Tag Archives: leprosy

Dr. Jacinto Convit Turns 100: A Birthday More-Than-Worthy of Celebration

leishmaniasis, NTDs,

 

By Dr. Mirta Roses Periago

Jacinto_ConvitOne of the most influential medical experts in leprosy and leishmaniasis celebrated his 100th birthday last week on September 11 – an impressive feat in and of itself. Dr. Jacinto Convit’s work on some of the world’s most challenging public health concerns led to the development of an anti-leprosy vaccine and an immunotherapy for leishmaniasis – not to mention a Nobel Prize nomination and countless awards for his work.

Dr. Convit’s focus on leprosy began in the 1930’s while working in a leper colony in his home country of Venezuela. At the time, leprosy was highly feared as an incurable and highly contagious disease. But in 1940, Dr. Convit gave leprosy patients hope by using blocked Mycobacterium leprae to treat more than 14,000 people. Building on this success, Dr. Convit developed a vaccine for treating and preventing leprosy.

This vaccine led to a multidrug treatment which reduced Venezuela’s leprosy rate to a point that the disease was no longer a public health concern. However, Dr. Convit continues to stress the need for more research and development to fully eradicate the disease.

Dr. Convit’s knowledge of parasitic diseases has also lead to influential work on leishmaniasis — a disfiguring neglected tropical disease (NTD) transmitted by sand flies. He has worked to break down the stigma associated with both leprosy and leishmaniasis – diseases that cause victims to be shunned by their own communities.

Dr. Convit’s dedication to improving millions of lives through global health is truly an inspiration. As he has previously stated, “The only limitation to work is imagination.” Learn more about Dr. Jactino Convit in a video interview that is part of the Pan American Health Organization (PAHO) Reflections project to honor the voices of public health specialists from different fields who have made contributions to health in the Americas.

Dr. Mirta Roses is an NTD Special Envoy for the Global Network and former Director of the Pan American Health Association (PAHO).

NTDs: A Cross-Cutting Issue

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Collaboration was a major theme at the recent Uniting to Combat Neglected Tropical Diseases: Translating the London Declaration into Action conference held in Washington D.C. While the focus was primarily on the seven most common NTDs, numerous cross-cutting issues were identified. Participants stressed emphasis on the potential for synergy and mutual inspiration among disease advocates.

A side meeting showcased both Leprosy specialists and NTD advocates. Presenters urged the audience to explore common elements and approaches in research and advocacy for both disease groups.

Besides disease prevention, it was noted that the following areas also offer potential for collaborative efforts in dealing with Leprosy and Neglected Tropical Diseases:

  • community awareness
  • detection
  • treatment
  • training
  • supervision
  • patient education and self-care
  • monitoring
  • information systems
  • community participation
  • rehabilitation
  • stigma related issues
  • research
  • surveillance

Mr René Stäheli of ILEP said: “We can really contribute with our expertise in morbidity and disability management, and in stigma, to name just two areas. But we can also profit from the experience that other disease communities bring in.”

Read more.

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

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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.

Four NTD successes you should know about

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By: Alanna Shaikh

I don’t know about you, but I’ve found world news to be pretty depressing this week. It seemed like a good time to remind ourselves that things do improve, and we can change global health for the better. I therefore offer you four NTD success stories:

1.       Guinea Worm, aka Dracunculiasis, is on the verge of being eradicated. It is, as you may recall, one of the most wiggly and revolting NTDs, consisting of a giant worm that lives inside you and has to be removed manually and with excruciating slowness. And we’re going to make it the third disease ever to be eradicated.[1] We’ve gone from 3.5 million cases of guinea worm in 1986 to under 5000 in 2009. How awesome is that?[2]

2.       Leprosy is being reduced in a big way. 14.5 million people have been cured of leprosy since 1985. (Yes, cured. Leprosy is a bacterial infection and doesn’t stand a chance against strong antibiotics.) It’s now a problem in only seven countries. [3] It’s a disease to old — it was mentioned in the Bible, and we’re getting rid of it most likely within our lifetime.

3.       China eliminated lymphatic filariasis in 2007. Also known as elephantiasis, lymphatic filariasis makes your limbs swell up to enormous proportions. It causes intense pain, and, obviously, disfigurement. And now it’s gone from China. Boom![4]

4.       2007 was a good year for NTDs.[5] It also saw the elimination of onchocerciasis in Colombia. It was the result of effective action from the government of Colombia and donations of ivermectin from twice-annual mass drug administration of ivermectin to people at risk for the disease. The program became a model for Latin American and was an example of mass drug administration as an effective approach to eliminating onchocerciasis. It’s been copied all over the world.

Insofar as there is a bright side to NTDs, this is it: we can fight them and win. We’ve done it before, and we’ll do it again.

[1] You’re thinking it will be the second disease to be eradicated, aren’t you? Well, you’re forgetting rinderpest. Sure, rinderpest isn’t a human disease, but I think we can agree it’s a good thing if cattle don’t get diarrhea, oral erosions, and necrosis and then die.

[2]Harshing the vibe somewhat – slightly less awesomely, this had to be achieved through changing human behavior because we still don’t have any really effective treatments for Guinea Worm disease. We’ll keep that down here in the fine print so we don’t ruin the happy. And when you consider it, behavior change on that level is pretty awesome too.

[3] For the record, leprosy does not actually cause limbs to fall off, although it can make them numb. We’re not talking zombies here.

[4] Yeah, I don’t know. Boom just seemed like a happy thing to write. The actually eradication process took years of diligent effort and was not boom-like at all. There is almost no boom in global health.

[5] Well, a bad year for the diseases; a good year for the people who might get them.

Alanna Shaikh is an expert in health consulting, writing about global health for UN Dispatch and about international relief and development at Blood & Milk. She also serves as a frequently contributing blogger to ‘End the Neglect.’ The views and opinions expressed by guest bloggers are not necessarily the views and opinions of the Global Network. All opinions expressed here are Alanna’s own and not those of any employer or the US government.