Information and news about disease category

Kala Azar DiseaseKala Azar, the second-largest parasitic killer in the world after malaria, is quite deadly. Known as Kala Azar, Black Fever and visceral leishmaniasis, the disease kills 95% of its victims if left untreated. This “Poor Man’s Disease” can be very hypocritical. While this disease infects the poverty-stricken, the treatment is hard to come by, if not impossible. Even if the patient finds a doctor that can treat the disease, the price is astronomical. And sometimes, there is no stopping the contraction of the Black Fever.

The Spread

As the disease transmits through a sandfly bite, Kala Azar preys on the vulnerable. More than 1 billion people are at risk. East Africa, India and even some parts of the Middle East are endemic to Kala Azar. Poor housing conditions and lack of waste management in these countries cause an increase in the bloodthirsty sandflies’ breeding sites. This specific culprit is the female, Phlebotomine sand fly. While just one bite from it can put someone on bed rest for weeks, malnutrition only worsens the situation. For example, low vitamin D, iron and zinc can cause an infection to progress into disease much quicker. If Kala Azar killed the equivalent number of people in the U.S., it would be the third-largest killer, killing more citizens than those who die from strokes.

OneWorld Health

The real fighting began in 2003 with a collaboration between OneWorld Health, the WHO and a 4.2 million dollar grant from the Bill and Melinda Gates Foundation. With this grant and WHO’s resources, OneWorld Health was able to start its final testing to find an affordable cure for Kala Azar and the disease it causes. They are reinventing an old medicine and turning it into the treatment now called paromomycin. “It’s not every day one can say an affordable cure for a deadly disease may be imminent and we believe our approach will be successful,” said Dr. Victoria Hale, founder and CEO of OneWorld Health. It is to be a 21-day treatment and it will be readily available in every Indian clinic and, hopefully, one day, everywhere.

Drugs for Neglected Diseases Initiative (DNDi)

Unfortunately, nothing came of the OneWorld Health drug, paromomycin until February 2019. The Drugs for Neglected Diseases Initiative (DNDi) is fighting to change that. In a press release on the DNDi website, they share that Wellcome, a U.K. based foundation aiming to improve health for everyone, committed 12.9 million dollars for the development of drugs for Kala Azar. They are essentially funding a program that will test pre-existing drugs (that never made it to the world) and choose one to put on the market. DNDi is hoping it to be an oral drug as the drugs taken to fight Kala Azar can be painful and “require patients to take toxic and poorly tolerated drugs — often over a long period and through painful injections,” as said by Dr. Bernard Pécoul, Executive Director of DNDi.

The Impact

There is an estimated 50,000 to 90,000 new cases each year. Most families of the infected do not even go to the doctor, knowing that they will not be able to pay for the treatment. While there are many organizations funding drugs to treat Kala Azar, the cure is not coming fast enough. The current treatment for this parasitic disease is not reasonable. How can a family that can barely provide for themselves spend thousands of dollars on treatment?

The prevention and an end to Kala Azar lie in our hands. Organizations need funding to take preventative measures like spraying for these deadly sand flies, monitoring the epidemics and educating the communities affected by the disease.

Bailey Sparks
Photo: Wikimedia Commons

NASA SatellitesIn 1999, The National Aeronautics and Space Administration (NASA) scientists theorized that in the near future, they would be able to track disease outbreaks from space. They were mainly concerned with Rift Valley Fever. This is a disease prevalent in East Africa that is deadly to livestock and occasionally deadly in humans. NASA scientists already had surmised that outbreaks were directly related to El Niño weather events. Areas with more vegetation on abnormally precipitous years breed more disease-carrying mosquitoes. To see the exact areas that would be most at-risk, NASA satellites would need to be able to track differences in the color and density of vegetation from year to year.

Tracking Rift Valley Fever

In 2006, NASA scientists were able to predict and track an outbreak of Rift Valley Fever in East Africa. Even with intervention efforts, the outbreak led to the deaths of over 500 people and cost the regional economy over $60 million due to export restrictions and livestock deaths. Although the researchers could not adequately predict the outbreak then, the results of that mission gave them confidence that they could predict the next outbreak even better the next time El Niño conditions arose.

Ten years later, the NASA team successfully predicted the location of the next potential outbreak. They subsequently warned the Kenyan government before the disease could strike and gave them ample time to prepare. Thanks to the combined efforts of the Kenyan government and NASA satellites, Kenya saw no outbreak of Rift Valley Fever in 2016. The country protected the lives and livelihoods of rural farmers throughout the country and saved millions of dollars.

The success of the Rift Valley Fever prediction models gave the researchers more confidence in their methods. They believed that NASA satellites could predict and halt all manner of outbreaks. Researchers focus on neglected diseases like cholera. These diseases have connections to environmental conditions that hit developing countries and impoverished people the hardest. Newer satellites add the ability to measure variables like temperature and rainfall. Researchers are able to use it more than just the visual data utilized in the initial Rift Valley Fever predictions, thanks to the improved models.

Tracking Cholera

Cholera infects from 1.4 to 4 million people and kills more than 140,000 each year. There are two distinct forms of cholera: endemic and epidemic. Endemic cholera is present in bodies of water primarily during the dry season. This means communities living along the coasts are typically prepared for an outbreak. Epidemic cholera comes about during weather events like floods and often leaves inland communities unprepared for the disease. Due to its infectiousness and connection to weather events, it is the most promising disease that new scientific models have analyzed.

In 2013, a research team successfully modeled cholera outbreaks in Bangladesh using NASA satellites. The real test of the team’s predictive models would come in 2017, however, when it used the same model in a very different part of the world: Yemen. The model worked nearly perfectly. Researchers predicted exactly where the outbreaks would occur nearly a full month in advance. The fact that the models worked in impoverished and war-torn Yemen is especially notable for those concerned with extreme poverty. It means that the previously expensive and dangerous work of entering countries like Yemen in order to do disease research is no longer necessary. Instead, early warning systems can be implemented. But even if they fail, governments and organizations can send vaccines and medicines to exactly the right locations. Cholera outbreaks and their disproportionate death rates among the global poor will hopefully soon be a thing of the past.

Hope for the Future

By halting outbreaks before they begin, international aid dollars can have more efficient use. Prevention is always less expensive than reaction. Information in and of itself is valuable and the more information poverty-fighting organizations have, the better they can spend their dollars to maximize utility and help the most people. As satellite technology advances along with newer predictive models, preventing disease outbreaks could save developing economies and aid organizations hundreds of millions of dollars each year.

Jeff Keare
Photo: Pixabay

African vulture poisoningOf the 22 unique species of vultures, the International Union for Conservation of Nature (UCN) categorizes over two-thirds as near threatened, threatened, endangered or critically endangered. Seven of the 11 African vulture species are endangered or critically endangered. Vultures face a variety of threats across Africa, including direct and indirect poisoning due to poaching and human-wildlife conflict. However, African vulture poisoning does not just affect the birds themselves; it also affects human populations.

Decline of African Vultures

In just three generations, populations of endangered African vultures have plummeted by more than 80%. Because females may only lay a single egg in two years and hatchlings don’t reach sexual maturity for at least five years, this population trend may bring several species of African vultures to the brink of extinction.

Vultures play an important role in their natural environment. They can consume over two pounds of meat per minute, making them the most effective of all vertebrate scavengers. Their acidic stomachs allow them to consume diseased animal carcasses without any harm to themselves. This unique function makes vultures essential for recycling matter in an ecosystem as well as reducing the spread of diseases like anthrax, rabies and tuberculosis and bacteria.

Vultures also prevent other scavengers from spreading disease. For example, in 2006, vultures in India, Pakistan and Nepal fed on diseased cows treated with an anti-inflammatory medication. This led the vulture population to decline by 96%. Further, the population decline led to an increased population of carrion-eating feral dogs, causing human rabies contraction to skyrocket. This led to approximately 48,000 human deaths.

African Vulture Poisoning in a Human Society

African vulture poisoning, intentional or not, happens more than one might think. An interdisciplinary study conducted by the National Socio-Environmental Synthesis Center (SESYNC) out of the University of Maryland (UMD) by researcher Meredith Gore and collogues from organizations including the Peregrine Fund and the Endangered Wildlife Trust made this clear.

The researchers focused on the Great Limpopo Transfrontier Conservation Area (GLTFCA) in southern Africa. They found that farmers there use herbicides and pesticides as poisons. The chemicals they use often contain substances known to pose environmental and human health risks. However, farmers lace water and dead animals with these poisons to kill large predators that attack their livestock. Some also target large herbivorous animals like elephants that may trample or otherwise damage their crops. Although outside the intended purview of these poisons, vultures die as a result of consuming the victims after they die.

The researchers also found intentional African vulture poisoning by poachers, predominantly in eastern Africa. Circling vultures can signal the death of a protected animal to law enforcement, so poachers may lace a carcass with poison to kill the birds as a self-protective measure. More than 500 vultures may feed on and die from a single poisoned elephant carcass. Gore and her collogues believe that a solution to African vulture poisoning will rely on collaboration between local agencies, non-profits and science and criminology experts. They propose several measures to reduce poisoning.

Ending African Vulture Poisoning

First, the researchers recommend increasing efforts to stop African vulture poisoning. These may include licensing and certification of the sale of chemicals used to poison vultures, campaigns to raise awareness on safe handling and disposal of chemicals and diligent tracking of chemical movements. They also recommend increasing the risks associated with intentional African vulture poisoning. This could include creating a phone number and reward system to alert authorities to vulture poisoning and aiding local organizations’ abilities to enact preventative vulture poisoning measures.

Furthermore, the researchers suggest reducing rewards related to vulture poisoning. This could mean withholding livestock and crop damage compensation when farmers poison vultures. Similarly, the researchers endorse provocation reduction measures like education about non-poisonous measures of human-wildlife conflict resolution. They do note, however, that the underlying socioeconomic issues linked to African vulture poisoning include poverty, food insecurity and resource deficits. This means that solving poverty may be key to ending African vulture poisoning. 

The Future of African Vulture Poisoning

Gore and her colleagues also believe that governments should minimize valid excuses for poison use. This may include creating cheap or free chemical disposal programs and responsible corporate buy-back schemes. These would operate in addition to publicized national and regional poison response plans. Finally, the researchers encourage increasing incentives to conserve vultures by prioritizing local conservation efforts that are culturally appropriate and account for traditional and indigenous knowledge.

Without intervention, vulture population decline will lead to the spread of disease and disrupted food chains, both of which have far-reaching ecological and human-health consequences. Fortunately, scientists, criminology experts, community groups, governments and non-profits have a myriad of ways to inspire engaging and effective solutions to reducing African vulture poisoning. By doing so, they will reduce the spread of disease that plagues many African countries.

Avery Saklad
Photo: Unsplash

tuberculosis in madagascar
Madagascar, a country off the southeastern coast of Africa, comprises of tuberculosis cases among its citizens of low socioeconomic status. In 2012, 70.7% of the Malagasy population was living below the poverty line and in 2017, the incidence rate for tuberculosis in Madagascar was 233 cases per 100,000 people. Encouraged and perpetuated by poverty, this disease makes Madagascar the perfect candidate for an outbreak.

Tuberculosis, commonly known as TB, is the most infectious fatal disease in the world. Although it is a very treatable illness, it kills more than 1 million people annually across the globe. The vast majority of TB diagnoses and deaths derive from individuals residing in poor, developing nations.

Risk Factors

Lack of quality living conditions, nutrition and healthcare amplify the risk of getting tuberculosis in Madagascar. Limited access to toilets and handwashing facilities for the majority of Malagasy people have left many at risk. According to CIA World Factbook data, sanitation facility accessibility in Madagascar was unimproved for 88% of the total population in 2015. TB is also the leading cause of death for people with HIV. As of 2018, there were roughly 39,000 Malagasy people diagnosed with HIV but only 20,865 known TB cases that also had documented HIV statuses. Without quality systems in place to document HIV and TB rates across the country, solving the epidemic in Madagascar will not be easy.

The Global Fund Support

The added historical stigma surrounding TB makes matters worse. While already struggling financially, patients often fear that exposing their diagnosis will cause them to lose their jobs. This stigma is combated through support systems like The Global Fund, an organization that provides relief for epidemics through fundraising and education for those affected by TB. The fund’s employees act as a support system, thus debunking the shame that infected patients may feel due to their diagnosis.

In 2018, The Global Fund’s donations and work helped cure 33,000 patients with tuberculosis in Madagascar. For 2020-2022, the organization projects that a total of $18,045,448 will go toward tuberculosis management in Madagascar. In 2017, these funds helped increase Madagascar’s TB treatment success rate to 84%.

Biotechnological Solutions

Although TB is preventable and curable, Madagascar lacks the necessary medical tools to diagnose and treat this disease. Not only are there minimal supplies, but there is also a need to expand and strengthen Madagascar’s ability to analyze TB samples according to Niaina Rakotosamimanana, the head of the mycobacteria unit at the Health Institute of Madagascar.

Researchers from the Health Institute of Madagascar, Stony Brook University and Oxford University are also collaborating to find solutions for this issue. These institutions are working together to grant access to a portable and affordable tool, the MinION. The MinION helps to diagnose and efficiently test the resistance of TB strains to antibiotics, while at the same time being a cheap, affordable option that is accessible to Malagasy people.

Tuberculosis is still one of the top 10 leading causes of death in Madagascar, but the country is making significant progress towards the eradication of the disease. The efforts Madagascar is taking in tracking TB are positive steps that contribute to the fight against this epidemic.

Sophia McGrath
Photo: Pixabay

Benin's Health Care
The Republic of Benin is located in the western region of the African continent. The sub-Saharan country possesses a tropical climate and a population of approximately 12 million people. Benin’s economy highly relies on agriculture. Its production of cotton provides 40% of Benin’s GDP and 80% of its exports. Unfortunately, Benin is an impoverished nation with about one-third of the population living beneath the international poverty line. The citizens of Benin also experience many different issues regarding the handling of healthcare in Benin.

Lack of Resources

As of now, the government spends only 3.3% of the GDP on services relating to healthcare in Benin. The average life expectancy is around 60 years old. However, the infant mortality rate stands at 63 deaths per 1,000 births, while the maternal mortality rate stands at 500 deaths per 100,000 births.

Despite Benin’s relatively large size (about 110,000 square kilometers), there are only four hospitals within the national borders. A survey conducted in 1999 reported that for every 1,000 patients who arrived at hospitals to receive treatment, only 0.1 doctors and 0.2 beds were available. As a result, one of the primary methods to improve Benin’s health care is to hire and train more doctors.

Diseases

The Joint United Nations Program for HIV/AIDS states that anywhere from 38,000 and 120,000 individuals in Benin may be infected with the HIV/AIDS virus. These figures are comparatively lower than in other African countries, but the virus is still spreading among young adults. Waterborne diseases such as tuberculosis, cholera and meningitis have high risks and rates of infection. Typhoid Fever poses a highly dangerous threat in Benin, as only 23% of the population has access to adequate sanitation services. Further efforts need to emerge to improve the quality of drinking water. Until then, the citizens of Benin have to rely on boiling their water to remove bacteria.

Natural Disasters

In 2010, Benin experienced the worst series of flooding that it had seen in decades. The floods affected over 800,000 people and wiped away entire villages. Due to the lack of water clean-up and filtration, people were consuming water that overflowing latrines had contaminated. As a result, reports to hospitals determined that there were nearly 800 new cases of cholera. The disaster prompted the U.N. refugee agency to activate an emergency plan to help those the floods displaced.

Malnutrition

Despite Benin’s current progress in healthcare, child malnutrition still remains a critical marker of poverty and improper healthcare. Assumptions have also determined that over 25% of infants and children younger than 5-years-old suffer or die from malnutrition. However, the government of Benin has recently developed an innovative plan for improving child nutrition.

The new Early Years Nutrition and Child Development Project (EYNCDP) is the first step in a series of three operations that aim toward improving the delivery and quality of selected health and nutrition interventions throughout the country. This first project focuses on integrating early stimulation and learning, primary school feeding programs and policy improvement.

Nonprofit Aid

There is further hope toward improving the lives of the people in Benin. Since 1995, the nonprofit organization CARE has been working on projects to help families in Benin receive improved income and education. For example, CARE has organized programs to combat gender-based violence, provide access to better nutrition and improve Benin’s healthcare.

It also provides aid to communities plagued with frequent flooding. Additionally, CARE grants further assistance by helping local farmers in rural communities improve their income via loan associations. By aiding farmers with their loans and savings, CARE ensures that their families are able to make proper investments, and in turn, can buy better livestock, seeds and farming equipment.

Projects like CARE can go a long way to provide aid to people living in difficult conditions like those in Benin. Through its efforts to aid communities experiencing flooding, healthcare in Benin should improve.

Aditya Daita
Photo: Pixabay

Heart Disease in Bolivia
Bolivia is the second poorest country in South America, performing poorly in education, life expectancy, economic strength and overall development. Most alarmingly, it lacks sufficient medical care due to a limited supply of adequate resources. Bolivia’s unique geography advances its tremendous healthcare challenges, causing children to be 10 times more likely to be born with congenital heart defects. These conditions are nearly impossible to treat without trained cardiologists and updated facilities, two things often inaccessible to most Bolivians. Thus, addressing heart disease in Bolivia is quite challenging as a result of these factors. However, Franz Freudenthal, inventor and cardiologist, is improving medical care with a simple technique that utilizes an indigenous hobby to heal holes in hearts.

What is PDA?

Patent Ductus Arteriosus (PDA) is a common congenital heart defect, particularly prevalent in certain parts of Bolivia. The defect is caused by an opening between two major blood vessels traveling away from the heart. The opening is crucial to a baby’s circulatory system before birth, but it should close almost immediately upon exiting the womb. PDA cases, however, present holes in the heart that remain open. Although the exact cause of congenital heart defects like PDA is typically unclear, decreased oxygen levels have a direct impact on fetal heart health. Because La Paz, Bolivia sits at 3,600 meters above sea level, where the atmosphere has lower oxygen levels than most parts of the world. Therefore, Bolivia’s altitude is the likely cause of irregular blood. Also, the mother’s inability to provide appropriate oxygen levels to her child can result in severe complications.

Breathlessness and failure to thrive are the most common symptoms in mild cases, but fatigue and failure to gain weight can also occur because harmed hearts must work three times harder to pump blood than healthy hearts. Children with severe cases of PDA are at a higher risk for pulmonary hypertension, arrhythmias, infective endocarditis, anticoagulation and congestive heart failure. However, each of these symptoms can be relieved by skilled women in the Andes Mountains’ high plains.

Ingenuity to Fight Heart Disease in Bolivia

Aymara women have been knitting clothes and blankets for centuries, but with help from Franz Freudenthal, they are now knitting heart-closure devices to mend PDA. The Nit Occlud is a hi-tech medical advancement modeled after an occluder, an industrially-produced device intended to block holes in babies’ hearts. Unlike a normal occluder, the Nit Occlud’s design cannot be mass-produced due to its intricate design. Therefore, Freudenthal had to search for an alternative production plan. The perfect method, he soon found, was the wonderful weaving skills of the Aymara women.

The Nit Occlud is composed of a super-elastic metal known as nitinol, a nickel-titanium alloy capable of memorizing its own shape. After a doctor inserts the device through the body’s natural channels, it travels through blood vessels, expands to its original shape, plugs the heart’s hole and permanently restores basic cardiac functionality.

Typical treatments for PDA include surgical procedures, cardiac catheterizations, or heart transplants, but these are not available Bolivia and are not welcomed by the Aymara people. Even though the Aymara people have recently adopted Catholicism, they still believe in the power of the Andes Mountains spirits and their effects on human souls. Keeping in mind that manipulating a heart – performing open-heart surgery or a transplant – is considered desecration according to the spirits, Freudenthal created a minimally invasive innovation to respect patient beliefs and to “make sure that no child is left behind.”

Making Impact

Although congenital heart defects remain the fourth leading cause of premature deaths in Bolivia, the rate has dropped 36% since 2007. Freudenthal’s Nit Occlud has saved more than 2,500 children in nearly 60 countries after experiencing immense success in Bolivia. The country is also succeeding in its fight against poverty. The number of Bolivians living on less than $3.20 a day is projected to decrease by 35% in the next 10 years. Additionally, more children are being vaccinated and more prenatal care opportunities are becoming available to mothers. With these advancements in healthcare and poverty reduction, the economy will soon flourish and rates of heart disease in Bolivia are sure to drop .

Natalie Clark
Photo: Flickr

Tuberculosis in BangladeshTuberculosis (TB) is an airborne disease; common symptoms include cough with sputum and blood in some cases, chest pains, weakness, weight loss, fever and night sweats. TB can lead to the death of an infected person when left untreated. According to the World Health Organization (WHO), TB has caused about 2 million deaths worldwide, and 95% of deaths were recorded in developing countries. Bangladesh ranked sixth among high TB burden countries. The National Tuberculosis Control Programme (NTP) has attained more than 90% treatment success and more than a 70% case detection rate. Despite these successes, tuberculosis in Bangladesh remains a serious public health problem.

Reasons for Higher Infection of Tuberculosis in Bangladesh

  1.  Delays in the Initiation of Treatment: Patients in Bangladesh often receive late treatment. Delays in treatment increase chances of negative treatment results, death and community transmission of TB. A study on 1,000 patients reported that, on average, there were 61 days of delay in the treatment of women and 53 days of delay in the treatment of men.
  2.  Role of Informal Health Practitioners: Most of the impoverished people in Bangladesh prefer to go to their local practitioners due to the ease of accessibility and low cost. A recent survey showed that approximately 60% of the Bangladesh population prefers to go to these uncertified doctors. However, such doctors typically lack formal training. This may lead difficulties in accurately diagnosing and treating TB.
  3. Lack of Awareness: Directly observed treatment short-course (DOTS) has been recognized as one of the most efficient and cost-effective approaches for treating TB. In 1998, the DOTS program became an integrated part of the Health and Population Sector Programme. The inclusion of the DOTS strategy in the Programme helped TB services transition from TB clinics to primary level health facilities. These health facilities typically incorporate GO-NGO (government-organized non-governmental organization) partnerships, and the NGOs have advocated for work on literacy, social awareness along and health care development. As part of the Health and Population Sector Programme, DOTS is freely available to the public. Unfortunately, many remain unaware of the treatment option.  As a result, detection of new TB cases has stagnated at around 150,000 cases per year since 2006.
  4. Poverty: A large portion of the country is still suffering from poverty. Poverty can often lead to overcrowding and poorly ventilated living and working conditions. People with less income also cannot afford food, leading to higher incidences of malnutrition. The culmination of these factors typically make the impoverished population more vulnerable to contracting TB.

The Effort to Combat TB

Tuberculosis is a major public health problem in Bangladesh. However, continuous efforts by the NTP and various NGO organizations have played an important role in decreasing the spread of the disease. DOTS, for instance, demonstrated a 78% cure rate in 1993. Due to its success, a phase-based treatment plan was implemented in 67 million rural populations in 1996.  Since implementation, the NTP has attained a 90% treatment success rate. Further efforts to combat the disease include development of the FAST program (Find cases Actively, Separate safely and Treat effectively). The program intends to detect active TB cases and decrease spread of the disease in healthcare facilities. However, despite efforts by the NTP and a number of NGOs, significant delays in care-seeking and treatment initiation still exist as major hindrances to the program’s goals. 

Challenges to TB Programs

Tuberculosis in Bangladesh kills more than 75,000 people every year. Despite free services like DOTS and other NTP programs, limited access to quality service, lackluster funding and insufficient screening prevent adequate detection and treatment of the disease. The lowest quartile of the population is still five times more likely to contract TB, potentially due to a lack of awareness of TB-treatment programs among the general public. Adding to the problems for TB programs, private health professionals are typically inactive in national programs. While NTP programs have made progress in addressing the disease, these challenges persist, and tuberculosis remains a major health problem in Bangladesh.

Solutions

To stop the growth of tuberculosis in Bangladesh, community organizations such as the Bangladesh Rural Advancement Committee (BRAC) have shown impressive results in lowering the percentage of those afflicted by TB. Effective treatment of TB includes investment in medicine, local health services and diagnostics. To ensure full recovery, social protection of patients is also required. Multidrug-resistant TB (MDR-TB), for instance, requires two months of drug treatment and a four month continuation period. If treatment programs can satisfy requirements investment and social protection requirements, the chance of curing TB patients reaches 92%. The application of a more successful method will help in curing the most complex TB cases, such as drug-sensitive TB, with improved results. With the implementation of proper and effective treatment strategies, we can eliminate tuberculosis in Bangladesh and the benefit even the poorest members of society.

– Anuja Kumari

Photo: Pixabay

Trypanosomiasis in the Central African Republic
Trypanosomiasis, a parasitic infection that is transmittable to humans through bites from the tsetse fly, is an illness common only among those living in sub-Saharan Africa. People living in rural areas and those who depend on agriculture, hunting or fishing for their food are most exposed to the infection. Poverty, war and failed healthcare systems can contribute to the spread of trypanosomiasis. Proper diagnosis requires a skilled staff and early treatment can help prevent the infection from worsening. The Central African Republic (CAR) has the highest number of cases of the disease in the world. Trypanosomiasis in the Central African Republic is a pressing health issue, which demands sustained funding for treatment and medical training.

About the Infection

Also known as human African sleeping sickness, trypanosomiasis is most prevalent in the 36 sub-Saharan African countries, including the CAR. There are two types of trypanosomiasis. Depending on which parasite causes the disease, an infected individual could have Trypanosoma brucei rhodesiense or Trypanosoma brucei gambiense (the more common of the two). If an individual becomes sick with the latter, symptoms can go unnoticed for months or years before the infection begins to affect their central nervous system. Symptoms include fever, headaches, confusion, poor coordination and irregular sleep patterns. Transmission of trypanosomiasis can occur from mother to child, a tsetse fly bite or sexual contact with an infected person.

If trypanosomiasis goes untreated, an individual can experience worsening symptoms and can eventually enter a coma — hence the infection’s nickname (sleeping sickness). People in the CAR are especially susceptible to contracting the disease from doing agricultural work. Much of the population of the CAR lives in rural areas, depending heavily on subsistence farming to survive. More than 55% of the nation’s GDP stems from agriculture and 80% of the workforce is in the farming industry. Since citizens are dependent on farming and hunting for their food, they are at a higher risk of exposure to the tsetse fly and thus, have an increased rate of contracting trypanosomiasis.

Treating Trypanosomiasis

Infected individuals’ symptoms often go unnoticed or untreated. The CAR’s political climate, high poverty rate and lack of proper healthcare centers all facilitate the spreading and worsening of the infection. As of 2018, more than 71% of the population lived below the world’s poverty level, meaning that medical staff and treatment were inaccessible to most citizens living with trypanosomiasis in the Central African Republic. The country is also recovering from the violence of late 2013, which left many hospitals and offices ransacked or closed. Due to these various factors, citizens suffering from trypanosomiasis in the Central African Republic have few options for testing and medication.

There is one well-known medication that can treat the disease, called nifurtimox-eflornithine combination therapy (NECT). Though NECT can significantly help patients with trypanosomiasis, the treatment includes multiple injections and close monitoring of the symptoms — both of which are usually unavailable or difficult to follow through to completion.

The Good News

However, with combined efforts from the government and other organizations, more patients suffering from the illness are receiving treatment. With help from the World Health Organization (WHO), CAR’s government is monitoring the cases and number of deaths from trypanosomiasis and working to provide more clinics, healthcare professionals and medication. The WHO and CAR’s health sectors aim to eliminate transmission of the disease by 2030. With only 997 cases and 164 deaths reported in 2018 (the lowest number in the 80-year battle with the disease), the CAR is on track to reach this goal partially due to consistent outside aid.

One notable international organization, Médecins San Frontières, mobilizes doctors and nurses throughout the CAR to provide free diagnoses and medication for those who have trypanosomiasis. Citizens are made aware of the free medical care and the organization can screen thousands of patients.

Over the next few years, help from organizations like the WHO and Médecins San Frontières can lead to adequate testing and medication for citizens with trypanosomiasis in the Central African Republic. It is imperative that organizations and countries in a position to help — contribute trained medical staff, funding and medicine to aid in the CAR’s fight against trypanosomiasis.

Danielle Kuzel
Photo: Flickr

Documentaries About Healthcare
During quarantine, many people resort to watching Netflix shows and movies. Though the pandemic has freed up more time for binging meaningless films, one can also use this time to learn about how impoverished countries are handling the COVID-19 pandemic. While documentaries have a reputation for being boring, many documentaries about healthcare are the opposite. Here are five documentaries about healthcare around the world.

1. “The Final Inch” (2009)

Rating: PG-13

Where to Watch: HBO

In the late 2000s, polio spread through India, Pakistan and Afghanistan. “The Final Inch” focuses on efforts to eradicate polio in these countries (it has since seen elimination in India, but there are ongoing efforts to reduce the numbers in Pakistan and Afghanistan). Produced by the philanthropic division of Google, this documentary aims to increase awareness of the outbreak of polio in these countries and the efforts of healthcare workers to eradicate the disease. This documentary follows numerous workers and volunteers in their efforts to administer the polio vaccine in these vulnerable places. While dangers arose in Afghanistan while filming, this documentary about healthcare provides a raw outlook on the polio epidemic and its effects on these countries.

2. “Sicko” (2007)

Rating: PG-13

Where to Watch: Amazon Prime Video

Directed by Michael Moore, “Sicko” is a political documentary that investigates healthcare in the United States. Centered around the American pharmaceutical industry, this film compares the non-universal U.S. healthcare system to systems in Canada, France and Cuba. “Sicko” follows Moore’s journey to understand the difference in how the United States and other countries around the world handle the same problems. Moore considers issues of health insurance and money, revealing horror stories behind healthcare policies. Moore effectively combines tragedy and comedy in this raw film and exposes the truth behind American healthcare. 

3. “Living in Emergency: Stories of Doctors Without Borders” (2008)

Rating: Unrated

Where to Watch: Amazon Prime Video

Doctors Without Borders is a nonprofit organization that provides medical care in impoverished countries around the world. Set in the Congo and post-conflict Liberia, Oscar-nominated documentary “Living in Emergency” follows four doctors and their efforts to provide emergency medical care to the public. Through the chaos, this documentary about healthcare follows these volunteers as they confront many challenges and make tough decisions. The doctors often face limited resources, personnel and poor living conditions. “Living in Emergency” provides a new, more realistic perspective for those privileged enough to access proper healthcare.

4. “Period. End of Sentence” (2018)

Rating: TV-PG

Where to Watch: Netflix

While menstruation is a shared experience across the world, it is a taboo topic in India. In rural communities in this country, sanitary products are out of reach, as proper healthcare is often available only in urban areas. “Period. End of Sentence” follows a group of women in the Harpur district outside of Delhi, India as they create sanitary products. Throughout the film, these women not only learn how to produce pads, but they also rid their community of stigma against menstruation. Nominated for an Oscar, this documentary about healthcare in India has severely changed the view on periods in healthcare systems and rural communities as well. Beyond changing the way people view menstruation, “Period. End of Sentence” has also yielded significant praise as a documentary.

5. “Cervical Cancer in Uganda: Three Perspectives” (2014)

Rating: Unrated

Where to Watch: YouTube

In sub-Saharan Africa, the most prominent form of cancer is cervical cancer. Research from the National Center for Biotechnology Information concludes that cervical cancer causes the most cancer-related deaths in Uganda. While cervical cancer is common in this country, however, it does not get mainstream attention. This documentary follows Sascha Garrey as she travels through the country to understand the prevention and treatment options for women in Uganda. Produced by the Pulitzer Center, this documentary on healthcare educates viewers on cervical cancer and its prevalence in impoverished countries.

While these five documentaries may not all be the most recent, watching them during the pandemic can provide valuable insight into healthcare in impoverished countries. Instead of watching mindless films to pass the time, consider watching an informative and interesting documentary about healthcare conditions around the world.

Aditi Prasad
Photo: Flickr

Tuberculosis in BotswanaBotswana is a southern African country with just over 2 million residents living inside its borders. Every Batswana lives with the threat of tuberculosis, an infectious disease that remains one of the top 10 causes of death on the African continent. Tuberculosis has a 50% global death rate for all confirmed cases. Investing in tuberculosis treatments and prevention programs is essential. Botswana has one of the highest tuberculosis infection rates in the world with an estimated 300 confirmed cases per 100,000 people, according to the CDC. Preventative and community-based treatment shows promise in combating tuberculosis in Botswana.

Treating Tuberculosis in Botswana

Tuberculosis treatment cures patients by eliminating the presence of infectious bacteria in the lungs. The first phase of treatment lasts two months. It requires at least four separate drugs to eliminate the majority of the bacteria. Health workers administer a second, shorter phase of treatment to minimize the possibility of remaining bacteria in the lungs.

Early identification of tuberculosis is a crucial step in the treatment process and significantly reduces the risk of patient death, according to the Ministry of Health. Preventative treatment methods are vital because they inhibit the development of tuberculosis infection. They also reduce the risk of patient death significantly.

Health workers detect tuberculosis with a bacteriological examination in a medical laboratory. The U.S. National Institutes of Health estimate that a single treatment costs $258 in countries like Botswana.

Involving the Community

Botswana’s Ministry of Health established the National Tuberculosis Programme (BNTP) in 1975 to fight tuberculosis transmission. The BNTP is currently carrying out this mission through a community-based care approach that goes beyond the hospital setting. Although 85% of Batswana live within three miles of a health facility, it is increasingly difficult for patients to travel for daily tuberculosis treatment. This is due to the lack of transportation options in much of the country.

Involving the community requires the training and ongoing coordination of volunteers in communities throughout the country to provide tuberculosis treatment support. Community-based care also improves treatment adherence and outcome through affordable and feasible treatment.

The implementation of strategies such as community care combats tuberculosis. For example, it mobilizes members of the community to provide treatment for tuberculosis patients. The participation of community members also provides an unintended but helpful consequence. For example, community participation helps to reduce the stigmas surrounding the disease and reveals the alarming prevalence of tuberculosis in Botswana.

A Second Threat

In addition to the tuberculosis disease, the HIV epidemic in Africa has had a major impact on the Botswana population, with 20.3% of adults currently living with the virus. Patients with HIV are at high risk to develop tuberculosis due to a significant decrease in body cell immunity.

The prevalence of HIV contributes to the high rates of the disease. The level of HIV co-infection with tuberculosis in Botswana is approximately 61%. African Comprehensive HIV/AIDS Partnerships (ACHAP), a nonprofit health development organization, provides TB/HIV care and prevention programs in 16 of the 17 districts across the country in its effort to eradicate the disease.

Fighting Tuberculosis on a Global Scale

The World Health Organization (WHO) hopes to significantly reduce the global percentage of tuberculosis death and incident rates through The End TB Strategy adopted in 2014. The effort focuses on preventative treatment, poverty alleviation and research to tackle tuberculosis in Botswana, aiming to reduce the infection rate by 90% in 2035. The WHO plans to reduce the economic burden of tuberculosis and increase access to health care services. In addition, it plans to combat other health risks associated with poverty. Low-income populations are at greater risk for tuberculosis transmission for several reasons including:

  • Poor ventilation
  • Undernutrition
  • Inadequate working conditions
  • Indoor air pollution
  • Lack of sanitation

The WHO emphasizes the significance of global support in its report on The End TB Strategy stating that, “Global coordination is…essential for mobilizing resources for tuberculosis care and prevention from diverse multilateral, bilateral and domestic sources.”

– Madeline Zuzevich
Photo: Flickr