Tag Archives: sanitation

What’s the Matter with the Water?

NTDs, Soil Transmitted Helminths (STH), Trachoma, Tropical Medicine, Water and Sanitation, , , , , , ,

By: Amanda Miller

Many of us don’t think about infectious tropical diseases in the United States or Europe – but it was less than a couple hundred years ago that a cholera epidemic spread throughout Europe.  One outbreak in September 1854 killed over 500 people in just ten days.   A search for the cause and cure was unsuccessful.

Photo taken from http://johnsnow.matrix.msu.edu/

Dr. John Snow then developed a theory of cholera transmission that was contradictory to other accepted beliefs – transmission of cholera was due to drinking water contamination.  He mapped cholera cases and found that they had taken place near the infamous Broad Street pump.  By providing one of the earliest examples of epidemiological research, Dr. Snow made one of the first known connections between water and disease.

It makes perfect sense to us these days that you can get very sick from contaminated water.  It’s the first thing people say when traveling to other countries – “don’t drink the water.”  Yet think of a world just a couple hundred years ago where we didn’t quite understand why people were getting sick.

So what’s the big deal?  And what does it have to do with NTDs?

Well, we have the ability to think about NTDs through many different lenses.  One is through treatment and reducing prevalence.  Another is routine preventative chemotherapy through mass drug administration.   And yet another is through long-term solutions like water and sanitation.  But is one good without the other?

Photo taken by author

We know that poor sanitation and contaminated water contributes to the transmission of NTDs.  Of the seven most common NTDs, the transmission of six is directly related to unsafe water, inadequate sanitation and insufficient hygiene.

This is why water, sanitation, or hygiene (WASH) becomes a key factor in NTD initiatives.  Of course, long-term solutions are expensive and complicated.  Behavior change is slow, and infrastructure building is even slower.  But since we found out 200 years ago that water is inextricably linked to many infectious diseases in developing countries, isn’t it time we focused on the root cause?  It all points towards clean water and sanitation.

If Dr. Snow hadn’t pulled the handle off of the Broad Street pump in the middle of a cholera epidemic, how many more people would have died before we figured out what to do?

Amanda Miller is the Asia Program Officer for the Global Network for Neglected Tropical Diseases. Amanda has public health experience in Rwanda and Botswana, and in her free time enjoys knitting.

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Water in the World of Global Health

Global Health, Public Health, Water and Sanitationdiarrheal diseases, , , , , World Water Day 2011

By: Alanna Shaikh

March 22 was World Water Day, which meant a ton of interesting blog posts, forceful press releases, and well-researched articles on water. It was a fantastic opportunity to learn more about a really important issue in global health and development.

It depressed me. It should depress you too. Water is everything in global health, and I mean everything. Clean water is key to stopping a whole range of infectious diseases, from cholera to onchocerciasis. It’s especially important to saving the lives of children, since they are so easily killed by the diarrheal diseases that are transmitted so often by dirty water.

And the task ahead of us is massive. Clean water isn’t just possibly the most important health issue out there. It’s also an infrastructure issue, a governance issue, an agriculture issue. It ties to just about everything anyone is trying to do in development. In cities, access to clean water means stuff like building functioning sewers and providing running water to places where people live. In rural areas it means boreholes, pit latrines, and keeping the drinking water from getting contaminated by agricultural chemicals.

Everywhere, it means a whole lot of education about water – what clean water consists of[i], why it matters, and how to keep it clean. Don’t feed water to your animals at the same watering places humans use. Don’t dig your latrine too close to the well. Don’t wash your clothes in the drinking water, especially not diapers. Wash your fruits and vegetables before you eat them. For that matter, if you can ever afford any, wash your meat.[ii] Continue reading →

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Helminthic Zoonosis in the U.S.

Latin America and the Caribbean, NTDs, parasitesCDC, exotic pets, helminths, kinkajou, ,

National Geographic Photo by Mattias Klum

The kinkajou, apparently also known as the honey bear, is a Central/South American rainforest mammal and is related to the raccoon.  Perhaps you have seen Ms. Paris Hilton toting one around like a new designer bag but do not let their adorable, innocent faces mislead you; kinkajous have recently been found to carry parasites that are deadly to humans.  According to The Centers for Disease Control and Prevention (CDC), helminthic zoonosis, the transmission of parasites from non-human hosts to human, is growing rapidly.  Yesterday, CDC’s Morbidity and Mortality Weekly Report (MMWR) stated that pet kinkajous in three U.S states–Indiana, Tennessee, and Florida–between 1999 and 2010, have been tested positive for Baylisascaris procyonis (BP), a ubiquitous roundworm infection found in raccoons. Human exposure to roundworm can be deadly and it is important that exotic pet owners have routine de-worming of their pets and avoid contact with potentially infected fecal matter.

As part of the exotic pet trade, kinkajous are imported from South America and bred in captivity; the offspring are sold as exotic pets. Because the disease is transmitted by the fecal-oral route, human cases of BP infection typically occur in younger age groups, mainly infants, who often engage in oral exploration of their environment and are therefore more likely to be exposed to BP eggs.

These findings show that infectious diseases commonly associated with tropical regions are not confined to those areas;  infection and disease travel across land and water.  The Kinkajou, an exotic pet imported into the U.S from  South and Central America, is just one example of how tropical infections can travel to other biomes.

Read the full report here.


Leprosy, Possibly the Most Annoying NTD

Commentary, Global Health, grassroots, MDA, NTDs, opinion, , , ,

By: Alanna Shaikh

Here’s the thing about leprosy. It’s totally, completely, absolutely treatable; World Health Organization (WHO) provides free drugs to make treatment even easier. Leprosy progresses slowly – like 20 years slowly and it is not infectious. So what the heck? Why can’t we just eliminate leprosy already? Why do people still get this disease? Why does it go untreated long enough that we still see ?

WHO pronounced the elimination of leprosy as no longer a public health threat, in 2000. That means that the disease has a prevalence of less than one case per 10,000 people[1], largely because multi-drug therapy for leprosy is really effective. (And, as I previously mentioned, free as the result of donations from Novartis and the Novartis Foundation for Sustainable Development.)

But “not a public health threat” doesn’t mean “gone”. The 2008 disease burden for leprosy was 213,086 cases. Not a big number, I admit, but not zero. I want zero. Why can’t we have zero?

The reasons we are not at zero are, of course, depressingly familiar.  Though the drugs to treat leprosy are free, transportation and administration costs are not. You need a functional health system to diagnose leprosy, start patients on treatment, and make sure that they are able to finish their treatment.

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