started setting up everything for a day full of activities. The students of the Benito Juárez Primary School watched us closely, realizing this would not be an average school day. State health workers dressed up to represent a larger than life water drop, hand, and soap bar welcomed students on the playground. The party had started.

In Chiapas, many children live under poor conditions: Illiteracy is 52.37 percent, many people lack access to potable water and sanitation, and many homes don’t have cement floors. Due to these conditions, more than 300,000 people, mostly members of indigenous communities, are at risk of contracting a Neglected Tropical Disease.

At 8 am, a team of health workers speaking in Tzeltal, one of the local indigenous languages, split the excited kids into groups. Younger students in first and second grades started the morning learning the basics of the SAFE strategy (Surgery, Antibiotics, Facial cleanliness and Environmental change). With the help of the larger than life representations of hand, soap, and water the health workers conducted a workshop on hand and face washing to prevent soil-transmitted helminthes and trachoma -a disease that can cause blindness, still present in rural communities of this Mexican state.

Meanwhile, fifth and sixth graders participated in presentations about these and other NTDs, including Chagas disease and leishmaniasis, conducted both in Spanish and Tzeltal. The students learned about the ways these diseases are transmitted, symptoms, and prevention measures such as identifying the tick responsible for transmitting the parasite that causes Chagas in their homes. Over 120 cases of this disease are diagnosed in Chiapas every year.

“We try to make learning about NTDs fun for the kids in these communities. We tailor the messages and the activities to the different age groups and to their cultural context” said Dr. Janet Morales, State Coordinator for Chagas and Leishmaniasis of the Chiapas Health Institute. “We believe that working with these kids is highly effective. While they are playing and having a good time, they learn about NTDs and then transmit all this information to their parents at home, educating their own communities”.

Once these activities came to an end, the students received crayons and coloring books with games and drawings about good habits for preventing these diseases. “Ending the health education activities in this festive manner makes kids think of NTDs with a different perspective. Preventing them is up to them, and it can be fun” said Dr. Morales. One thing is clear: the kids of Huixtán will surely remember this day for a long time to come, and I also hope they will remember how to support the elimination of these diseases in their communities.

Agustín Cáceres is a Communications and Outreach consultant at the Social Protection and Health Division of the Inter-American Development Bank (IDB) in Washington DC. He implements communications, advocacy and social mobilization activities for the Neglected Tropical Disease Initiative for Latin America and the Caribbean.

Agustin’s work focuses on health and its social conditionings, particularly neglected tropical diseases and other diseases of poverty, health education and youth at risk.

Can an antibiotic help a child grow?


This blog was re-posted with permission from the Inter-American Development Bank’s blog
First Steps, a blog that talks about child development in Latin America and the Caribbean.

By Agustin Caceres

Antibiotics are known for helping control bacterial infections in both children and adults. But antibiotics are also known for some of their side effects: diarrhea, allergic reactions, collateral infections… But what if an antibiotic could have a positive side effect in the development of malnourished children aged 1-5 in developing countries? I read about this idea when I found an article published by the London School of Hygiene and Tropical Medicine, which talks about some unexpected findings related to the use of one of the most commonly-used antibiotics, azithromycin. This drug is widely used to fight trachoma, a Neglected Tropical Disease that is sadly the most common infectious cause of blindness, and that still affects poor communities in some areas of Latin America like Chiapas (Mexico) and Southern Colombia.

This antibiotic has proven effective in the treatment of this disease thanks to different studies since the early 90s. But the surprise came when three years ago, a study published at University of California in San Francisco showed that all-cause mortality in children aged 1-5 years was reduced by almost 50% in Ethiopian communities in which all children received an annual dose of azithromycin.

Now, a team lead by Professor David Mabey has been awarded a $10m grant from the Bill & Melinda Gates Foundation, to study the impact of the antibiotic on child mortality in three countries in Africa: Niger, Tanzania and Malawi. The funds will support the study of the mechanism underlying this finding, by looking at the effect of azithromycin on the function of the bowel, the absorption of nutrients, and on the growth of babies in Malawi.

Hopefully this study will help find a new solution to the challenge of identifying the causes of slow growth during the first 1,000 days of life of a little boy or girl. The positive effects of deworming among children and the use of micronutrients have been widely demonstrated. What if this antibiotic could reduce multiple infections and therefore help absorb nutrients better, improving the growth and early development of kids? Stay tuned to the work of these researchers to find out more.

Agustin Caceres is a Communications and Outreach consultant at the Social Protection and Health Division of the IDB in Washington DC.

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

This Caribbean country has succeeded in controlling or eliminated most NTDs. Dr. Dave Chadee, Professor of Environmental Health at the University of the West Indies, shares his vision about this success story, and highlights ideas that can be applied in other countries where 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.

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PROFILE

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 Social Protection and Health Division of the Inter-American Development Bank (IDB) in Washington DC.

More from World Water Week 2011

World Water Week 2011 took place this past summer August 21 – 26 2011 in Stockholm, Sweden. The Global Network for Neglected Tropical Diseases along with our Latin America and Caribbean water initiative partners — the Inter-American Development Bank (IDB) and FEMSA Foundation — had our very own session during the conference entitled “Focus Latin America and the Caribbean: Fighting Poverty in Latin America: Integrating Water and Health Initiatives.” Panelists convened to take in-depth look at NTDs in Latin America and the Caribbean, and  to discuss promising strategies to sustainably reduce the burden of NTDs within the region. Below are photos from the session:

Our booth during the event.

Panelists (from left to right): Ann Kelly, Partner, Global Philanthropy Group and The Global Water Initiative of the Howard G. Buffett Foundation, Vidal Garza Cantú, Director, FEMSA Foundation, Neeraj Mistry, Managing Director, Global Network for Neglected Tropical Diseases, Carlos de Paco, Operations Lead Specialist, Inter-American Development Bank, and Moderator Gian-Carlo Ochoa, Board Member, Charity Water.

Group photo with Global Network Managing Director Dr. Neeraj Mistry and event participants.