Tag Archives: Public Health

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

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.

Oct. 6, 1956: Sabin Polio Vaccine Ready to Test

On this day in 1956, the Sabin Polio Vaccine was ready for mass testing. Developed by Dr. Albert B. Sabin, the live-virus oral polio vaccine would eventually help bring an end to the polio epidemic that ran rampant in America during the early 20th century. Below is an excerpt from Wired magazine’s blog, “This Day in Tech” which showcases Dr. Sabin and his revolutionary polio vaccine, take a look:

1956: Dr. Albert Sabin announces that his live-virus oral polio vaccine is ready for mass testing. It will soon supplant the Salk vaccine.

Poliomyelitis is an infectious disease caused by viruses. Its effects range from complete recovery to death. Intermediate possibilities are mild after-effects, moderate to severe paralysis of a limb or limbs, or paralyzed chest muscles, necessitating the confining but lifesaving use of an iron lung.

Polio epidemics periodically ravaged American cities in the first half of the 20th century. Children were especially vulnerable, but the disease also struck adults, most notably former Assistant Secretary of the Navy Franklin D. Roosevelt in 1921.

Roosevelt was elected president in 1932, and he founded the National Foundation for Infantile Paralysis (as the disease was then often called) in 1938. The foundation conducted a huge annual fundraising campaign called the March of Dimes.”

Click hereto read the full blogpost.

Part Two of Speaking Books Interview

Last week we posted part one of our two part interview with Brian Julius, President of Books of Hope. Read the conclusion of the interview below.

Photo Courtesy of Books of Hope

Have the books been well-received by communities?

Specific comments on the “Speaking Book” Suicide Shouldn’t be a Secret

  • ‘This book has shown me that even that I am a child, I can save someone’s life or I can help depressed people and I did” (Male, from Northwest)
  • “My friend was stressed. He wanted to kill himself, the book help him avoid the stress” (Female from Limpopo)
  • “The book helped them stop suicide and to stop laughing at someone who is in trouble or is seeking for help ” (Female, from Soweto, Gauteng)
  • “I would just say that this book is going to help save many people’s lives because we are losing many family and friends because of depression” (Female, from North West Province)

We have received phenomenal responses for many of our books – I will also attach some other user comments. Continue reading

Why Deworming is Cool

By: Amanda Miller

This month, I came across two news articles (which can be found here and here) highlighting deworming activities in India.  First, Deworm the World, a US-based non-profit, aims to deworm 21 million school-age children in Bihar State, India.   Starting this month, the program will be rolled out in over 67,000 schools until April 2011.  Then I came across an article stating that the Orissa State government announced their intention to deworm school-age children in six districts of the state starting in May 2011.  According to the article, free deworming drugs will be distributed in all six districts twice per year.

Intestinal worms rob children of vital nutrients and slow their mental development. Chronic infection with intestinal worms can impact on the lives of children by impairing their physical growth, mental development, capacity to learn in school, and ability to contribute to their families.  These deworming programs mean that well over 30 million children in India will receive treatment for their intestinal worms, giving them the opportunity to be well and learn in school.  Which I think is pretty cool.

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