Information and news about disease category

Malawi Eliminated Trachoma
According to the World Health Organization (WHO), Malawi is among 15 countries that recently eliminated trachoma. Presently, trachoma is one of the 20 most dangerous neglected tropical diseases identified by WHO. The eradication of trachoma has been a 12-year process by the Malawi government and non-governmental organizations. Here are all the facts about how Malawi eliminated trachoma and the lessons from their success in global health.

The History of Trachoma and Malawi

During the last 20 years, people at risk of blindness from trachoma decreased from 1.5 billion to 125 million. However, trachoma remains a severe health problem for more than 35 countries throughout the poorest regions of Central and South America, Asia and Africa. Specifically, trachoma disease is most prevalent in Africa, representing 84% of the worldwide concentration.

In Malawi, trachoma became endemic during the 1980s. But the government ignored the disease until 2008 when WHO and Sightsavers implemented surveys in the country. Afterward, the government of Malawi noted that 7.6 million people could contract trachoma in 2015.

The Path to the Eradication of Trachoma in Malawi

In 1996, WHO created the Global Elimination of Trachoma by 2020. The plan defined the elimination of trachoma as less than 2% in adults ages 15 or older and only one case per 1,000 people. According to WHO, the project targeted children ages 1 to 9  years old to obtain less than 5% infection. Specifically, Malawi was among the key 25 African countries in the project for the elimination of trachoma.

The effects of trachoma were especially life-threatening for millions of children in Malawi and caused financial instability for their families. However, between 2013 and 2015, the Malawi Ministry of Health mapped and targeted 25 districts most at risk of developing trachoma. The Malawi Ministry of Health used the Global Trachoma Mapping Project guidelines to establish the most endemic districts, which totaled about 9 million people. There were six districts, as the Malawi Ministry of Health reported, but none had surgery services. Lastly, in the Mchinji district, the disease prevalence was 21.3% for children ages 1 to 9 years old.

The Solution

In 2022, the Malawi Ministry of Health eliminated trachoma through SAFE, a strategy that WHO recommended. Furthermore, the Sightsavers organization and the Queen Elizabeth Diamond Jubilee Trust partly organized and funded the strategy. The SAFE strategy includes surgery to stop eyelashes from scrapping the eye, antibiotics, facial cleanliness and environmental improvements, according to Uniting to Combat NTDs.

As a result, trained local surgeons treated more than 6,000 cases of trachoma and volunteers distributed more than 22 million drug treatments that Pfizer donated. They supported more than 250 schools to improve hygiene and sanitation in their community. Lastly, Malawi is one of the first countries to adopt the Kigali Declaration on neglected tropical diseases, strengthening their political commitment to eradicate the disease.

A Victory for the People

The eradication of trachoma represents a victory for the people and government of Malawi. However, many lives did not survive in time along the path to find the solution. Still, the complete elimination of the disease represents the effectiveness of collaboration among international efforts.

The Malawi Ministry of Health, WHO, nonprofit organizations and the willingness to adopt the SAFE strategy demonstrate the value of continual support for these international organizations by high-income countries and individuals.

– Andres Valencia
Photo: Flickr

Schistosomiasis in Tanzania
The World Health Organization (WHO) considers schistosomiasis “a disease of poverty.” Schistosomiasis is categorized as a neglected tropical disease (NTD) as it primarily affects tropical locations “where people do not have access to clean water or safe ways to dispose of human waste.” Schistosomiasis is “highly endemic” in Tanzania — it has the second highest number of cases in sub-Saharan Africa behind Nigeria. As a result, efforts are underway to help counter the spread of this disease.

The Background

Schistosomiasis, more commonly known as bilharzia, is an infectious disease that affects around 240 million individuals globally, according to WHO. After malaria, bilharzia is the second most devastating illness that parasites cause, the Centers for Disease Control and Prevention (CDC) says. WHO says “infection is prevalent in tropical and sub-tropical areas, in poor communities without potable water and adequate sanitation.”

A person can become infected when the skin comes into contact with freshwater contaminated with Schistosoma parasites. More significant signs of infection, such as fever and muscle aches, begin within one or two months. “Symptoms of schistosomiasis are caused by the body’s reaction to the eggs produced by worms, not by the worms themselves,” the CDC says. This immune reaction can cause damage to the organs and bring about other health issues.

There are two main forms of the disease: intestinal and urogenital. Children who become infected with these parasites several times “can develop anemia, malnutrition and learning difficulties.” Furthermore, “after years of infection, the parasite can also damage the liver, intestine, lungs and bladder,” according to the CDC.

Chronic schistosomiasis arises when the parasites remain in the body for a long time and the body produces immune responses against the parasitic eggs once they reach body tissue. Cases of chronic schistosomiasis in Tanzania are common and may limit people’s capacity to work.

Past and Current Epidemiology

During the 70s and 80s, Tanzania noted a pressing need to build new irrigation systems and dams to provide clean water for the growing population. However, these innovations had a negative effect on the expansion of the disease since schistosome parasites that live inside snails grow optimally in fresh water. Furthermore, the prevalence of the disease seems to rise as the country’s population size expands. In Tanzania, in 1977, the prevalence rate stood at 19% but swelled to 51.5% (more than 23 million people) by 2012. In 2019, around 15 million people in Tanzania required treatment for schistosomiasis in Tanzania.

Efforts to Tackle Schistosomiasis in Tanzania

WHO recommends “large-scale treatment of at-risk population groups, access to safe water, improved sanitation, hygiene education and snail control” to adequately address schistosomiasis. WHO endorsed treatment for the disease involves the administration of an anti-parasite drug known as praziquantel. In Tanzania, praziquantel is distributed on a large scale to schools and communities.

According to WHO, Tanzania received approximately 33 million praziquantel treatments for mass administration from 2009 to 2018, with a focus on school children.

Thanks to the Zanzibar Elimination of Schistosomiasis Transmission (ZEST) program, which took place from 2011 to 2017, the prevalence of the disease was reduced. Among children aged 9-12, prevalence decreased from 6.1% to 1.7%, while among adults aged 20-55, prevalence decreased from 3.9% to 1.5% by 2017. This successful project, launched by the Zanzibar government, mainly focused on the distribution of praziquantel twice a year, snail control measures and behavioral adjustments among the populace.

However, knowledge about the disease and how to prevent or treat it is integral for reducing future cases. Many people still do not have access to treatment and others prefer not to take the treatment due to a lack of information. This, added to the fact that one can become reinfected, shows why control is difficult. For example, in Mtama, a city that belongs to the Lindi region in Tanzania, the prevalence of the disease is still more than 50%. This is due to a lack of knowledge, interrupted access to praziquantel and unhygienic water practices, among other reasons.

WHO Guideline

In February 2022, WHO released a guideline for the control of schistosomiasis in affected nations. The guideline covers several evidence-based recommendations, including:

  • Snail control measures to decrease transmission risks.
  • Water, sanitation and hygiene efforts in approaches to control the disease.
  • The “expansion of preventive chemotherapy to all in need, including adults and preschool-aged children.”

Schistosomiasis in Tanzania is still a problem that affects a large part of the population, despite the control systems implemented throughout the years. In a country with a population of about 58 million in 2019, 15 million people required treatment for this disease. Implementing comprehensive measures will safeguard the well-being of citizens in an endemic country.

– Carla Tomas
Photo: Flickr

Diseases Impacting Burkina Faso
The World Bank has reported that more than 40% of the people in Burkina Faso live in poverty. In general, developed countries have longer life expectancy rates as these nations have higher standards of living, better access to health care and other resources that influence health. Statistics from 2018 place the life expectancy in Burkina Faso at 60 years. According to data from 2019, the top three diseases impacting Burkina Faso are malaria, lower respiratory infections and neonatal disorders. Malnutrition, air pollution and inadequate water, sanitation and hygiene (WASH) facilities made up the top three risk factors that influenced both death and disability in Burkina Faso in 2019.

Top 3 Diseases Impacting Burkina Faso

  1. Malaria. Malaria, transmitted through the bite of the Anopheles mosquito, is endemic in Burkina Faso — the World Health Organization (WHO) reports that Burkina Faso had 12.4 million malaria cases and more than 29,100 malaria-related deaths in 2020 alone. In 2018, according to the Ministry of Health, malaria caused 66% of deaths among children under 5. Burkina Faso forms part of the 10 sub-Saharan African countries with the highest burdens of malaria, the WHO reports.
  2. Lower respiratory infections. These types of infections include pneumonia, bronchitis and tuberculosis. Air pollution, common in developing countries, can contribute to lower respiratory infections and overcrowded environments allow for these diseases to spread faster. Specifically, in 2020, the World Bank reported 46 cases of tuberculosis per 100,000 people in Burkina Faso, down from 70 in 2000.
  3. Neonatal disorders. According to the WHO, most neonatal mortalities occur in developing countries. Furthermore, “neonatal infections are primarily bacterial in origin and include pneumonia, sepsis and meningitis.” UNICEF data indicates that the neonatal mortality rate in Burkina Faso in 2020 stood at 26 deaths per 1,000 live births while the infant mortality rate stood at 53.

Other Diseases Impacting Burkina Faso

Another disease impacting Burkina Faso is HIV/AIDS. In 2021, UNAIDS notes 88,000 HIV infections among adults and children in Burkina Faso. In particular, UNAIDS noted 6,100 HIV cases among children between the ages of 0 and 14. Particular groups are most at risk. In 2017, sex workers had an HIV prevalence rate of 5.4% while the prevalence rate for prisoners stood at 2.2% and 1.9% for men who have sex with men.

Initiatives to Reduce the Impact of Diseases in the Country

The Centers for Disease Control and Prevention (CDC) has partnered with Burkina Faso’s Ministry of Health since as early as 1991. Initially, the CDC provided support to address polio outbreaks across the nation. The CDC then expanded its efforts to cover other diseases preventable through immunization, such as measles and meningitis. The CDC set up an office in Burkina Faso in 2016, “focused on strengthening the country’s ability to prevent, detect and respond to public health threats and to strengthen the country’s capacity in surveillance, laboratory systems, workforce development and emergency management,” a CDC factsheet says.

All in all, the CDC has given 17 million doses of polio vaccines and 2.4 million doses of measles vaccines to children under 5 in Burkina Faso. The CDC has also provided support to immunize more than 12 million Burkinabe people against meningitis. “National diagnostic capacity” across laboratories now allows lab technicians to test for a minimum of 40 pathogens., including “10 priority pathogens.” These priority pathogens include influenza, Mycobacterium tuberculosis and HIV.

The fight against diseases impacting Burkina Faso is one of the country’s priorities. The country has made progress in terms of health, but, continued aid is necessary to further strengthen the healthcare system and implement preventative disease control measures.

– Elena Luisetto
Photo: Flickr

Aboriginal Community
In a remote area in north-west Queensland Australia, there have been reported deaths of members of the Aboriginal community. An illness known as rheumatic heart disease (RHD) is claiming the lives of those living in this small population. RHD is an entirely preventable disease that rarely exists among Australians.

Who Contracts the Disease?

Rheumatic heart disease develops as a fever called rheumatic fever that worsens over time. Statistically, young children are most at risk of contracting the disease. Aboriginal cultural consultant Janelle Speed addressed the prevalence of the disease among aboriginals in the Australian Journal of General Practice: “Aboriginal and Torres Strait Islander people in Australia have the world’s highest rates of acute rheumatic fever [ARF]/RHD.”

Symptoms of RHD

An untreated strep throat infection can lead to acute rheumatic fever and can cause irreparable damage to the major cardiac valves causing rheumatic heart disease. Of the more than 5,000 people living with RHD in Australia, 71% are Aboriginal and Torres Strait Islander people. Without the proper diagnoses and treatment, 8,667 Aboriginal and Torres Strait Islander people could develop ARF/RHD by 2031. This could lead to 1,370 severe cases of RHD and 663 to die.

Curing Rheumatic Heart Disease

The Federal Government hopes to eliminate RHD by 2030, however, the Australian Institute of Health and Welfare figures show the disease continues to increase in prevalence. People with RHD normally require ongoing medical care, antibiotic treatment and possibly cardiac surgery. By 2031, it will cost an estimated $273.4 million in medical care to treat the disease.

RHD Research

The End Rheumatic Heart Disease Centre of Research Excellence began its journey in 2014 to provide a robust plan to eradicate RHD in Australia.

Recently, The Queensland Health Minister, Yvette D’Ath, allocated $7.3 million to further research and planning for RHD. Former Federal Health Minister, Greg Hunt, issued a statement claiming, “Working in genuine partnership through shared decision-making and co-design with the Aboriginal community-controlled sector is critical and is the foundation of the new approach to the Government’s Rheumatic Fever Strategy commencing this year [2021–22].”

Hunt also said that the country will spend $25 million on supporting strategies to prevent RHD including an additional $12 million for activities aimed at preventing RHD throughout the country. Moreover, the University of Western Australia is working to develop a Strep A vaccine that will hopefully “accelerate the elimination of RHD.”

Solutions

In order to prevent the progression of ARF into RHD, it is necessary to improve the early and accurate diagnosis of ARF and the delivery of secondary prophylaxis.

The collective experience of clinicians, Aboriginal Community Controlled Health Organizations, government and non-government organizations, and research, means the knowledge now exists to permanently eliminate rheumatic heart disease in Australia.

– Kiara Finch
Photo: Picryl

Urban Diseases
People generally consider non-communicable diseases “urban” diseases due to the fact that they usually occur among older people who live in generally more developed and urban areas. According to the World Health Organization (WHO) in 2019, NCDs accounted for seven of the top 10 causes of death in the world. This study by WHO, which analyzed data from 2000 to 2019, observed a rise in deaths from cardiovascular diseases, diabetes and other NCDs. The study also showed that heart disease is killing more people over the years, with almost 9 million deaths from heart disease in 2019. Deaths as a result of diabetes have also increased by 70%.

In general, many consider NCDs to be more frequent in urban settings and often overlook them in refugee camps where the primary concern is communicable diseases arising from poor hygiene or diet. However, refugee camps such as the Mahama refugee camp in Rwanda are seeing a sharp increase in NCDs and are struggling to deal with this rising challenge.

The Case of Mahama Refugee Camp in Rwanda

The Mahama refugee camp in Rwanda is experiencing a sharp rise in cases of NCDs among refugees, as The Guardian reported that more than 1,200 people have been registered with NCDs by the camp’s health centers. The medical team continues to see new cases each month as well. The camp, which the UNHCR estimated houses around 47,700 refugees as of 2021, is facing increasing difficulties with this sudden onslaught of urban diseases.

In an interview with The Guardian, Dieudonne Yiweza, a senior regional public health officer for the UNHCR said that “Before, we could see (NCDs) were affecting older adults and elderly people. Now, they are affecting children and young people.” Yiweza also reported that patients between the ages of 10 or 15 were having strokes. Due to refugee camps already being low in supplies, professionals often overlook such cases until they cause serious disabilities. The limited resources, as Yiweza said, mean that health centers at the camp do not have the training to deal with such cases.

According to The Guardian’s profile on the camp, one of the reasons for this rise in urban diseases is simply the limited housing and bad diet at the camps. One community health supervisor, Liliose Mukankuranga, told The Guardian that “These people don’t have anything. They are sick but there’s no support and they have nothing to eat.” Poor diet combined with the living conditions of displaced individuals can all greatly increase the probability of contracting NCDs. Moreover, due to the unexpected nature of NCDs developing in refugee camps where the primary concern has always been communicable diseases, medical facilities are either underprepared or simply unaware.

Solutions

One medical doctor at the Mahama camp told The Guardian, “When people develop complications, they cannot afford care on their own. The interventions are very expensive. We need to be here raising awareness, starting treatment early to prevent complications.” The fact that many refugee camps do not receive enough funding and only have what they need to deal with communicable diseases means that medical professionals often overlook any presence of NCDs.

Some headway is occurring, as the UNHCR introduced Community Based Health Insurance (CBHI) for urban refugees in 2019. The program aims to provide financial support for refugees to get access to health care facilities. Rwanda has also had prior success with HPV vaccination programs in 2011, as well as being on track to becoming the first country in the world to wipe out cervical cancer with a successful elimination program. Implementing similar policies to address other urban diseases could potentially help millions of refugees living in Rwanda.

Umaima Munir
Photo: Flickr

Diseases Impacting Thailand
Thailand is a country in Southeast Asia, bordering Myanmar, Cambodia, Laos and Malaysia, with a population of 69 million as of 2018. In 2019, Thailand had nearly 40 million tourists with an expenditure of $15 billion, decreasing to just $3.68 billion in 2020 when COVID-19 struck. Since 2006, Thailand’s national poverty line has been steadily decreasing from 21.9% to 6.8%. However, there have been alternate increases throughout the years due to outbreaks of disease where less developed cities have not been able to stay consistent with the national poverty line. Here are the top three diseases impacting Thailand.

The Top 3 Diseases Impacting Thailand

  1. Ischemic Heart Disease. This disease impacting Thailand is a non-communicable cardiovascular disease. Heart attacks or strokes caused 75% of worldwide cases, where there are often no other symptoms. Once diagnosed, there are treatments a person can take to monitor the disease, however, there is no cure. It is the number one cause of death in Thailand and has risen 35% from 2009 to 2019. In 2022, the World Health Organization (WHO) stated that air pollution causes 23% of stroke and ischemic heart disease deaths, where Thailand’s annual mean for pollution is 32 µg/m3, an increase of 27 µg/m3 from the WHO’s guideline of 5 µg/m3.
  2. Chronic Kidney Disease. Diabetes and high blood pressure cause 75% of all chronic kidney disease cases. These illnesses can also cause anemia, weak bones, poor nutritional health and nerve damage. A person may have a higher risk of having chronic kidney disease if they have a family history of kidney failure, are older or have high rates of diabetes and high blood pressure or are African-American or Asian. If the disease is in its early stage, treatment can prevent it from getting worse. However, if the disease has progressed and the kidneys are failing, the individual may need to have a kidney transplant as there is no cure. This is the fourth top cause of death and the second top disease impacting Thailand, which has not decreased since 2009 despite the addressing of other high-ranking causes of death such as road injuries, COPD and HIV/AIDS.
  3. Diarrhoeal Disease. Diarrhea is a deathly symptom of many digestive diseases, which is the fifth top cause of death in Thailand, especially among children and the disease impacts Thailand’s poorer communities. About 74% of Thailand’s population does not have safe sanitation areas. Additionally, drinking unsafe water and poor sanitation areas and personal hygiene have caused 38% of deaths from diarrhea. Having safe food and water to consume, taking zinc supplements or children breastfeeding can reduce the severity of diarrhea. However, if the digestive disease has progressed or salmonella, which is a leading cause of diarrhoeal disease, was the cause, the sufferer will require further treatment.

Looking Ahead

In 2017, the average life expectancy in Thailand for females was 82 and for males, just 74. In 2018, individuals either earned or received and spent a total of $292 on health care, which could increase significantly by 2050. However, from 1990 to 2019, providing effective and essential health services has only improved by 14%, from 57.6% to 71.6% of what satisfiable health services Thailand needs to protect its citizens.

The National Economic and Social Development Plan (NESDP) and the 20-year National Public Health Policy work to improve quality and security and have primarily looked at air pollution, TB control, malaria, HIV/AIDS, teenage pregnancy and unsafe abortions. While the top causes of death have sometimes changed, the policy should now focus on reducing disease due to stressful and unsanitary environments. The tiers currently include antimicrobial resistance, managing the health of the population by focusing on global health and trading, supporting migrant health by strengthening partnerships and services, reducing non-communicable disease by controlling tobacco, reducing childhood obesity and improving services to detect early signs of disease, and finally, improving road safety.

The CDC is currently working with Thailand to put into practice the WHO’s Global Hearts Initiative to reduce non-communicable diseases and death. In addition, the Thai FETP-NCD is researching cardiovascular health and disease in a bid to reduce premature deaths. There are also financial resources available for diarrhoeal disease, but there is only 50% of the support needed, and as it is a communicable disease, this number needs to drastically increase, especially in the summer when deaths rise due to severe heat, illness and disease that tourism helped spread.

Solutions to the Diseases Impacting Thailand

High blood pressure is a sign of stress that could lead to a stroke or heart disease. About 25% of adults from Thailand have hypertension, but almost half are unaware as there are no symptoms. To help irradicate cardiovascular disease, Thailand has set a goal to reduce 25% of hypertension by 2025 and reduce 30% of salt and sodium intake, where the average Thai consumes more than double the daily recommendation, via the Ministry of Public Heath’s 2016-2025 national sodium reduction policy and action plan. The plan focuses on surveillance, raising awareness, research and education for the public and companies so that the production of goods contains less salt and sodium, and people are aware of what and how much they are buying and consuming.

About 11.6 million people in Thailand have chronic kidney disease as of 2020, however, many people struggle to afford a health assessment or the treatment needed to save their life, especially in Northeast Thailand. The Bumrungrad Hospital in Thailand created the Chronic Kidney Disease Program to prevent or delay the disease in order to stop complications. The program involves regular assessments of kidney function, diet-control advice from nutritionists, instruction about self-care and medicine with a handbook, overall health consultation and care and assessments from nephrologists and the hospital’s team.

The third of the diseases impacting Thailand is the most likely disease to affect Thailand’s poorer households. To irradicate diarrhoeal disease, water and sanitation areas require improvement. Thailand is currently planning for all areas to have safe and affordable drinking water, which includes reducing pollution and the dumping of harmful chemicals and materials, adequate sanitation and hygiene areas, particularly for women and girls, water support for nature and the ecosystem and starting international support for other developing nations by 2030.

– Deanna Barratt
Photo: Flickr

Monkeypox in AfricaWhile monkeypox in the United Kingdom hit headlines in May 2022, Africa has a long history of combating the disease and isolating cases. Monkeypox, similar to smallpox, is a zoonotic disease that causes skin lesions, fever and body aches. In endemic countries, 3-6% of reported cases of monkeypox in Africa result in death. Monkeypox is endemic in 10 African countries, often in poor rural areas.

Smallpox only infected humans, making it simpler to eradicate through vaccination. Monkeypox also spreads from animal to human, making it more difficult to control the spread. Vaccines became readily available to non-endemic and wealthier countries this year when monkeypox cases appeared outside Africa, but are still not available to African nations, which have experienced sickness and death due to monkeypox for decades.

Strains of Monkeypox in Africa

Cases of monkeypox, specifically in sub-Saharan Africa, increased in the past 30 years. Several strains of monkeypox plague Africa, the most deadly being the Congo Basin strain that kills 10% of those infected. Despite its deadly nature, the Congo Basin strain has never strayed outside of Africa. Individuals self-isolate when infected to slow the spread. The Democratic Republic of the Congo experienced the most deaths in 2022 with 58 total deaths by June 2022. The West African strain is less deadly, with a mortality rate of 1-3%.

How Monkeypox Spreads

The first known case of monkeypox emerged in 1970 in the Democratic Republic of the Congo. At the same time that scientists were trying to end smallpox, a 9-month-old child appeared to have monkeypox. Despite its name, historically, scientists have only found monkeypox in African monkeys once. It is most commonly contracted by rats and squirrels that live in close proximity to humans.

Monkeypox can spread from human to human by symptomatic infected individuals, such as through contact with bodily fluids and skin lesions. The year 2022 is not the first time monkeypox spread to countries outside of Africa. In 2003, monkeypox entered the United States via infected prairie dogs that came into contact with Gambian pouched rats from Ghana. These dogs, sold to people through pet shops, infected the humans who came into contact with them.

Risk Factors and Treatment

The World Health Organization recommends providing food and fluids to those infected. However,  in the Democratic Republic of the Congo, 57% of residents do not have clean drinking water and 43% of children are malnourished, says Opportunity International.

Monkeypox has a higher mortality rate for the young and immune-compromised. Children infected with monkeypox in Africa have a higher risk of death than adults. During the 2017 monkeypox outbreak in Nigeria, about 57% of residents who died were HIV-positive.

In 2022, the European Medicines Agency (EMA) licensed an antiviral treatment for smallpox, known as tecovirimat, to treat monkeypox. The treatment is not readily available in Africa yet. The vaccine for smallpox is about 85% effective in protecting against monkeypox, additionally, in circumstances similar to the coronavirus vaccine hoarding by wealthier countries, wealthier countries are stockpiling monkeypox vaccines as well.

Reducing animal trade from Africa lowers the risk of creating groups of infected animals in other countries as most cases come from contact with sick and dead animals

Vaccine Inequity

From January 2022 to June 1, 2022, Africa has noted 63 deaths from monkeypox while non-endemic countries have not noted any deaths. In Africa, the sick must isolate and recover without the medications other countries provide to the sick.

Despite a history of inequity, there is hope as organizations work to extend relief to Africa.

Hope for Africa

As of May 31, 2022, Africa reported almost 1,400 cases of monkeypox to the World Health Organization (WHO) for the year 2022.

The WHO is now working with endemic African countries and other relevant parties to “bolster laboratory diagnosis, disease surveillance, readiness and response actions to prevent further infections.” The WHO is also supplying Africa with the knowledge and tools necessary to conduct testing, provide medical treatment and manage infections. The organization is also providing guidance on “how to inform and educate the public about monkeypox and its risks and how to collaborate with communities to support disease control efforts.”

The Jynneos vaccine, approved for use by the United States FDA in 2019, is known to prevent serious and fatal cases of monkeypox. Jynneos is 85% effective at preventing monkeypox cases and is administered in two doses spread four weeks apart. The WHO is working to improve access to the Jynneos vaccine in more countries, including those in Africa. While the history of monkeypox in Africa is long, organizations are working to reverse the course of health inequity often visible during global health crises.

– Sara Sweitzer
Photo: Wikimedia Commons

Shoes Can Eliminate Preventable Diseases
Wearing shoes protects feet from more than just scratches and heat. Shoes can eliminate preventable diseases, many parasitic infections, epidemics and dangerous bug bites. While adults can wear a pair for years, this is not the case with growing children. Because children have a much higher demand for shoes than adults, a few inspiring projects are providing impoverished children with shoes.

Soil-Transmitted Disease

Soil-transmitted diseases are most prevalent among those who cannot afford shoes. By giving shoes to those who are most in need, epidemics that can eventually lead to death can decrease entirely. Many diseases are due to contaminated soil and involve parasites that can cause slow development, organ damage, amputation and even death if left untreated. South America and Sub-Saharan Africa suffer the most from these diseases, and some communities in these areas can be difficult to reach. NGOs and charities similar to Samaritan’s Feet have started to tackle these epidemics at their root. Shoes can eliminate preventable diseases by creating a barrier between contamination and bare feet. By preventing disease instead of medically treating it, the solution and work are cheaper, less invasive and eliminated entirely with enough effort.

Shoes = Opportunity

Infections and parasitic jigger fleas, which require painful treatments, are common in children who do not wear shoes in certain areas. Sometimes a lack of self-confidence or cleanliness can be an even more painful barrier. Shoes can eliminate preventable diseases, offer a safer ability to walk and give many the ability to take the first step in creating a better life. Buckner Shoes for Orphan Souls is a project within Buckner International that understands how being barefoot can prevent many children from attending school and can affect their self-worth.

By providing a pair of shoes for children, family workshops and job training programs for parents, many will eventually no longer rely on the donation program. In addition to the big picture, Buckner believes that a more hopeful future can arise through its program. Children can find a way out of poverty if they have good shoes and the opportunities that come with them.

Innovation and New Solutions

One pair of shoes provides a child with opportunities and foot protection for as long as the shoes fit. By finding a way to lessen the demand for new shoes every time a child grows, this large concern can shrink to one-fifth of its size. The Shoe That Grows™ is a type of shoe that can expand by five sizes so that children can have a single pair of shoes for a longer period of time than usual. The Because International website has stated that “Over 1.5 billion people suffer from soil-transmitted diseases worldwide,” showing the necessity of having good-quality shoes.

Every time children outgrow shoes, the potential of disease exposure increases. However, The Shoe That Grows™ provides shoes that have a longer wear time than other shoes, subsequently taking away the burden of purchasing shoes once a year. The project distributed more shoes for Christmas 2021 than any other year and is looking to continue making the shoes more durable and create jobs with the company’s manufacturers. The Shoe That Grows™ can save families and organizations time and money, providing a better chance of helping more children.

Looking Ahead

Shoes are an unexpected solution to a deadly problem that faces the poorest of the poor. With simple and innovative solutions to bring people the protection they need, this deadly issue has an end goal in sight. Children’s continuous growth can cause difficulties, many organizations are effectively helping these children with a need that will bring physical protection and future opportunity.

Karen Krosky
Photo: Flickr

Monkeypox Outbreak in Africa
As monkeypox cases continue to come on the radar in the U.S. and Europe, wealthier countries are rolling out vaccines and medications to address the issue, bringing to light the inequities Africa faces in response to the monkeypox outbreak in Africa.

What is Monkeypox?

According to the World Health Organization (WHO), monkeypox is a zoonotic disease (transmitted to humans from animals) with symptoms that closely resemble the indications of smallpox, although less severe. The name of the disease, monkeypox, arose “from the initial discovery of the virus in monkeys in a Danish laboratory in 1958.” The first case of monkeypox among humans occurred in the Democratic Republic of the Congo (DRC) in 1970.

Symptoms begin with “fevers, chills, sweats, fatigue and enlarged, tender lymph nodes in the neck and groin.” The next phase involves “a multi-stage rash” that eventually develops into prominent pustules, mostly on an individual’s face, palms and soles of the feet. The disease is generally mild, however, serious illness and mortality can occur.

According to the WHO, the monkeypox virus transmits “from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding.”

Monkeypox Outbreaks

Monkeypox endemic countries fall within Central and West Africa. The first known group of infections to occur outside of Africa happened in 2003 in the United States. The outbreak began as a result of “imported Gambian rats” transferring the virus to prairie dogs. Humans then acquired these dogs as pets, resulting in the infections of 87 children and adults. There were no fatalities but three children endured severe illness.

Before 2022, the United Kingdom, Israel, Singapore and the U.S. noted several isolated cases from travelers who had visited Nigeria. On May 7, 2022, the U.K. noted a case of monkeypox from a traveler returning from Nigeria. As of June 6, 2022, the U.K. and 29 other non-endemic countries have noted more than 550 cases of monkeypox.

Africa Sees Inequity in Monkeypox Response

Health care officials in developed regions have access to vaccines and medicine to steady the progression of the monkeypox outbreaks in these areas. This has brought to light the reality that monkeypox treatment has been available for a long time, yet Africa has struggled without resources to combat this virus for decades.

Africa notes “more than 1,400 monkeypox cases and 63 deaths in four countries where the disease is endemic — Cameroon, Central African Republic, Congo and Nigeria.” As wealthier countries roll out vaccines and antivirals, Dr. Adesola Yinka-Ogunleye, leader of Nigeria’s monkeypox working group, said that “there are currently no vaccines or antivirals being used against monkeypox in [Nigeria].” People with potential monkeypox infections enter isolation and authorities monitor their contacts.

Dr. Jimmy Whitworth, a professor of global public health at the London School of Hygiene and Tropical Medicine, acknowledged this inequity, noting “a different attitude to the kinds of resources we deploy depending on where cases are.” He said further that “It exposes a moral failing when those interventions aren’t available for the millions of people in Africa who need them.” The World Health Organization has about 31 million smallpox vaccines that could treat monkeypox, however, it has never dispensed these vaccines to address the monkeypox outbreak in Africa.

Jay Chudi, an expert living in Enugu, Nigeria, an area noting monkeypox cases since 2017, says cases in wealthier countries prompted the world to confront the spread of monkeypox. “We are now seeing it can end once and for all, but because it is no longer just in Africa. Now everybody is worried,” Chudi said.

JYNNEOS Smallpox (Monkeypox) Vaccine

In 2019, the FDA approved a two-dose vaccine called JYNNEOS to prevent both smallpox and monkeypox in adults. As of June 8, 2022, this vaccine is available in the United Kingdom, United States, Europe, Denmark, Germany, France, Spain, Canada and Nigeria.

Despite the availability of vaccines, many African countries continue to endure the hardships of the monkeypox epidemic. With the availability of the  JYNNEOS vaccine in Nigeria, Africa now has newfound hope.

– Jacara Watkins
Photo: Flickr

Diseases in Puerto Rico
Chronic diseases in Puerto Rico have been on the rise in recent years. According to the Puerto Rico Report, more than half of the deaths reported on the island are due to chronic diseases. In 2010, 57% of deaths were due to heart disease, diabetes, cancer and strokes. The Puerto Rican Report also said more than one-third of Puerto Ricans have diabetes, more than 18% have arthritis and 17% have reported asthma throughout their adulthood.

Poverty and Chronic Diseases

Puerto Rico Report stated in an article that poverty has a connection with the increase of chronic diseases as households with an income of around $15,000 per year or less have higher chances of developing a chronic disease. Chronic diseases result in disabilities that can deteriorate the workforce and exacerbate the health care system. The CDC stated that 21% of Puerto Ricans have reported having serious mobility restrictions.

A study that the International Journal of Environmental Research and Public Health published stated that, compared to the general mainland population in the United States, chronic disease occurrence levels and mortality rates are higher for the people living in Puerto Rico. Around 44.3% of individuals who reported food insecurity in the study also reported that they perceived their health to be average or poor. The study also found that as of 2020, 5,000 doctors had left the island to work in the United States for economic reasons leaving the island, marking a 36% decline in medical staff on the island. Health care services in Puerto Rico currently face the risk of funding reduction in the Medicaid program that could lead to 1.5 million people losing health care coverage.

Financial Burdens

The Puerto Rico Report stated that citizens of the island are currently not eligible for Supplemental Security Income due to its status as a colony. The rising cost of pharmaceutical medicines and treatments has left the high levels of chronic disease to increase the financial burdens on the island. More than half of Puerto Rican residents are eligible for Medicaid. However, they do not receive enough funding to cover the cost of their disease’s treatment.

Solutions

In 2014, the Puerto Rican government released the “Puerto Rico Chronic Disease Action Plan” that focuses on collecting data, chronic disease self-management education, intervention plans within communities and increasing access to nutritious food and physical activity. The plan could strengthen the health care system on the island while increasing the economic position of Puerto Rico as the government looks to build medical manufacturing on the island to increase profit and medications. The plan is also looking to increase a clinical trial network within the island and develop local primary health.

The Puerto Rican government developed the model from the chronic model that the Pan American Health Organization/World Health Organization (PAHO/WHO) created and implemented in countries such as Brazil, Argentina, Colombia and the Dominican Republic. This model has reduced hospitalization rates due to diabetes, hypertension and other chronic conditions. It has also decreased the economic strain of the health care system in the different countries. “The model has six components: organization of care, community engagement, support for self-management, clinical information systems, design of service delivery systems, and support for clinical decisions,” PAHO stated.

The government has yet to release any update on the progress of the model due to the pandemic drawing attention away from the increasing risk of chronic diseases on the island. Chronic illnesses still present a big risk factor on the island from both the economic and health care perspective. However, many of the education sections of the model have increased health awareness on the island. As the island begins to move away from the COVID-19 pandemic hope increases for an increase in resources for chronic illness treatment.

– Nuria Diaz
Photo: Flickr