Monthly Archives: October 2012

How a Nigerian General Became an Advocate for Stopping River Blindness

Onchocerciasis, 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.

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.

 

Learning about NTDs can be fun – at least in the schools of Chiapas

NTDs
Children at Cinepolis

Children in Chiapas, photo courtesy of IDB.

By: Agustin Caceres

The sun rose over the mountains in Huixtán, Chiapas, and like every morning, students woke up to attend Benito Juárez Primary School. But when the students arrived, they realized 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.

As part of the social mobilization campaign of an NTD project in Mexico supported by the Inter-American Development Bank, students participated in a pilot program that integrate health education about NTDs, basic hygiene activities, games and the projection of movies.

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 diseases 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 transmiting 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. As a part of the planned activities, the kids spend the end of the day watching a movie, eating popcorn, and unwinding after all these fun but tiring activities. The movie was part of the Rural Cinema Route which takes the magic of cinema to remote communities where kids don´t have access to this type of entertainment. This activity was put on by one of the partners of the project, Fundación Cinépolis. “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.

 

View more photographs from the Rural Cinema Route here.

 

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.

 

PLoS NTDs Celebrates Its 5th Anniversary

NTDs
The first issue of PLoS NTDs

The first issue of PLoS NTDs. Photo courtesy of PLoSNTDs.org.

On Thursday, the open-access journal, PLoS NTDs, celebrated its fifth anniversary. To commemorate this great achievement, the journal compiled editorials and research papers published over the last five years to create a collection called “The Geopolitics of NTDs.”

The collection focuses on the geographic distribution of NTDs by region, inspiring readers to think about the significant regional differences among NTDs and the populations they impact. For example, the major NTDs found in Latin America and Caribbean and their socio-economic effects are quite different than those found in South Asia.

However, there is one overriding similarity in NTD infections across the globe,—they disproportionately infect people living in extreme poverty. As PLoS NTDs editors Dr. Peter Hotez and Dr. Serap Askoy explain in an exclusive interview with PLoS’  “Speaking of Medicine” blog:

“Wherever we find poverty we find the NTDs, whether it’s in Uganda or in the United States.”

Since it began publication in 2007, PLoS NTDs has become invaluable to the global health community. Thanks to support from the Bill and Melinda Gates Foundation, PLoS has been able to offer its readers open access to all of its research and editorials—fulfilling an underserved need in the community.

You can download the special collection on the PLoS NTDs homepage and read the full question and answer interview with Drs. Hotez and Askoy at http://www.plosntds.org.

 

Northeastern University Launches Integrated Global Health Initiative to Tackle NTDs

African Sleeping Sickness, Chagas, leishmaniasis, R&D

By Angela Herring

Drug discovery is by definition slow and costly. The multiphase process, which begins with basic science research and ends with clinical trials, can consume up to two decades and more than a billion dollars.

Credit: Mary Knox Merrill, Northeastern University

For NTDs such as African sleeping sickness and Chagas disease, the outlook is even grimmer: anti-infective drugs tend to have higher fail rates than other drugs, as parasites quickly develop resistance. And since NTDs predominantly affect low-income populations, the incentive for big pharmaceutical companies to improve on current treatments is low.

But current treatments are ghastly. In some cases, the drugs themselves can be poisonous and have high mortality rates. With one-third of the planet’s population at risk for NTDs, a new paradigm is required.

Northeastern University chemistry and chemical biology professor Michael Pollastri believes an open-source science model will hasten the drug discovery process. Despite great advances in NTD research over the last decade, the global research effort is largely uncoordinated. Continue reading →