Tag Archives: MDA

Millions Treated for NTDs in Burundi

A few of the many Burundians treated in the December 2009 MDA

A few of the many Burundians treated in the December 2009 MDA

By Indra Struyven

In December 2009, the Burundi NTD Control Program successfully treated 3.6 million preschool and school-age children, along with 115,008 pregnant women in the ongoing battle against neglected tropical diseases (NTDs). The program also successfully trained 1,467 health care workers for diagnosing and treating NTDs in its third year of operation.

The main target of this mass drug administration (MDA) was one of the most prevalent and debilitating group of parasitic infections, namely the soil-transmitted helminthiases (intestinal worm infections). These are diseases that cause anemia, malnutrition, pain, and physical and mental underdevelopment in children.

One person who benefited from this MDA is Béoline Nsengiyumva. Béoline is a 14 year old girl living with her family in Mukungu, Makamba province in Burundi. She’s in her 5th year of primary school, has a very joyful and cheerful demeanor, and, like many of her schoolmates, was afflicted with soil-transmitted helminths. The parasitic disease caused her to suffer from exhaustion, nausea, and abdominal pains, forcing her to miss school and make frequent trips to the local health clinic. But that was all before she received treatment in December, Since Béoline has become healthy again.

Another key part of a MDA is education to prevent getting infected again in the future. Béoline is learning the importance of hygiene. When asked if she knows how prevent intestinal worm infections, she says that she has to wash her hands. Simple steps such as using the latrines at her school and wearing shoes can go a long way towards preventing future re-infection.

The Burundi NTD Control Program organized the MDA in partnership with several other programs from the Ministry of Health, UNICEF, the Schistosomiasis Control Initiative, CBM and the Global Network for Neglected Tropical Diseases.

IndraIndra Struyven is a medical doctor. She completed the diploma course of tropical medicine in London (LSHTM). Currently she’s working for CBM,  as a technical assistant to the Ministry of Health in Burundi, to assist the team of the Ministry in their fight against NTD’s. Before she was working as a GP in Dar es Salaam.

Clearing the Air on MDA

Last night, Alanna Shaikh of Global Health Basics brought an interesting article to our attention: following mass drug administration (MDA) to treat lymphatic filariasis in Indonesia, “…nine people were dead last week and nearly 1,000 had fallen ill with symptoms such as nausea, dizziness, muscle soreness and vomiting. Hundreds were hospitalized.” She rightfully asked us, “what happened here?”

As it turns out–and it’s a topic we don’t cover much on our blog or website–these symptoms, even for populations in the thousands, are to be expected for MDA.  Like treatment for many other NTDs, when you treat for LF with the drugs DEC and albendazole, infected people will commonly exhibit symptoms including headache, nausea, and fever; those who are uninfected will likely experience minimal side effects.  Additionally, when treating populations en masse, it is probable that some may die from other causes within the treatment period; the correlation between receiving NTD treatment and death may just be coincidental or related to un-screened conditions.

The fear and hysteria that occurred in Indonesia is a reminder that effective media, education, and sensitization campaigns are critical in ensuring a successful MDA campaign.  We are fortunate to have drugs that are safe and effective for wide population demographics, but individuals and communities must feel comfortable taking the drugs and must anticipate the (highly normal) side-effects if we expect them to return in the coming years for treatment.