Category Archives: lymphatic filariasis

Lymphatic Filariasis Early Detection Study Commences in Myanmar

lymphatic filariasis

 

The Global Network is happy to share the work of Jan Douglass, PhD Candidate at James Cook University, who is conducting a study in Myanmar focused on lymphatic filariasis in young people. 

By Jan Douglass, PhD Candidate at James Cook University

Infection with Lymphatic Filariasis (LF) can lead to distressing disfigurement and disability, but the time between infection and development of chronic disease can take many years. In a first-of-its-kind study, researchers from James Cook University in Australia are measuring early stage changes in young people infected with LF.

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Dr Khin Than Win (WHO) inspects the legs of a young man in Magwe region who has developed elephantiasis.

 Physical measurements, more usually employed to detect changes in lymphedema after cancer treatments, are being used to detect early stage changes in young people aged 10 – 21 living in a Filariasis endemic region in Central Myanmar. ICT test cards were used to identify the 50 positive case in Amarapura Township. These were then gender and age matched with 50 negative young people.

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Dr Tint Wai Tun (Mandalay VBDC) and Jan Douglass conduct ICT testing in Amarpaura Township during October 2014.

Jan Douglass and local Myanmar research assistant Wanna Aung measure skin changes in the legs of a young person infected with LF

Jan Douglass and local Myanmar research assistant Wanna Aung
measure skin changes in the legs of a young person infected with LF

 Plasma samples are also taken and will be analysed for levels of pro inflammatory cytokines and vessel endothelial growth factors (VEGF). These biochemical markers will be compared to the physical measure to determine if a simple test can be developed to identify young people infected with LF who may be most at risk of developing chronic disease.

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Lab Technician Thiha Soe (Mandalay VBDC) draws blood from a young participant in the study.

Jan Douglass is conducting this study as part of her PhD Candidature James Cook University and travelled to Myanmar in October 2014 to collect baseline data. A mass drug administration (MDA) of deworming drugs will be carried out in December 2014 and Jan will travel back to Amarapura Township in February 2015 to take follow up measures. Comparing the physical measurements and biochemical markers before and after MDA may provide valuable information on the continued risk of lymphatic dysfunction even if the MDA is successful in interrupting disease transmission in endemic regions.

Funding for this project has come entirely from private donors, to contribute to the project please visit www.myanmar-project.com

To view the video blogs of baseline data collection please visit www.myanmar-project.com/blog

See the work Global Network is supporting in Myanmar here: www.end7.org/impact/myanmar

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

Guyana, Latin America and the Caribbean, lymphatic filariasis

 

“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 , 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 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 on LF in Guyana and the work that is being done to control and eliminate the disease.

Haiti’s National Program for the Elimination of Lympathic Filariasis Prevails Despite Adversity

Haiti, Latin America and the Caribbean, lymphatic filariasis, , ,

 

Photo by Olivier Asselin

Photo by Olivier Asselin

Haiti has made remarkable progress against lymphatic filariasis (LF), a disfiguring and stigmatizing neglected tropical disease (NTD), despite facing many challenges. A recently published PLOS NTDs editorial highlights the perseverance and support displayed by the Haitian government and development partners, resulting in scaled-up mass drug administration (MDA) across the country, integrated programs with soil-transmitted helminths (also known as intestinal worms) and increased morbidity management. With these successes, the Haitian effort to eliminate LF can certainly be a model for other countries.

The Haitian Ministry of Public Health and Population (MSPP) established the National Program to Eliminate LF (NPELF) in 2000 to stop LF transmission and reduce the suffering of infected people. Key partners include the Bill & Melinda Gates Foundation, United States Agency for International Development (USAID), Centers for Disease Control and Prevention (CDC), CBM, Inter-American Development Bank (IDB), Abbott Foundation, PepsiCo, Frank Eck Family Foundation and others.

In the first MDA, conducted in Léogâne in 2000, the NPELF and local partners trained community leaders and health volunteers on medicine distribution techniques and educated them about LF treatment, transmission and prevention. Social mobilization was another integral component, spreading messages by banners, posters, radio and megaphones to increase the number of people participating in MDA.

Efforts then focused on scaling up the program to reach all people in need. However, over the course of many years, natural disasters and political and social unrest challenged expansion of the LF program. Just some examples include random acts of violence, devastating hurricanes and flooding, an earthquake and a vicious cholera outbreak.

Yet, increased advocacy, new funding and reinvigorated planning provided the necessary boosts to scale up and achieve results. One of the meetings that jumpstarted new progress was organized by the Global Network, Pan American Health Organization (PAHO) and IDB. As the PLOS NTDs paper explains, “The partners affirmed their support for NTD control and elimination of LF, and the donor community responded. With new funding for MDA in Port-au-Prince from CDC and others, Haiti was finally poised for the first time to achieve full coverage of the entire country with MDA, with a population in excess of 10 million.”

Now, Haiti has achieved full national coverage, and it must strive for interrupted LF transmission. With strong partnerships and continued political commitment, this milestone is in Haiti’s grasp.

To read the full paper, “Haiti National Program for the Elimination of Lymphatic Filariasis — A Model of Success in the Face of Adversity,” click here.

Highlighting the Women of Orissa on International Women’s Day

Asia, END7, India, lymphatic filariasis, NTDs, , , , , ,

 

Anupama standing with the women she met at the Church’s Auxiliary for Social Action (CASA)

Anupama standing with the women she met at the Church’s Auxiliary for Social Action (CASA)

In honor of International Women’s Day, I’m sharing the stories of a group of women living in Orissa State, India. Last month, I had the opportunity to travel to a community center in Banamalipur run by the Church’s Auxiliary for Social Action (CASA), an NGO that works on a range of development and health issues, including morbidity management and disability prevention from lymphatic filariasis (LF). LF is a painful and disfiguring neglected tropical disease (NTD) that impacts more than 20 million people across India.

At the community center, I was introduced to a group of women suffering from the impacts of long-term LF infection. Many of them were grandmothers and mothers, and while we needed a translator to speak to each other, we were full of smiles and eager to learn about one another.

The women I met spoke openly and honestly with me about the challenges they face as women living with LF. Some of the women described how their disease impacted not only themselves, but their daughters as well.

Women in Orissa State, India

Sulochana Behara, 43, from Dhalapathar village, for example, has five healthy daughters for whom she’s having trouble finding grooms; many people incorrectly believe that the swelling of her leg caused by LF is hereditary and that her daughters will also develop this same disability.

The visible signs of LF, which include swelling and inflammation of the extremities, often do not present themselves until adult age. In fact, the average age of the individuals with LF that CASA works with is about 57. Yet one woman I met explained she began noticing symptoms when she was only 12 years old. Now 40, she explained with tears in her eyes that she never married because of the stigma she faced.

In addition to the social stigma, LF also makes it hard for women to work and live comfortably. Many women explained that even working at home was difficult and that they couldn’t sit in certain positions for long periods of time because of the pain they suffered.

For these women, CASA is a welcomed respite from the stigma and challenges they often face as women living with LF. Staff and volunteers who work at CASA help the women wash and care for their swollen legs. The health workers carefully cleanse the women’s skin to remove bacteria. This process can reduce or reverse skin or tissue damage. This type of care does not cure, but can manage, the symptoms and progression of LF.

Unfortunately, the experiences of the women I met are not unique. Millions of women in India are living with or are at risk of contracting LF. As a whole, India bears 45 percent of the world’s population living at risk for LF.

WOMENSDAY (1)I am hopeful that with the support of our celebrity Ambassador, Abhishek Bachchan who accompanied me on the trip, we can help give voice to the stories and experiences of these women and end the stigma that they face. I am also hopeful that India’s efforts to eliminate LF will help protect millions of women from having to deal with the pain, disability and stigma of LF.

This International Women’s day, let’s share these women’s stories and raise the awareness needed to ensure that no woman lives a life of pain and stigmatization due to this preventable disease.

photos by Vivek Singh