Archive for category: Disease

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Common Diseases in Zimbabwe

Common Diseases in Zimbabwe
Zimbabwe is an African country situated just above South Africa. Known for their rich culture and sense of community, Zimbabwe is the twenty-second poorest nation in the world, according to Business Insider.

With 66% of Zimbabweans working in agriculture, it is not uncommon for diseases with agricultural origins to spread. Here are some of the most common diseases in Zimbabwe for those working in agriculture:

Cholera

Cholera is a contaminated food- or water-borne disease that causes diarrhea and vomiting. Both of these symptoms can lead to dehydration and even death. Between August 2008 and July 2009, there was a massive cholera outbreak in Zimbabwe. According to World Nomads, “cholera deaths have decreased recently, although the disease is still present and may break out again with little warning.”

Malaria

This terrifying disease spreads through mosquitos. For Zimbabweans working in the fields, malaria is a highly possible occurrence and “a major killer across Africa.” Protection from this deadly disease is a simple mosquito net. However, with the average African living on about $3 a day, even a tool that could save their lives is too costly.

Rabies

According to the Centers for Disease Control and Prevention (CDC), “Rabies is a deadly disease caused by a virus that is spread in the saliva of infected animals.” Working outside with livestock, Zimbabweans in agriculture can be very prone to this terminal disease.

Although these three common diseases in Zimbabwe are especially susceptible to those in agriculture, anybody in Zimbabwe could become infected with them. Here are some of the other common diseases in Zimbabwe that could affect everyone:

HIV/AIDS

Zimbabwe has a very high rate of HIV/AIDS. According to World Nomads, “15 percent of the population has the virus,” and it is the number one killer of people in Zimbabwe. This sexually-transmitted disease is incredibly harmful and a huge issue in many African countries.

Typhoid

Typhoid fever is very similar to cholera in that this disease spreads through the intake of unclean food or water. However, typhoid is not always as serious as cholera. Symptoms of typhoid include high fever, weakness and stomach pains, but rarely death.

Measles

Measles starts when an infected person sneezes or coughs, and continues with fever, cough and red patches on the body. Although there has been some progress on the measles disease, it is still among common diseases in Zimbabwe. In the 1990s, “measles was considered one of the five major causes of morbidity and mortality among children aged <5 years,” according to the CDC.

These common diseases in Zimbabwe are an issue in the everyday lives of natives. With increased education and aid, these health problems will become a thing of the past.

– Sydney Missigman

Photo: Flickr

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Preventing the Spread of Common Diseases in Chad

Diseases in Chad

The degree of the risk to get infectious diseases in Chad, the biggest landlocked country on the African continent, is critically high. Typhoid, cholera, malaria and hepatitis E tend to become more widespread in the rainy season.

Chad’s population continuously grows due to the country’s high fertility rate and a large youth cohort. More than 65% of the populace is under the age of 25, although the mortality rate is high and life expectancy is low. Diseases in Chad caused the world’s third-highest maternal mortality rate. According to UNICEF, 33% of children between 12-23 months are not vaccinated against childhood diseases.

Among blood or waterborne diseases in Chad, the most concerning are bacterial and protozoal diarrhea, hepatitis A and E and typhoid fever. Vector-borne diseases such as malaria and dengue fever, water contact disease schistosomiasis, respiratory disease meningococcal meningitis and some of the animal contact diseases including rabies had a large outbreak in 2016 and are also among the most threatening. In the past decade, Chad has faced epidemics of meningitis, measles and cholera with increasing severity.

Doctors Without Borders (MSF) identified the first hepatitis E cases and treated 885 patients with Acute Jaundice Symptoms (AJS), with numbers increasing to an average of around 60 new cases a week. AJS commonly causes the yellowing of the skin and eyes, which can indicate if a person has hepatitis E. In total, 45% of cases tested positive for hepatitis E. Since September 2016, 11 have died, including four pregnant women among hospitalized individuals, but the fatality rate could be underestimated. Nearly 90% of the AJS cases were reported from Am Timan which appears to be the epicenter of the outbreak.

The government of Chad officially declared a cholera epidemic on August 30, 2010. In January 2011, the number of cases started to increase again and during September, 4,410 cases and 83 deaths were reported. The high mortality rate appeared due to the weakness of the monitoring system, the lack of appropriate health strategies and of access to health services for patients and the poor quality of existing health services.

As with some other diseases in Chad, cholera appears during the rainy season in the regions surrounding the Lac Chad. In 2014, 172 cases of cholera were notified in the regions of Lac, Mayo Kebbi and N’Djamena. In 2016, no cases were notified. Given the low levels of access to a sustainable water source (only 52% of Chad’s population have access) and improved sanitation (12%), it is likely to be a continuous problem.

In 2016, more than a million cases of malaria were notified among other diseases in Chad. UNICEF and the World Health Organization have launched a distribution of bed nets, medicines, malnutrition treatment for children under five and stimulated prenatal services such as vaccination and preventive malaria treatment.

The causes of malaria are dirty water and garbage that become the nests for mosquitoes. More important, even with vaccination, is to use nets, especially covering children’s and elders’ beds, as the disease affects them the most.

Travelers to Chad should follow standard hygiene recommendations in terms of water and food safety. These should protect them against hepatitis E, as the risk of person to person transmission is very low. In order to control these epidemics and reduce morbidity and mortality rates associated with cholera, malaria, yellow fever, measles and meningitis outbreaks, UNICEF in collaboration with Chad’s government plans to launch mass vaccination of the entire population and returnees of all ages to prevent further spread of epidemic diseases in Chad.

– Yana Emets
Photo: Flickr

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Care Helps Limit Top Diseases in Monaco

top diseases in Monaco
Monaco already is making records with the highest life expectancy in the world. The average expectancy is 90 years old, which crushes the average worldwide life expectancy of 72. Monaco has a very small population, coming in at 37,731 in 2015. There aren’t many of the top diseases in Monaco that aren’t seen around the world, yet communicable diseases are coming in very low at just 6%. Non-communicable deaths account for 86% of the total number of fatalities in the country.

Non-communicable deaths account for the vast majority of the deaths and diseases in Monaco. Just more than a quarter of all non-communicable deaths are people under the age of 60. Just about 17% of males die before reaching the age of 60, while females are sitting at about 8.5%.

The top two of the top diseases in Monaco are cardiovascular diseases at 33% and the various cancers at 28% of total deaths in Monaco. These are both on the higher end of both of these spectrums as compared to the rest of the world. Cancers, especially, usually have a lower proportional mortality percentage. The treatment and care for those that are stricken with these diseases are very good in Monaco thus contributing to its very high life expectancy.

Injuries and other communicable diseases make up just 14% of the diseases in Monaco. It is fairly common for communicable diseases to be very low around the world in each country.

The only two risk factors that were stated in 2008 by the World Health Organization were physical inactivity and tobacco use. This is a good trend with the majority of the other risk factors not existent among the citizens of Monaco.

Monaco is a fairly safe area to travel to with the majority of the country in the higher income group and better off than most of the world. Just routine vaccinations should be enough before leaving.

Monaco is a country with a lot of wealth and resources to be able to take care of those that are in need. The life expectancy is not all that surprising when looking at the resources at hand to help those that need it.

– Brendin Axtman

Photo: Flickr

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Combating Non-Communicable Diseases in the Maldives

Top Diseases in Maldives
The top diseases in the Maldives mirror those in much of the rest of the globe. Non-communicable illnesses dominate the majority of the diseases in the Maldives. However, at 77 years, life expectancy in the Maldives is much better than the majority of the world. In addition, the annual mortality rate among healthy people in the Maldives is 578 per 100,000 people. This is with a very small population of around 400,000.

Worldwide, there needs to be more of a focus and research on cardiovascular diseases. It impacts hundreds of thousands of individuals every year, and it is the most common disease in the Maldives. Of all the major diseases, 37% of them are various types of cardiovascular disease.

The majority of the top diseases in the Maldives are non-communicable, including different cardiovascular diseases. Some of the other non-communicable diseases that impact the Maldives included chronic respiratory diseases, which have a mortality rate of just over 9%. Mortality rates for diabetes and other blood and endocrine diseases sit at just over 8%. Cancer is a major disease around the world that is receiving a lot of research, and the mortality rate in the Maldives is sitting at 7.5%.

Unintentional injuries also have a high spot on the list of mortality rates at just over 7%. Additionally, self-harm is just over 2%. Injuries seem to be a lot higher on lists than other countries around the world and are avoidable. The unintentional injuries are tough to prevent, but self-harm is preventable with proper help and care.

One of the most common communicable diseases is neonatal disorders (6% mortality rate). Additionally, diarrhea and lower respiratory diseases have a 5% mortality rate. These are rarely seen around the world.

Risk factors in the country include tobacco smoking, with 42% of current male smokers at risk and only 7% of females at risk of medical problems caused by tobacco smoking. Elevated blood pressure is also a problem, with 23% of the country having blood pressure problems. The other major risk factor in the Maldives is obesity.

Zika is still a major concern in the Maldives, so there are many precautions for individuals visiting the area. Travelers need to be aware of other diseases in the area and have their vaccinations up-to-date before entering the Maldives.

Non-communicable diseases dominate the list of top diseases in the Maldives. There needs to be more of a focus on preventing and treating cardiovascular diseases and other non-communicable diseases in this region.

– Brendin Axtman
Photo: Flickr

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HIV/AIDS: One of the Top Diseases in Antigua and Barbuda

Top Diseases in Antigua and Barbuda
The country of Antigua and Barbuda currently has the fourth-lowest mortality rate in the Caribbean region. Despite a lower mortality rate, in this small country of 90,755 people, communicable diseases are some of the most deadly. Diarrhea and lower respiratory infections are the most common diseases, followed by the highly infectious HIV/AIDS virus, which affects 2.2% of the population and is one of the top diseases in Antigua and Barbuda.

Because HIV/AIDS is responsible for 19.4% of deaths in Antigua and Barbuda, the government has taken direct action to prevent, treat, and inform people of the disease.

In 2001, Antigua and Barbuda officially called upon the United States for a systematic global response to the HIV/AIDS virus—a plea that was met with generous funding for HIV antiretroviral drugs available to the country for increased accessible treatment. Further, the U.S. and other external agencies including the U.N. Programme on HIV/AIDS (UNAIDS) and the Central Asia Regional Economic Cooperation Program (CAREC) assisted the country in attaining accessible HIV testing to all individuals. Since then, the HIV/AIDS-awareness response in the country has grown tremendously, though the government still faces hardship in preventing one of the top diseases in Antigua and Barbuda.

In 2013, the HIV mortality rate had increased by an alarming 183 percent since 1990, and in 2015, the country, unfortunately, saw 48 new cases of diagnosed HIV in both males and females between 20 and 60 years of age.

The good news is that the country’s government provides continuous HIV/AIDS treatment and care services for free and operates from its own national response team with some help from outside relief organizations.

In 2015, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), tested and counseled more than 3,000 people in the Caribbean region and provided preventative, comprehensive and evidence-based interventions for more than 7,000 individuals. Progress like this proves that preventative care and external aid, paired with $22 million in funding to the region in 2016, has led to great success in combating one of the top diseases in Antigua and Barbuda.

Internal efforts to combat the disease have dramatically increased the speed of treatment and prevention in the country as well. In 2015, the Barbuda Council collaborated with agencies such as Antigua State College, Community Development Division and AIDS Secretariat and Partners, to host 36 HIV awareness programs. Among these were multiple counseling sessions including testing and distribution of informational materials and health fairs encouraging the education of HIV prevention.

Additionally, the government now provides a clinical care team to all patients, and health care providers receive training for new HIV Care and Treatment Guidelines.

Furthermore, the country is working to overcome challenges of treating HIV, such as limited data on people most at risk, by attempting to increase HIV testing for all people and preparing to mobilize HIV assessment and care into primary health care.

Because of relief efforts both inside and outside the country, the disease is becoming less prevalent. For example, premature deaths due to the virus decreased by 28.9 percent between 2005 and 2015. It is the government’s ambitious programming and training for the population that should continually decrease the number of people living with HIV/AIDS in Antigua and Barbuda.

– Olivia Cyr

Photo: Flickr

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10 Facts About SARS

SARS
SARS, or severe acute respiratory syndrome, comes from a coronavirus. Symptoms center around the respiratory system can lead to severe breathing problems if the patient goes without treatment. Here are ten facts about SARS:

  1. The first widespread case occurred in late 2002 in the Guangdong Province of the Republic of China. The delayed health response led to a global spread of the disease on par with the Ebola epidemic of 2014. The final statistic from WHO showed over 8,000 reported illnesses and more than 700 deaths.
  2. The disease was hard to diagnose due to its irregularity and similarity to pneumonia. Until 2000, cases of SARS were considered rare. Therefore, medical treatment of the virus was scarce, especially in developing countries where the spread happened fastest.
  3. Of the 194 countries that are the Member States of WHO, only 64 of them have efficient alert and response plans for unusual and rare disease outbreaks.
  4. The disease might have originated in animals. A report from the WHO Regional Office for the Western Pacific Region showed that “the palm civet in southern China may have played a crucial role in this respect and that the close relationship between animals and humans seems to have been a likely precondition for the virus to jump the species barrier.” A solution to preventing the initial infection of humans with SARS is to halt unhygienic veterinary and animal husbandry practices that are common in these areas.
  5. In Singapore, 76% of infections occurred in a healthcare facility. Additionally, SARS infected 42 percent of those were health care workers; 49 nurses, 13 physicians and 22 other specialists. Among the healthcare workers, there were no cases among laboratory workers or pathologists.
  6. The source of the Taiwanese outbreak was a 42-year-old laundry worker in a hospital who continued to work despite showing symptoms of SARS. It took 6 days for professionals to diagnose SARS.
  7. The epidemic in Taiwan was mainly due to the health care system’s poorly-executed response.
  8. In October 2012, the National Select Agent Registry added the SARS-associated CoV to its repertoire. The Registry handles the regulation and possession of bacteria, viruses and toxins that pose a potential threat to the public. The addition of the virus to this list ensures maintenance of a national database as well as inspections of objects that may possess, use or transfer SARS-CoV.
  9. SARS is no longer a large-scale threat, due to the global response and the willingness of countries to share their medical information with other countries to quickly control and eradicate the virus.
  10. Future outbreaks are still possible since the virus lives in wild bats and civets. Fortunately, since the end of the epidemics in 2004, there have been no reports of human cases.

SARS is no longer an imminent health concern, but reflecting on this outbreak can help prevent the spread of another viral outbreak like this. Training medical facilities in how to handle highly infectious diseases like SARS and open communication between health professionals around the globe is key to preventing the spread of such diseases.

– Taylor Elgarten

Photo: Google

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Heart Ailments Top List of Common Diseases in the Philippines


Heart ailments are still the most fatal and most common diseases in the Philippines, according to the country’s Department of Health.

Called the “silent epidemic” by former Health Undersecretary Teodoro Herbosa, cardiovascular diseases (CVDs) have topped the list of most common diseases in the Philippines over the past few years, responsible for 15 to 20% of reported deaths annually. In some years, these numbers are significantly higher. In 2012, the National Statistics Office reported that half of the country’s deaths stemmed from cardiovascular causes.

The most common of these ailments is coronary heart disease. Other heart ailments such as angina, atherosclerosis, hypertension and congenital heart disease have also been rampant among Filipinos.
Heart diseases can lead to other complications in vital organs, which makes the commonness of heart conditions alarming.

The Department of Health has estimated an increase in the number of kidney disease incidences from 10 to 15% annually starting in 2013. The trend coincides with increases in reported hypertension cases. Hypertensive patients are more likely to develop kidney complications.

Analysts trace the cause of these diseases to two main factors: growing urbanization and a general unawareness of public health issues. As cited in a 2015 study by the Philippine Institute for Development Studies, the quick development of high-paying industries and subsequent rapid economic growth have given Filipino consumers more purchasing power than ever before. Yet this growth has not always necessarily translated to a shift toward healthier options or awareness of healthier food alternatives. Fast food consumption is higher than ever before, with 25% a week according to Nielsen.

The Filipino government acknowledges the prevalence of cardiovascular diseases among the citizenry and has put in place several strategies and plans to combat the increase in cases. The Health Department has begun its efforts to remove CVDs from the top of the list of the most common diseases in the Philippines by targeting the most basic of social groups, schools, as a starting point for training, research and propagating information regarding the possible consequences of unbalanced diets and unhealthy life choices. The agency hopes that the chances of Filipinos adopting high-risk behaviors and habits that lead to the development of cardiovascular diseases will be diminished by informing citizens in their early years.

Other Health Department actions include the continued development of a framework for an integrated chronic non-communicable disease (NCD) registry system, which enables patients to access government programs more easily and train national hospitals for its operation. It has also established a national coalition on the prevention and control of NCDs. Its future plan of action involves the full implementation of the integrated NCD registry system and the development of service packages for patients, among many others.

– Bella Suansing

Photo: Flickr

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Fighting Non-Communicable Diseases in Brunei

Fighting Diseases in Brunei
Brunei is an incredibly small country that shares borders with Indonesia and Borneo. Some of the top diseases in Brunei include various cancers, diabetes, cardiovascular diseases and chronic respiratory diseases. These non-communicable diseases (NCDs) are a widespread issue for countries in The Association of Southeast Asian Nations (ASEAN). ASEAN focuses on improving political and international economic relations to improve the stability of Southeast Asia. Malaysia, the Philippines, Singapore, Thailand, Vietnam, Laos, Cambodia, Burma and Brunei comprise the organization.

Brunei’s Ministry of Health is working to promote the prevention and treatment of these diseases. The ministry is concerned because the prevalence of these NCDs has paralleled the economic growth of ASEAN countries. Consequently, they called a meeting in 2013 with the health sector of ASEAN. Together, the two groups established goals that will attempt to control NCDs in the region by 2025.

For 30 years, NCDs have been among the most common diseases in Brunei and have been the leading cause of death. The government launched the Brunei Darussalam National Multisectoral Action Plan, which is working towards reducing NCD mortality rates by 18% by 2018. This is part of the larger goal to reduce mortality rates from NCDs by 25% before 2025.

This action plan includes five main goals to combat common diseases in Brunei. They aim to reduce tobacco use, promote healthy diets, increase physical activity, identify at-risk individuals and improve NCD treatment. With these goals in place, Brunei expects to see a reduction in the rate of diabetes by 1 percent before 2018. Diabetes is a major issue in Brunei, where 62% of people are overweight.

These programs have been successful thus far. The World Health Organization (WHO) created the NCDs Progress Monitor to track the progress of ASEAN countries. According to the WHO, Brunei has made the most progress in terms of fighting NCDs out of all ASEAN countries. The WHO has highlighted Brunei’s progress in particular areas, including drug and alcohol counseling, tobacco usage warnings and public awareness programs.

Although there is still potential for further progress, this report from the WHO indicates that Brunei is moving in the right direction to combat NCDs.

Photo: Flickr

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Top Diseases in Belarus

Top Diseases in BelarusBelarus is a relatively large country in Europe with a population of 9.5 million people. The life expectancy in Belarus is 71 years with females living longer than males. Understanding the top diseases in Belarus is key to improving preventative care and medical assistance available to the citizens. The top 10 diseases in Belarus have remained the same over the last decade.

Ischemic heart disease is the most prevalent disease and has risen almost 9 percent in the last decade. Males are more likely to have heart disease later in life than females. Cerebrovascular disease has also maintained its position over the decade as the second-most prevalent diseases. However, it has seen a decrease of just about 5 percent over the last decade.

Belarus has the highest mortality rate due to cardiovascular diseases in Europe. There are other countries around Europe where the impact of heart disease is much lower. Places like Norway, France and the Netherlands all have relatively low rates of heart disease. Studying healthcare and government initiatives of these countries could help Belarus fight these disease on the home front.

Since 1983, cardiac rehabilitation has been routinely used by doctors in Belarus after a cardiac event. In 2016, 53 percent of patients underwent rehab to strengthen their heart back to working condition. The opportunity to monitor patients and control the rehab process with newer technology is working to bring people back to healthy lives after a cardiac event.

More of the top 10 diseases in Belarus include three different types of cancers. Lung cancer is the only cancer that is in the top five. The other two types of cancer are colorectal and stomach cancer.

Alzheimer’s disease saw an increase of 37 percent over the last decade and jumped from eighth on the list up to fourth.

The main risk factors for the top diseases in Belarus include diet, high blood pressure, alcohol and drug abuse and smoking. Many of these risk factors can be controlled with preventative measures. Controlling even a few of these risk factors could drastically reduce the number of cases of heart disease and cancers.

Belarus is still feeling the effects of communist rule under which healthcare was severely neglected. However, there is a very large number of doctors, about 42,000, relative to the size of the population. There is also emergency care available. The country has 834 hospitals and more than 100,000 beds.

The top diseases in Belarus are similar to the rest of the world, with heart disease as the leading cause of death. Focusing on controlling risk factors and increasing preventative care could help to decrease the prevalence of these diseases and increase the life expectancy for Belarusians.

– Brendin Axtman

Photo: Flickr

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Fighting the Top Diseases in Zambia Through Collaboration

Diseases in Zambia

In Zambia, located east of Angola and south of the Democratic Republic of the Congo, HIV/AIDS, malaria and tuberculosis have the highest incidence rates. The risk for infectious diseases in Zambia, as with many Southern African nations, is particularly high. Here are the most common diseases in Zambia:

  1. HIV/AIDS
    Human Immunodeficiency Virus (HIV) is a virus transmitted through certain bodily fluids that weakens or destroys the immune system’s cells. If not started on antiretroviral treatment (ART), HIV can lead to acquired immunodeficiency syndrome (AIDS)— the most advanced phase of the HIV infection.HIV/AIDS afflicts a large proportion of the Zambian population. In 2015, the adult prevalence rate of HIV/AIDS was the seventh-highest in the world, with an estimated 13 percent of Zambian adults aged 15-49 being HIV-positive.In 2016, the Zambian government partnered with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) to deliver anti-retroviral therapy to 693,599 Zambians. The partnership will also supply 2.7 million Zambians with HIV counseling and testing, support voluntary medical male circumcision and offer supportive care services to 366,447 Zambian youth affected by HIV/AIDS.
  2. Malaria
    Malaria is a mosquito-borne disease transmitted through the bite of an infected female Anopheles mosquito. Malaria can be prevented with interventions, such as indoor insecticide spraying and insecticide-treated mosquito nets and treated with anti-malarial drugs.Each year, malaria affects more than four million Zambians and is responsible for nearly 8,000 deaths. Pregnant women and children under the age of five are the most vulnerable groups, with malaria being the cause of 35 to 50 percent of under-five mortality and 20 percent of maternal mortality.Zambia is a member state of the Southern African Development Community (SADC) Malaria Elimination (E8), a regional alliance of eight Southern African nations committed to malaria elimination in Southern Africa by 2021. Recent interventions, including the distribution of more than 1.8 million insecticide-treated mosquito nets, indoor insecticide spraying programs and mass antimalarial drug administration have assisted Zambia in reaching its elimination targets.“The [Southern] province has done extremely well in the malaria elimination agenda. We are talking about zero mortality rate and single-digit malaria cases in most of the districts,” said Zambian health minister Chitalu Chilufya in an interview with Zambia Daily Mail on June 12, 2017.
  3. Tuberculosis
    Tuberculosis (TB) is an airborne bacterial disease that primarily affects the lungs. Most cases of TB can be treated with a course of antibiotics.Annually, an estimated 50,000 cases are identified in Zambia and about 5,000 deaths are attributable to TB. HIV-positive individuals are at higher risk than the general population for developing TB; in 2013, an estimated 50 to 70 percent of Zambian TB patients were coinfected with HIV.An initiative for a 75 percent reduction in TB-related deaths among HIV-positive individuals by 2012 was included in the 2016 United Nations Political Declaration on Ending AIDS (UNAIDS).“It is unacceptable that so many people living with HIV die from tuberculosis, and that most are undiagnosed or untreated,” UNAIDS Director Michel Sidibé said. “Only by stepping up collaboration between HIV and tuberculosis programs to accelerate joint action can the world reach its critical HIV and tuberculosis targets.”

HIV/AIDS, malaria and TB incidences are concentrated in the world’s poorest populations. Limited resources, deficient transportation and sanitation infrastructures and a number of other issues accelerate transmission and the severity of diseases in Zambia.

Recently, the Zambian government unveiled its 7 National Development Plan (7NDP), 2017–2021, which addresses the need for community-based preventive health services and new programs for prevention and reduction of diseases in Zambia. The plan proposes a conceptual framework to transition from sector-specific to multi-sector health intervention programs, which address the non-biological determinants of public health (e.g., water and sanitation, nutrition, education, household income and road infrastructure).

With the addition of new, multi-sectoral development programs for infectious disease control and reduction, the government anticipates declining incidences of HIV/AIDS, malaria and TB in Zambia.

– Gabrielle Doran

Photo: Flickr