Archive for category: Disease

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The Monkeypox Outbreak in Africa

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

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Diseases in Puerto Rico

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

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Diseases Impacting Kyrgyzstan

Diseases Impacting Kyrgyzstan
The central Asian country Kyrgyzstan is home to more than 6.7 million people while many citizens fall victim to pressing issues such as violence terrorism and diseases. The following list assembles the diseases impacting Kyrgyzstan.

10 Diseases Impacting Kyrgyzstan

  1. Ischemic Heart Disease: Ischemic or cardiovascular heart disease is the cause of 25% of deaths in Kyrgyzstan per year. Ischemic heart disease or coronary heart disease happens when there is a reduction of blood flow to the heart muscle.  This is due to the complete or partial blockage of the arteries responsible for circulating the blood.
  2. Stroke: Stroke is responsible for 15% of deaths in Kyrgyzstan per year. Strokes occur due to an artery blockage/leakage, or when a blood vessel bursts. Some lifestyle factors that can put one at risk of stroke include being overweight and inactive. They also stem from alcohol and substance abuse.
  3. Cancer: Stomach, lung, breast, cervix and liver are the most common cancers in Kyrgyzstan. Also,  approximately 600 women per year are diagnosed with cervical cancer. Most cases of cervical cancer are due to human papillomavirus (HPV).
  4. Lower Respiratory Infections: Lower respiratory infections are a leading cause of death in children less than 5 years.   This is said to be due to an overuse of antibiotics and the under-diagnosing of asthma. In many of these cases, family stress and financial burdens are also contributing factors.
  5. Chronic Obstructive Pulmonary Disease (COPD): Chronic obstructive pulmonary disease (COPD) is the seventh top cause of morbidity in Kyrgyzstan. COPD is an inflammatory disease in the lungs that causes obstructive airflow. Many people with COPD are current or ex-smokers.  Also, people with high exposure to biomass suffer from the disease.
  6. Cirrhosis: Cirrhosis is the fourth leading cause of morbidity. It is a chronic liver disease that can lead to scarring and liver failure. One of the most common causes of cirrhosis is alcohol abuse. One cannot generally undo the damage to the liver due to cirrhosis.
  7. Diabetes Mellitus: Diabetes mellitus is the cause of 428 deaths per year and The International Diabetes Federation estimates that the rate will further increase by the year 2025. Diabetes mellitus is an illness where the body is not able to produce enough insulin, causing blood sugar levels to reach abnormally high levels.
  8. Preterm Birth Complications: Preterm birth complications are a significant concern for newborn mortality. About 2,938 children less than the age of one died in 2015 due to birth complications. Folic acid deficiency is the number one factor that causes these complications. Hydrocephalus is another newborn complication that also occurs often when the mother is deficient in folic acid. To combat this problem, UNICEF took action to fortify flour in Kyrgyzstan by using the large mills that are in the country in order to get more of this nutrient into women’s diets.
  9. Cystic and Alveolar Echinococcosis: Cystic and alveolar echinococcosis are infectious tropical diseases that stem from tapeworm larva. The Kyrgyz climate and environment support the survival and durability of the parasitic eggs. In most cases, this disease tends to be under or misdiagnosed.
  10. Typhoid Fever and Brucellosis: Typhoid fever and brucellosis are infectious diseases that can spread to others through contaminated food and water. Kyrgyzstan has one of the highest numbers of cases worldwide. Many people who caught these diseases live in the Valley of the Mayluusuu River and in the uranium zone. In response, The World Bank created The Disaster Hazard Mitigation Project and has allocated more than $12.7 million to minimize radionuclides in the Mayluusuu area, improve emergency management and reduce the loss of property in those areas.

Looking Ahead

Poverty is a contributor to the diseases impacting Kyrgyzstan because many people suffer from malnutrition, whether underweight or overweight. Poor diets are one of the top contributors to malnutrition. Many Kyrgyz people do not have the finances to eat diets rich in nutrients the World Health Organization (WHO) has recommended. Most households share a diet high in trans fats, saturated fats, sugar and salt. This diet has led to various health issues such as noncommunicable diseases (NCDs), which cause 80% of morbidity in the country.

Many of the diseases impacting Kyrgyzstan pose an immediate threat to its citizens; solutions to these issues can seem nearly impossible. However, improvements in the medical and sanitation industries can alleviate some of these burdens. Additionally, the work of The Disaster Hazard Mitigation Project and UNICEF should help reduce the prevalence of preterm birth complications, typhoid fever and brucellosis.

– Christina Papas
Photo: Flickr

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Everything to Know About Health Care in Congo

Health Care in Congo
The Republic of Congo is one of the most resource-rich and “least densely populated” nations in Africa. Its economy is heavily dependent on oil exports so it is vulnerable to dropping oil prices and economic crises. This, combined with its history of civil conflict, has resulted in a high poverty rate of 52.5% in 2020. Further, in times of economic decline, a lack of government funding has plagued health care in Congo. In turn, that has led to high out-of-pocket costs for the majority of patients. It also has resulted in a lack of health care professionals and an uneven distribution of health care services. Finally, the financial strain of the health care system exacerbates the country’s burden of communicable diseases, such as tuberculosis, malaria and HIV. It has also contributed to the nation’s high rates of maternal and infant mortality.

Effects of Communicable Diseases

A major challenge that health care in Congo faces is the high rates of tuberculosis (TB), malaria and HIV. Tuberculosis is the leading cause of death in Congo and early diagnosis is a critical first step in ensuring successful treatment. To increase Congo’s TB testing capabilities, the World Health Organization (WHO) equipped the cities of Brazzaville and Pointe-Noire with GeneXpert diagnostic machines, which the Global Fund financed.

Delivered in December 2021, the GeneXpert machines have increased the TB testing rate eight-fold at the Antituberculosis Centre in Brazzaville. In the past, TB centers in Congo could only treat the most critical cases due to backlogs created by inefficient machines. By increasing the number of diagnoses, the GeneXpert machines have proven to be a cornerstone in expanding access to TB treatment.

The GeneXpert machines are part of the Global Fund’s two grants that total more than $64 million to strengthen prevention and treatment services for TB, malaria and HIV in Congo. Implemented by the UNDP and Catholic Relief Services, the goals of the grant are threefold:

  1. Successfully treat 90% of TB cases by 2023.
  2. Scale-up access to antiretroviral treatment for HIV-infected patients, with a special focus on pregnant women.
  3. Deliver 3.5 million mosquito nets across Congo by 2023 and increase access to malaria treatment and diagnostics.

Maternal and Infant Health Care Successes

In the past two decades, Congo has made significant strides in reducing maternal and infant mortality rates. The maternal mortality rate has fallen from 739 deaths per 100,000 live births in 2000 to 378 deaths per 100,000 live births in 2017. Similarly, the infant mortality rate has fallen from 106 deaths per 1,000 live births in 2000 to 63 deaths per 1,000 live births in 2020.

To continue on this trajectory of improving maternal and infant health, in June 2021 the World Bank approved $50 million for the Kobikisa Health System Strengthening Project. The project’s goal is to improve the quality and availability of maternal and child health care in Congo among the most impoverished households. With financing from the International Development Association, the Kobikisa initiative will provide free health services for pregnant women and their children in 36 districts across the country. Included in these services are treatments for diseases such as malaria and tuberculosis and the provision of vaccines. By delivering essential health care services free of cost, the Kobikisa initiative will help alleviate the financial burden of health care for millions of Congolese citizens.

Strengthening Congo’s Health Infrastructure

In addition to these targeted interventions, the Congolese central government has also begun to prioritize strengthening the infrastructure of health care in Congo. In 2018, the government increased its investment in health care from 5% of the annual budget in the previous year to 13%.

The main focus of the Congolese government’s investment is improving primary care services and revitalizing health districts. At a workshop in September 2021, executives in the Ministry of Health and Population received coaching and the tools needed to train and supervise various health care professionals “from 93 health areas of the 2020-2021 Operational Strategy.” The training of health care actors at the community level will not only improve the quality of primary care patients receive but will also expand the availability of health care in Congo to remote and rural communities that are underserviced.

Ensuring quality and affordable health care in Congo is one of the cornerstones of the nation’s development. While there is still much work to do, improvements are visible thanks to the support of the international community.

– Kaitlyn DeWeerd
Photo: Flickr

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GPS Tracking of Livestock in Africa

GPS Tracking of Livestock in AfricaAround 85% of global citizens living in extreme poverty inhabit the sub-Saharan portion of Africa. Civilians rely heavily on agriculture, specifically livestock production, to support their livelihoods and the economy at large. However, these animals can transmit diseases harmful to humans, such as foot-and-mouth disease, ringworm, listeriosis and MRSA. Scientists and farmers in Tanzania have partnered up to create satellite GPS tracking devices to track livestock herds and gain a better understanding of how diseases spread between herds. GPS tracking of livestock in Africa can also prevent further infection.

Livestock Agriculture in Africa

About 70% of African civilians rely on agriculture to make a decent living. This sector contributes to improved food security, industrialization and domestic and global trade throughout Africa. Livestock is an essential part of agriculture. Farmers raise domesticated animals to provide resources such as dairy products, fibers and feathers. In fact, 60%-80% of rural homes in Africa keep livestock to support their economic and food necessities. The East Africa region is the nation’s largest exporter of live animals, “home to 107.2 million head of cattle, 178.8 million goats and sheep, 1.3 million camels and 4.4 million pigs” in 2019.

East Africa derives more than $1 billion worth of annual income from the export of livestock to the Middle East and Northern Africa. In addition, livestock agriculture contributes between 30% and 80% of the agricultural gross domestic product (GDP) across African nations.

Disease Risks of Livestock Agriculture

Due to the heavy reliance on livestock agriculture in Africa, one must consider diseases that could potentially transmit to other herds and humans. The avian flu, Ebola and COVID-19 are only a few of the many illnesses spread through animals. About 75% of emerging infectious diseases are “zoonotic,” meaning that the diseases originate from pathogens of infected live animals and then pass on to humans. With increased interaction between livestock and civilians in Africa, there is a higher risk for disease transmission. This could negatively impact livestock productivity and could worsen poverty and food insecurity across Africa.

GPS Tracking of Livestock

Livestock health authorities in Africa have little knowledge of which areas have the highest prevalence of disease transmission among cattle. GPS tracking of livestock in Africa could be the solution. In 2021, scientists and researchers from the University of Glasgow teamed up with farmers from rural villages of Tanzania to study how diseases spread among livestock to prevent future disease spread. Together, they developed satellite GPS tracking devices that could monitor the transportation of livestock.

Through this method, researchers discovered that disease transmission was most likely to occur in areas where the animals congregated for long periods, “such as at water holes and cattle plunge dips.” GPS tracking of livestock in Africa also reveals the far distances cattle often travel daily. Cattle would cover roughly five miles per day and reach maximum speeds of seven miles per hour, allowing room for intermingling between herds.

Looking Ahead

GPS tracking of livestock in Africa is paving the way for disease control and prevention. This research could potentially save lives and economies in continents like Africa where disease prevalence and agricultural demand are high. A better understanding of disease transmission between livestock and humans can also improve the animals’ health, contributing significantly to the strengthening of African livelihoods.

– Megan Quinn
Photo: Flickr

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The Rehabilitation 2030 Initiative

Rehabilitation 2030 initiative
The World Health Organization (WHO) has made rehabilitation one of its top priorities over the next several years through the Rehabilitation 2030 initiative. This program strives to increase the availability and accessibility of rehabilitation services around the world. According to WHO, rehabilitation involves “a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment.” Treatment can involve a combination of assistive devices, counseling and therapy to achieve this outcome. Unfortunately, “in some low- and middle-income countries, more than 50% of people do not receive the rehabilitation services” necessary to live a better quality of life. The Rehabilitation 2030 initiative seeks to address this.

The Global Need for Rehabilitation

Hundreds of millions of malaria cases occur every year with the large majority happening in developing tropical nations in Africa and Southeast Asia. Around 10% of malaria survivors experience significant cognitive and neurological impairments that can impact their motor function, hearing and sight and their ability to process information. Rehabilitative techniques, such as cognitive therapy, can treat these disorders and give people a chance to improve their health and quality of life. Unfortunately, cognitive exercises and other similar rehab treatments are not widely available in many countries with high rates of malaria.

Over the past decade, the prevalence of diseases associated with severe disabilities has increased by more than 20%. This includes ailments like rheumatoid arthritis and cancer that can take a heavy physical toll on an individual, limiting one’s independence. The technologies and knowledge to rehabilitate many of these symptoms exist, but their availability is inadequate in many parts of the world, especially in low- and middle-income countries. In fact, the availability of trained rehabilitation specialists is about 10 per one million people.

Even when these services are readily available, cost, lack of transportation and waiting times serve as constraints to accessibility. Individuals with disabilities who go without rehabilitation are likely to remain hospitalized for longer and are at higher risk of developing complications. They are also less likely to achieve the independence required to return to employment and their social roles.

Disabilities and Poverty

Around “50% of disabilities are preventable” and tie closely with poverty. Unmanaged disability can become an obstacle to education, impacting literacy rates. According to a 2000 publication by the Department for International Development (DFID), UNESCO estimates that “1–2% of children with disabilities in developing countries receive an education.” Without access to an adequate education, people with disabilities are unlikely to find gainful employment. In turn, many of those individuals cannot pay for the cost of their own care, placing that burden on other family members.

In addition, families members may have to drop out of school or work to care for the person with a disability, reducing household incomes and closing the doors to future prosperity. These outcomes not only hurt those with disabilities and their families but also the societies that host them. Communities without adequate rehabilitation services bear financial burdens that go beyond direct medical costs, such as the loss of otherwise productive members of society who previously could contribute to the economy.

Rehabilitation 2030 Initiative

In 2017, more than 200 stakeholders met in Geneva to support WHO’s “Rehabilitation 2030: a call for action” conference. From this, the Rehabilitation 2030 initiative was born with an emphasis on three points:

  1. The open availability of rehabilitation for all populations.
  2. To strengthen and integrate rehabilitation into larger health care systems.
  3. To acknowledge that rehabilitation is an important service to develop to reach universal health coverage.

Under this initiative, participating nations accept these three points and agree to commit themselves to 10 areas of action. These areas address the need for rehab financing, the strengthening of networks that connect people and health care services and the need for further research into rehabilitation. In support of these goals, WHO has lent technical assistance to more than 20 countries in the creation of strategic plans. In 2019, representatives from member states and organizations reconvened and shared their strategies and progress with each other, reifying their commitments to increasing the availability of rehabilitation.

There is a growing need for expanding the availability of rehabilitative care around the world. Untreated disability can constrain people’s learning and economic potential. Fortunately, many nations around the world are acknowledging the importance of rehabilitative care through their commitments to the Rehabilitation 2030 initiative and strive to improve services.

– Gonzalo Rodriguez
Photo: Flickr

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5 Facts About Infectious Diseases in Madagascar

Infectious Diseases in Madagascar
Madagascar is an island country off the southeastern coast of Africa. It is famous for its unique climate, vibrant ecosystems and a Disney movie bearing its namesake. However, despite its colorful outward appearance Madagascar is not only a country that has been struggling with the burdens of extreme poverty. It is also a country that has strived to respond to the constant risks of infectious diseases in Madagascar that are rampant throughout its population.

5 Facts About Infectious Diseases in Madagascar

  1. Of the top 10 leading causes of death in Madagascar, four are infectious diseases. Compared to the United States, which only has one infectious disease in its top 10 causes of death, Madagascar’s rate of death due to these largely preventable illnesses is staggering. These four killers are diarrheal diseases, lower respiratory infections, malaria and tuberculosis. Diarrheal diseases and lower respiratory infections, the top two leading causes of death in Madagascar, are not on the lists of countries such as the United States. Easily preventable simply through clean water and relatively basic medical equipment and treatment, these infectious diseases are just one of many lethal circumstances stemming from poverty.
  2. More than 60% of the population of Madagascar lives far from health centers. Additionally, the methods of travel are dangerous and difficult. Underdeveloped and often undermanaged roads and means of travel are when coupled with the scarcity of adequate care, literally a hard road to health. All four of the leading causes of death by infectious diseases are prevalent in Madagascar are preventable and treatable given adequate recovery time, proper equipment, medication and access to proper nutrition. However, if travel is expensive and exhausting those in need will not have the time or resources to spare to travel to one of these remote health care facilities.
  3. Diarrheal diseases are the leading cause of death in Madagascar. According to the World Health Organization (WHO), in 2018, diarrheal diseases were responsible for 10,832 deaths or 7.88% of deaths in Madagascar. These diseases are particularly deadly due to the high rates of malnutrition in the population. Diarrheal diseases are especially draining and resource-heavy upon one’s body and for those without healthy and consistent diets coupled with the lack of potable water and adequate hygiene that may have caused the disease in the first place. Although attention for this issue is very minimal, there are efforts to help the people of Madagascar prevent these diseases through the allocation of health hygiene products and the spread of health information. Project WASH Madagascar provides information to children and adults about the importance of cleaning their hands and drinking clean water. It has been distributing WASH kits that contain additional information as well as cleaning products.
  4. Malaria rates have been steadily climbing since 2009. Deaths due to malaria in Madagascar increased by 7.5%, between 2009 and 2019. The United Nations OCHA reported an increase of malaria cases from 402,385 in 2019 to 663,558 in 2020. This may be partly due to the decrease in incoming aid and available health services during the COVID-19 pandemic. Malaria is an infectious disease that, with the proper resources, is entirely preventable and treatable. However, just as with these other infectious diseases, circumstances from poverty block the road to health and kill thousands.
  5. After a measles outbreak in 2018 – 2019, infection and death rates are almost completely down. Madagascar has been struggling to address these issues even amidst the hectic state of the world. However, it is important to acknowledge the successes that Madagascar has seen through coordination between The Ministry of Public Health and WHO and partners in combating these infectious diseases. The distribution of vaccines led to vaccine information, education and free emergency care to those in critical condition, helping control the outbreak. Between January and April of 2019, 46,187 people became infected with measles and 800 dead during a widespread measles outbreak. Medical science and collective human effort contained the measles outbreak with only 34 cases since January 2020, according to Outbreak News Today.

Looking Ahead

As the world collectively becomes intimately aware of the threats of infectious diseases, especially in cases where there is no supporting health infrastructure, the circumstances of people like those in Madagascar become plainly dire. There are measures to take and aid to disperse that would solve many of these problems. While there is a long way to go, Madagascar continues to work in the hopes of preserving its people and ensuring their safety.

– John J. Lee
Photo: Fickr

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Mobile Phone Data Can Improve Disease Response in the DRC

disease response in the DRC
The Democratic Republic of Congo (DRC) “has the third-largest population of [impoverished people] globally.” The coronavirus has hit the DRC’s economy hard, further reducing the country’s capacity to fight disease. One advancement in disease response in the DRC is the government’s use of mobile phone data for population mapping, which helps create public health policies for COVID-19 and could do the same for other prevalent diseases in the country in the future.

Ties Between Disease, War, Poverty and COVID-19 in the DRC

The DRC has historically faced challenges in combatting cholera, malaria, HIV, measles, Ebola and Rift Valley fever. Factors contributing to the challenges in combatting disease include a weak health care system, low laboratory capacity, a lack of plans regarding border lockdowns for disease containment and a lack of information about vaccination and disease prevention for the public.

Additionally, the DRC endured a civil war from 1997 to 2003. The civil war ravaged the country’s infrastructure and the ongoing political instability in the country currently poses obstacles for aid workers to safely enter the country. The effects of the civil war also reduce the government’s ability to fight prevalent diseases in the DRC.

Furthermore, in 2019, the DRC’s economic growth stood at 4.4%. After the COVID-19 pandemic began, the DRC’s economic growth shrank to 0.8% in 2020. The slowdown in economic growth has made it even more difficult for improved disease response in the DRC.

Using Mobile Phones to Combat COVID-19

Low-income countries, including the DRC, struggle with data collection. However, data collection is vital in order to provide government officials with information to make sound public health decisions. The good news is that the DRC is starting to utilize mobile phone data for population mapping to combat COVID-19, which could greatly improve the DRC’s response to other diseases as well.

Orange DRC, a telecommunications company, provides anonymized mobile phone data to a marketing company called Kinshasa Digital. Using the phone data, Kinshasa Digital is constructing a dashboard for the DRC so that health officials can follow population movement after implementing various public health policies. The dashboard is useful because it allows the government to follow the spread of COVID-19 and use this data to create policies that will be most beneficial for the public’s health.

Data-Informed Responses

In addition, Vodacom DRC, a mobile carrier, and Flowminder, a company that analyzes mobile data, have created a report utilizing call detail records that analyzes how population movement patterns in Kinshasa’s Gombe district have changed in response to the DRC’s COVID-19 confinement policies. The report indicates “a drop of 70% in the total flow of subscribers traveling to Gombe after the confinement,” which shows that many people are complying with the government’s policies.

The creators shared the report with government officials. Reports like these can help the government measure how effective its public health policies are. As the technology and analytics industries develop, these reports can further improve the government’s response to COVID-19 and possibly other diseases too.

The DRC faces challenges in disease response, but the current innovation with mobile phone data to create more effective COVID-19 policies shows a promising development. As mobile phone companies, analytics companies and the government continue to work together, disease response in the DRC as a whole could greatly improve.

– Anna Ryu
Photo: Unsplash

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Combating Kidney Disease in Southeast Asia

Kidney Disease in Southeast Asia
End-stage renal disease, the last stage in chronic kidney disease, is one the deadliest illnesses in the modern world. This rise in end-stage renal disease can result in a considerable loss of economic growth and cause a massive loss of life. Growing countries and communities experience a harsher result from end-stage renal disease. Southeastern Asian countries face challenges that are damaging to poverty-stricken countries. Many vulnerable individuals face the challenging task of securing medical assistance for combating chronic kidney disease because of healthcare systems lacking financial support, including renal support. The 21st century has brought to light a new, dangerous illness. The process of combatting kidney disease in Southeast Asia must occur through global initiatives and support.

The Silent Chronic Illness

The term “silent illness” is a long-term sickness that results in death. Chronic kidney disease, known as CKD, is one of the deadliest diseases globally, killing millions each year. With more than 10% of the population suffering from the disease, its lethality has grown sharply. It increased from the 28th deadliest cause of death to the 19th. This sharp rise in death rate is comparable to only AIDS, and HIV has a sharper increase in death rate. This statistic showcases the challenges in combating kidney disease.

A recent study from the scholarly journal, Nephron Clinical Practice, displayed the significant financial and medical expenses that could come from the sharp rise in kidney disease illnesses and deaths. These issues will hit developing countries the hardest. More than 23 developing countries could lose more than $85 million in economic development. Southeast Asian countries suffer the worst. Renal Replacement Therapy costs 10 times as much as the per capita income. Furthermore, very few medical coverages support renal medical treatment. Only 10% of individuals suffering from chronic kidney disease have access to renal medical resources, a worrying statistic for the future of developing countries that work hand in hand with other developed countries to continue to flourish against kidney disease in Southeast Asia.

Kidney Disease in Southeast Asia

Kidney disease preventative centers and policies are not very accessible in Southeast Asia. Many governments have just become aware of the extensive and damaging results that kidney disease carries. Southeast Asian countries lack the essential resources to help with a deficiency of dialysis treatment.

This disease is, however, especially deadly in impoverished communities worldwide. Experts from The International Society of Nephrology, the world’s leader in chronic kidney disease research, found in a recent study that more than 10 million people die every year from chronic kidney disease. The BNC Nephrology systematic review also saw a sharp decline in human resources in kidney services and disproportionate effort within the healthcare system of these respective Southeast Asian countries.

Combative Practices

Political and social policies have always provided support to those who need it. However, recent years have been more optimistic towards a more renal secured Southeast Asia. One country that has doubled down on this matter has been Thailand. In the past decade, Thailand has created three new national kidney foundations. The kidney foundations work through direct financial and medical support to those most in need and politicians to secure a poverty-ending medical support policy for those at risk and suffer from chronic kidney disease.

Some are working on the introduction of a renal replacement therapy policy within Southeast Asia today, with help from the International Society of Nephrology. The society is holding various forums to work with the Southeast Asian governments for more inclusive policies.

Malaysia and the Philippines both have two national kidney foundations to educate and secure funds needs for renal therapy and medical support. Consequently, the increase of chronic kidney patients has increased the demand for dialysis nurses and doctors.

Malaysia, Thailand and Singapore are receiving public-private partnerships in supporting renal therapy and medical support. The acknowledgment of policies that allow further funding from private organizations and liberal implementations of new policies would also trigger community involvement, drafting a new healthcare system with the inclusion of kidney care to combating the rise of kidney disease in Southeast Asia.

Conclusion

Chronic kidney disease has been dismantling families and hitting poverty-stricken communities the hardest. Southeast Asian communities have followed a pattern in renal disease medical needs. Millions of people with and without preexisting conditions are at risk. But, Southeast Asia can become a much more healthy and prosperous place for those who suffer from chronic renal disease. Combating kidney disease in Southeast Asia will continue to be an uphill battle. However, the next generation of policy for a healthier healthcare program will usher in a new era of kidney care for those most at risk in Southeast Asia.

– Mario Perales
Photo: Flickr

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Reducing Disease in Sub-Saharan Africa

disease in Sub-Saharan Africa
The threat of disease transmission plays a significant role in the life of sub-Saharan Africans. Diseases such as malaria, HIV/AIDS, tuberculosis, heart disease and diarrheal diseases remain leading causes of death for African citizens. Of particular worry is HIV/AIDS, the fourth leading cause of death on the continent. Furthermore, urbanization has direct links with reducing disease in sub-Saharan Africa. The United Nations Programme on HIV/AIDS estimates that 25.5 million people currently live with HIV/AIDs in sub-Saharan Africa, representing approximately 64% of the world’s cases. The transmission rate is particularly high in sub-Saharan Africa due to high rates of poverty, with over 60% of the population spending less than $1 a day.

Fortunately, in recent years, sub-Saharan Africa has witnessed a downturn in disease trends. For example, in the last six years, Africa has reduced AIDS deaths by over 30%. One can partly explain the successes in stopping the transmission of disease in sub-Saharan Africa by the process of urbanization that sub-Saharan Africa has undergone in recent years. Physician’s Medical Center Labs explains this relationship, highlighting factors such as sex work, migration, polygamy and teenage marriages, all of which increase with higher poverty levels.

What is Urbanization?

Urbanization is the process of making an area more urban. Characteristics defining urban areas include higher population density, greater infrastructure and non-agricultural opportunities for specialization. Urbanization has been ongoing since the 1950s in sub-Saharan Africa – however, its pace has increased in the past few decades. The rate of urbanization in sub-Saharan Africa is the highest globally, with an average annual growth rate of 4.1%. Urban growth results from a multitude of factors, including migration and the reclassification of cities. Migration from rural areas to urban centers is predominantly based on educational and financial concerns.  However, seasonal and forced migration can also play a role in the growth of urban centers. This fast-paced urbanization is not without its challenges, including income loss, weak investment and less productivity. Nevertheless, urban areas can create circumstances that can reduce the transmission of disease in sub-Saharan Africa.

Improving Sanitation

Improved sanitation follows urbanization. Even in the most impoverished urban areas, sanitation conditions are still better than those in rural communities. The key factors contributing to sanitation levels are clean water and flush toilets. Poor urban areas remain two times more likely to have clean, piped water. They are also four times more likely to have flush toilets than rural areas. This is vital to disease prevention as poor sanitation in human waste is a key driver of disease transmission, specifically diarrheal diseases. Piped water can also reduce the threat of mosquito growth. Large amounts of stagnant water provide breeding grounds for dangerous mosquitos, which transmit viruses such as malaria. Piped water decreases the need for stagnant storage sites, diminishing this problem.

Empowering Women

Urban areas provide greater educational opportunities. While schools in rural areas remain understaffed, urban schools can cater to more students with a higher quality of education. This access to education is essential for females as women are 20% more likely to attend school in urban areas. Education for women is key to increasing awareness of sexual health needs and reproductive control. Along with education, the increase in infrastructure that results from urbanization can also increase access to resources for women. They can access the clinics and facilities necessary to control their fertility and protect themselves during sex. This is especially important for female sex workers in the region. In urban areas, the infrastructure of clinics, reproductive health resources and educational opportunities provide women with solutions that can decrease the prevalence of sexually transmitted diseases and infections.

Tracing Diseases

Urbanized areas have the infrastructure necessary to support cell towers and the internet. Because of this infrastructure growth, urban settings allow for high rates of cell phone usage. Meanwhile, rural areas tend to lack access to personal technology devices. In South Africa, around 50% of the rural population do not have access to a personal cellular device. The increased prevalence of mobile phones in urbanizing areas could play a consequential role in combating disease transmission in sub-Saharan Africa. The success of mobile phone contact tracing apps that some utilized during the COVID-19 pandemic highlights this. A Massachusetts Institute of Technology study has found that these apps can decrease the infection rate and break transmission chains even with limited use. People could utilize these tools, thanks to urbanization, to decrease the transmission of disease in sub-Saharan Africa.

US Foreign Assistance is Vital

When looking at the benefits of urbanization throughout the world, it is important to focus on the dangers it can present. While urbanization can foster gender equality, education and quality healthcare, poorly managed urbanization can worsen inequality and destabilize governments. The work of U.S. Foreign Assistance plays a consequential role in the lives of Africa’s urban population. However, U.S. assistance remains disproportionately focused on rural settings, leaving these urbanizing areas in danger. Thus, the continued role of the U.S. in supporting poverty reduction initiatives throughout sub-Saharan Africa is vital to support and foster long-term, stable urbanized growth. One cannot discount the role of urbanization to impede the transmission of disease in sub-Saharan Africa.

– Haylee Ann Ramsey-Code
Photo: Unsplash