Tag Archives: Nigeria

Towards a Less Wormy World

 

By Nina Cromeyer Dieke*

Nigeria is – by far – Africa’s most populous nation. It recently came to light that it is the continent’s biggest economy. It also has the highest burden of NTDs in all of Africa. Therefore, when an opportunity arose in late 2013 to run our GIS training course in Abuja, we were very excited and quickly set about preparing the materials.

Nina presenting at GAHI's Modern Tools for NTD Control Programmes training

GAHI’s Jenny Smith presents on modern tools for NTD control programmes.

Part of my job as communications manager for the Global Atlas of Helminth Infections (GAHI) team at the London School of Hygiene & Tropical Medicine (LSHTM) is the coordination of our five-day course on Modern Tools for NTD Control Programmes. The course is part of GAHI’s capacity building efforts and is aimed at data and programme managers who wish to use geographic information systems (GIS) and mapping to better target their deworming and NTD control plans. The course first took place in Nairobi in May 2013, with 18 participants from 7 African countries. One of the participants was Dr. Obiageli Nebe, the Nigerian Ministry of Health’s National Coordinator for STH and schistosomiasis. We were very pleased to hear, just a few months later, that Dr. Nebe successfully advocated for the course to run in Abuja, a feat that materialised in January 2014 with 21 participants from Nigeria’s FMOH and NGO’s.

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The group of participants from GAHI’s five-day course on Modern Tools for NTD Control Programmes

After a great visit to Nigeria, the year continued to bode well for GAHI with the re-launch of our website. Still on www.thiswormyworld.org, we now have a brand new design that makes searching for maps, data and our training resources much easier, including the interactive NTD Mapping Tool. We also have a new research section with information about our ongoing work, in addition to mapping. We’re very excited about our new look!

One of the great new additions to the website is maps (and their data) showing water supply and sanitation (WSS) coverage in Sub-Saharan Africa. These are the result of a recent paper in PLOS Medicine, led by GAHI’s Rachel Pullan with Matt Freeman at Emory University, Pete Gething at Oxford, and GAHI’s Simon Brooker. The study found stark in-country inequalities in access to water and sanitation, as well as in practicing open defecation. Demonstrated inequalities for some example countries include a 33.0% to 99.5% range in district-level coverage of improved drinking water in Benin, and a 13.8% to 93.6% range in open defecation in Burkina Faso. We recognise the important links between good WSS access and NTD control, and this type of multidisciplinary research to understand the context of control is increasingly a part of our work.

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It’s been a busy year for us so far, but we’re not alone. I’m thrilled by the ever growing momentum around NTD control and elimination, most recently demonstrated at the Uniting to Combat NTDs meeting in Paris. New funding commitments and increasing multi-sector partnerships are getting us closer to 2020 goals, in countries large and small.

Follow GAHI on Twitter, @ThisWormyWorld

*Nina Cromeyer Dieke is the communications manager at Global Atlas of Helminth Infections

NTD Workshop in Nigeria Equips States with Necessary Skills and Resources to Succeed

 

Together with international partners and NGOs, the government of Nigeria has the potential to drastically expand and strengthen their neglected tropical disease (NTD) program to treat and protect its population from the devastating impact of NTDs. Nigeria bears the largest NTD burden within sub-Saharan Africa, but the country’s national plan to tackle NTDs has already laid the groundwork for controlling and eliminating these diseases by 2020. However, additional training, especially at the state level, will help Nigeria scale up and maintain a sustainable NTD program that could lead to the control and elimination of NTDs by 2020.

Nigeria’s geography poses a unique challenge in the fight against NTDs. For example, each Nigerian state possesses its own quasi-autonomous state ministry of health — each with its own integrated NTD program. With this challenge in mind, The World Health Organization (WHO) and partners developed a training program for the first week in February for the 36 Nigerian states and the Federal Capital Territory (FCT) to provide representatives with the tools and technical skills needed to establish, scale up and sustain integrated NTD programs within their respective states. The training was supported by The Envision project, The United project, and was attended by state representatives, including federal ministers of health, members of federal NTD teams and zonal coordinators and NGO partners.

Highlights from the 5-day training were shared through Twitter, thanks to @NTDNigeria and RTIinterntional:

 

Throughout the training, facilitators from Nigeria and the U.S. led sessions on scaling up integrated MDA programs, monitoring and evaluation, data management and advocacy. The facilitators also went over some basic but essential tasks – including filling out the appropriate forms to apply for NTD medications.

During her session, Global Network senior program officer Wangechi Thuo stressed the importance of effective advocacy in creating sustainable NTD programs. She led participants through exercises, demonstrating how to effectively raise awareness about NTDs among key policy influencers with the goal of garnering sustained ownership, leadership, and commitment from governments and their partners for NTD programs

 

The training also brought together key government partners including Nigeria’s National Agency for Food and Drug Administration and Control (NAFDAC) and the National Primary Health Care Development Agency. Together, partners discussed ways to better and more effectively distribute NTD medicine to populations in need. While Nigeria has the medicine necessary to treat its population, delivering the medicine to more than a hundred million Nigerians is a difficult task.

As the globe moves towards NTD elimination by 2020, Nigeria must remain a top priority given its large NTD burden. Thanks to this month’s NTD workshop, Nigeria’s government expects to see more and more people treated for NTDs, and more precise monitoring and evaluation of drug delivery in the coming year. Through continued government and partner support, Nigeria can see the end of NTDs. In the words of Dr. Bridget Okuaguale, Director of Public Health (DPH) at the Federal Ministry of Health, “We must work as a team, or we cannot go anywhere.”

Nigeria Declared Guinea Worm-free: An Encouraging Accomplishment

 

Nearly three years ago, Nigeria reported the last case of Guinea worm disease, and this year, the World Health Organization (WHO) officially declared the country Guinea worm-free. When considered in tandem with Nigeria’s centenary celebrations, this encouraging declaration is further testament to just how far the nation has come in its fight against poverty, which Guinea worm has been found to exacerbate.

Referred to as a “scourge” by President Goodluck Jonathan, Guinea worm (dracunculiasis) is an ancient neglected tropical disease (NTD) spread by ingesting water contaminated by Guinea worm larvae. The larvae grow to be about one meter long and emerge through an excruciatingly painful blister on the skin after incubating for about 9-12 months in its host. In 1988, 653,492 cases of Guinea worm were reported in Nigeria, and 26 years later there are zero cases-a truly remarkable feat, thanks to the commitment of Nigeria’s government and international partners.

Moving forward, President Jonathan looks to harness the momentum generated from this success to address other endemic diseases in Nigeria, with a particular focus on wild polio, hoping that its transmission will be interrupted by the end of the year at the very latest.

While President Jonathan did not explicitly mention other NTD efforts during the WHO certification ceremony, it is important to note that he has already committed to seeing the end of these diseases (notably onchocerciasis, lymphatic filariasis, and schistosomiasis) as confirmed in his new year’s message.

The Nigerian government’s persevering commitment to disease elimination is encouraging, after having overcome the most expensive and challenging last mile of Guinea worm that are characteristic of any elimination campaign.

In Nigeria’s resolve lies hope for its African counterparts still in their last steps to eliminate the near-extinct disease, only 148 cases of which are still present across South Sudan (113), Chad (14), Mali (11), Ethiopia (7) and Sudan (3).

I congratulate President Jonathan and the people of Nigeria for their important achievement so far and encourage them to continue making NTDs a priority as we all seek to achieve the 2020 elimination goal!

How a Nigerian General Became an Advocate for Stopping River Blindness

Lieutenant General (Ret.) Theophilus Yakubu (TY) Danjuma knows river blindness firsthand. As a Nigerian who grew up in a country with one of the highest rates of river blindness (also known as onchocerciasis) infection in the world, he has not only witnessed the devastation this disease can bring to families and communities, but has also suffered from the disease himself.

River blindness produces rashes, skin lesions and severe skin inflammation that can make the skin change color and lose elasticity. People suffering from the disease often face daily social humiliation and isolation, and infected children struggle to pay attention in school because of intense itching. River blindness, however, is aptly named. Its most debilitating symptoms are severe visual impairment and irreversible blindness.

General Danjuma’s experience with this disease began in the 1960s. While leading a company of soldiers in Nigeria, he was bitten by the Simulium black fly that transmits the worm larvae that cause river blindness. For two years, the larvae spread throughout his body, maturing into adult worms and releasing bacteria that eventually trigger an immune system response. He awoke one morning with swollen eyes and itchy, inflamed skin. General Danjuma successfully underwent two weeks of treatment and experienced no lasting symptoms, but says he has never forgotten the sight of his own skin sample under the microscope at the local clinic. He still shivers at the memory of tiny worms swimming in and out of view under the lens.

General Danjuma is the Grand Patron of an important NGO based in Jos, in Northern Nigeria. The NGO, The Mission to Save the Helpless, better known by its acronym MITOSATH” is well known to the health team in the Africa Region as an important partner of African Programme for Onchocerciasis Control (APOC). MITOSATH is also among the most active NGOs in Nigeria contributing to the control of river blindness other neglected tropical diseases.

Controlling River Blindness in Africa: Setting an Example

A young boy leads a man impacted by river blindness. Photo by Olivier Asselin.

 

 

 

 

 

 

 

 

 

 

 

 

 

When river blindness control programs were first implemented in the 1970s, up to half of all adults in some hard-hit communities had gone blind from the disease. This tragedy caused many Africans to abandon their ancestral homes and livelihoods; the economic losses were estimated at US$30 million. The first Onchocerciasis Control Programme focused primarily on spraying insecticide over infected areas in order to minimize the prevalence of the black fly, preventing transmission of the parasitic worms from person to person, and eventually incorporated treatment with Ivermectin, the drug that treats river blindness, when it became available.

With the help of the World Health Organization and the World Bank in 1995, this program was expanded and renamed the African Programme for Onchocerciasis Control (APOC). Rather than attempting to control the black fly population, APOC sought to control the parasitic worms in humans through community-directed treatment with Ivermectin in 19 countries. Treatment with Ivermectin successfully kills the worms in the people who have them, thereby disrupting transmission of the disease.

Merck & Co. donates Ivermectin to Nigeria (and other countries in need), and APOC trains volunteers to distribute the drug in communities. Today, APOC provides Ivermectin to more than 96 percent of endemic communities in Nigeria, reaching more than 23 million people. Until everyone is treated, however, the risks of re-infection and new outbreaks remain. River blindness is still present in most Nigerian states, including Taraba state where General Danjuma was born. The disease continues to deeply impact communities and the lifetime productivity of the 31 million Nigerians at risk.

Now a successful businessman and politician, General Danjuma’s personal experience with river blindness and the success of MITOSATH and APOC motivated him to donate US$1 million to the program in 2010. With his donation, he hopes to invigorate interest in public health challenges in rural Africa. General Danjuma noted that, “these are not the neglected diseases of tropical Africa, but rather the diseases of neglected people.”

General Danjuma’s crusade to raise the profile of rural health issues has already gained momentum. Following his example, in 2011, the government of Nigeria pledged an additional US$5 million to APOC to assist with its control efforts. General Danjuma hopes that other countries and the private sector will join the movement to eliminate this debilitating disease once and for all.

 

In March 2012, General Danjuma participated in a panel discussion at the Center for Strategic and International Studies. Read our blog post on that event here.