Category Archives: schistosomiasis

Honoring Ida

Africa, schistosomiasis, ,

 

Photo courtesy of BBC

Photo courtesy of BBC

 

We use a lot of numbers to tell the big picture about neglected tropical diseases (NTDs) and it’s easy to forget that often there are real people, with profound stories, behind those numbers.  We can talk about how NTDs infect more children than the total populations of the U.S. and Brazil combined.  We can tell you that schistosomiasis (snail fever) kills nearly 300,000 people a year – half the global toll of malaria.  But until those figures are linked with real people, NTDs remain abstract, even impersonal.

A few months ago, a film crew from BBC captured a story that presented NTDs in starkly human terms. As part of Comic Relief’s Red Nose Day in the United Kingdom, , a 29 year-old woman from Malawi suffering from late-stage schistosomiasis. Ida contracted schistosomiasis by drinking contaminated water from a local pond – her only water supply.  She lived in constant pain as parasites multiplied inside her body and slowly destroyed her organs.

What makes NTDs like schistosomiasis even worse is the collateral damage they have on families.  Parents become so weak that they cannot work or care for their children, while kids with NTDs often miss out on educational opportunities that could help them break free of poverty.  In the video, Ida revealed that she had a two year old son named Samuel. “I worry a lot because my son is still very young and I worry about how he will be helped if I’m dead,” Ida said.

Ida could not produce milk to feed her son because she was too sick. Instead of milk, she was forced to fill her hungry son’s stomach with the only available resource she had – the dirty, contaminated pond water that bred the parasites slowly killing her.

The BBC film crew took Ida to the hospital, but it was too late to help her. We learned that she had died a few weeks later and that Samuel died shortly after.

Ida’s story alone is enough to convey the severity and reality of the suffering caused by schistosomiasis.  But the horrific reality is that thousands of people just like Ida die every year from the same disease. Children are orphaned, communities are devastated and the cycle of poverty continues.

The BBC video inspired Comic Relief to dedicate £100,000 to one of our partners, the Schistosomiasis Control Initiative (SCI), for NTD control in Malawi. That donation will prevent unnecessary deaths by offering treatment to entire communities before it is too late.  

Any preventable death, particularly of a child, is difficult to share. This story is one of the hardest we’ve told, but it also strengthens our commitment to protect families from the unnecessary suffering caused by NTDs.

Sierra Leone Study Highlights the Need for Prioritizing Treatment of Preschool Children

Africa, schistosomiasis

 

By Dr. Gregory Simon, Senior Technical Officer, Global Network for Neglected Tropical Diseases

In lake and ponds, rivers and dams, people in developing countries throughout Africa, Asia and Latin America come in contact with parasites that can cause debilitating disease and sometimes death. More than 200 million people around the world are infected with the disease, known as schistosomiasis, often while swimming, bathing, fishing or simply doing domestic chores like laundry and herding livestock. This is because the disease is carried by fresh water snails and transmitted by contact with contaminated fresh water.

Dirty stream in the Kroo bay slum of Freetown, Sierra Leone. Wading in standing water in schistosomiasis endemic areas puts people at risk of contracting the disease. By Olivier Asselin, 2012.

A recent mapping survey was conducted in Sierra Leone to determine the infection rates of  schistosomiasis and soil transmitted helminths (STH) as part of routine surveillance performed in different areas and during different phases of preventative treatment known as mass drug administration (MDA, click here to learn more about how MDA is used treat and prevent diseases like schistosomiasis and STH). The results were somewhat surprising. The researchers found that preschool age children had high levels and heavy infections of schistosomiasis. But not STH.

The national control program currently does not target this group of children for schistosomiasis treatment or prevention, while MDA has been performed twice yearly for STHs in children 12-59 months of age since 2006.

The survey in Sierra Leone underpins a major problem with international efforts to control and eliminate schistosomiasis.

A woman holds her daughter at the Masongbo health center in the town of Masongbo, Sierra Leone. Health centers offer an alternative to ensure preschool aged children receive preventative treatment for schistosomiasis. By Olivier Asselin, 2012.

The current recommendations by the World Health Organization (WHO) do not include treatment protocols for pre-school age children within the context of an MDA strategy. Instead, the WHO recommends treatment of schistosomiasis in children aged less than 4 years on an individual basis by medical personnel.

Without an effective, safe way of administering schistosomiasis pills to pre-school age children, the spread of the disease in households and communities will not be halted. For the time being, in the absence of an appropriate pediatric formulation, broken or crushed tablets are recommended. Research is being conducted on a pediatric formulation that can be used for mass administration; however, approval for such a formulation could be some time away.

Until such a time, when a formulation for MDA in preschool aged children is approved, a potential strategy could be to have children in this age group treated in child health services where children are given vitamin A capsules, treatment for STH and routine vaccinations.

Learn more about schistosomiasis by visiting globalnetwork.org/schistosomiasis.

New Mechanism Discovery: How A Parasite Causes Cancer

schistosomiasis

 

By Catarina Amorim

About 200 million people across 75 of the poorest countries in the world are now infected by the blood parasite Schistosoma haematobium (S. haematobium). The infection causes severe urogenital disease, but also causes bladder cancer in a number of patients and why this occurs is not clear.

Now a group of Portuguese scientists believe they have the answer – their research shows how the parasite’s eggs can make human bladder cells behave as cancerous cells. And the key to that – according to the first author of the work Mónica Botelho– are catechol oestrogens, a molecule derived from estrogen (the sex hormone) that was found by the researchers in the eggs and is known to be highly carcinogenic (causes cancer).

The research, a collaboration of the CECA/ICETA from the University of Porto, the National Institute of Health in Porto, Portugal and the George Washington University, US could be a first step towards one day be able to identify S. haematobium infected patients at risk of bladder cancer or even prevent the cancer by targeting catechol-oestrogens. Schistosomiasis is also associated to fertility problems and the newfound molecules might hold the key to also understand this.

Schistosomiasis, despite the numbers infected, remains a neglected tropical disease that affects the world’s poorest with a socioeconomically impact in the developing world only second to malaria. The disease is transmitted to humans by freshwater snails from contaminated waters, with the worms entering our blood stream to release eggs that become embedded in the bladder wall where they cause chronic inflammation and, in some patients, lead to bladder cancer.

How common is this carcinoma among parasite-infected patients is difficult to know because the most affected countries are also the world’s poorest with scarce or even non-existing disease recording. Continue reading →

Sixty-Fifth Session of the WHA Highlights Progress in NTD Control, Adopts New Resolution on Schistosomiasis Elimination

NTDs, schistosomiasis, WHO

Neglected tropical diseases (NTDs) were on the agenda this week at the Sixty-fifth session of the World Health Assembly (WHA) in Geneva, Switzerland.

A major milestone was reached when the WHA today approved a new resolution on elimination of schistosomiasis.

Schistosomiasis, also known as “snail fever”, is a disease caused by parasitic worms carried by fresh water snails. It is found predominantly in tropical and sub-tropical climates, and infects 207 million people in 74 countries worldwide. Schistosomiasis ranks second only to malaria as the most common parasitic disease.

This new resolution urges Member States to: ensure access to essential drugs against schistosomiasis and soil-transmitted helminth infection, mobilize resources in order to sustain activities for control of schistosomiasis and soil-transmitted helminthiasis, promote access to safe water, sanitation and health education, mobilize resources in order to sustain activities for control of schistosomiasis and soil-transmitted helminthiasis, and include schistosomiasis control measures into other disease control programs and health systems.

While reinforcing past resolutions, this resolution also marks a new development in efforts to combat schistosomiasis because it sets the stage for changing the goal from control to elimination.  The resolution calls for the Director-General and the WHO to prepare guidance for reaching elimination and to develop processes to ascertain and certify when transmission has been interrupted and the diseases has been eliminated.

Programs against schistosomiasis have been very successful and many countries are ready to make the request for certifying elimination.  In passing this resolution, the WHA is ensuring that support is available for other countries to do the same.  Iran, Japan, Jordan, Mauritius, Morocco, Tunisia, parts of China and some Caribbean countries and territories are all ready to certify for elimination.   While much of the world is still working towards controlling schistosomiasis, these places are demonstrating that, ultimately, elimination of this debilitating disease is possible!

At the assembly, NTDs were also brought to the spotlight by Secretary of Health Surveillance, Jarbas Barbosa and Professor Therese N’Dri-Yoman, President of the Sixty-fifth World Health Assembly.

Barbosa spoke at the conference about the efforts that the Brazilian government has adopted for the elimination of NTDs and their view of NTD control as a key part of poverty alleviation.   He talked about , an initiative of the Brazilian Federal Government to eliminate extreme poverty in the country, which also incorporates a plan for NTDs. “We believe this integration promotes a synergistic opportunity to reach the poorest groups in our country,” Barbosa said.  He also mentioned that Brazil is close to achieving the elimination of two neglected diseases: lymphatic filariasis and onchocerciasis.

In addition, at a lunch-time technical briefing on May 21, delegates discussed the relationship between NTDs and poverty.  Professor N’Dri-Yoman described the movement to control and eliminate NTDs as an “unprecedented force” that now exists among the global health community. A number of other speakers emphasized the importance of collaboration as vital to ensuring continued progress.

Click here to learn more about NTDs.

Click here to learn about all previous WHA Resolutions on Neglected Tropical Diseases.