Archive for category: Disease

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The Color Blue Puts an End to Sleeping Sickness in Africa

sleeping_sickness
For rural Sub-Saharan Africans, a walk to the riverbank to wash clothes, gather firewood or collect water is a risky business. About 1 in 1,000 Tsetse flies, which swarm by the river’s edge, are carriers of a parasitic disease called sleeping sickness, which eventually infects the victim’s brains, driving them mad before killing them. In 2013, at least 7,000 cases of this rabies-like disease were reported.

Due to vague early symptoms such as headache, joint pain and bouts of fever, the disease is difficult to diagnose in the beginning. Although it is curable with drugs, patients are often experiencing its later stages before they realize they have been infected. True to its name, patients find it impossible to sleep during the night and impossible to remain awake during the daylight in its later stages.

Those living in rural areas may not make it to hospitals because of the far distance, but thankfully today, researchers have found that the number of individuals suffering from sleeping disease in the region of Uganda has been cut by 90 percent. The reason? Scientists have discovered a weakness for these insects with a lethal bite: the color blue. Because these flies search for something to bite which contrasts with green vegetation, bright colors, especially bright blue, drives them crazy.

With this newfound knowledge, along the riverbanks in the West Nile region in Uganda, handkerchief-sized blue squares attached to wooden stakes netted with insecticide are staked about every 50 yards. It only takes 3 minutes before these flies will drop dead. These life-saving fly traps are relatively cheap and have significantly contributed to a decrease in the number of people being affected by the disease. Last year, fewer than 10,000 cases were reported versus about 300,000 cases reported by the World Health Organization (WHO) during the height of its epidemic in the late 1990s.

WHO hopes to eliminate flies carrying the disease within five to six years. Ministry of Health worker Dr. Charles Wamboga has seen fewer cases and believes that a future free from this deadly disease is possible for a people whose very lifeline flows within their rivers.

– Nikki Schaffer

Sources: NPR, WHO
Photo: Flickr

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The Poor Find Haven In Monrovia’s Cemeteries

monrovia
Liberia has had a trying past couple of decades. Most recently, it was plagued by the Ebola virus, which killed thousands of people. Before this, it had suffered through a 14-year-long civil war, which had taken place just a few years after yet another civil war ended. Both wars killed hundreds of thousands of people, leaving many homeless and destitute. Lacking housing or money, many poverty-stricken Liberians have turned to living in cemeteries, many of which are in Monrovia, its capital.

Most go to the Palm Grove Cemetery. Many of these dwellers arrived when they were just children and after their parents had been killed. Some had been child soldiers. They were taken there by friends from the street who used the relative peace and security of the cemetery to indulge in marijuana, cocaine and heroin. They used tombs for shelter after smashing them open and throwing out their long-dead inhabitants.

Monrovians look upon the cemetery dwellers with distaste and fear. They are viewed as criminals and drug addicts who disrespect the graves of their families and are deprecatorily called “friends of the dead.” On Decoration Day, a public holiday when Liberians paint and adorn tombs, conflict always erupts between the tomb dwellers and the families of the tombs’ rightful owners.

Rather than provide an area for the homeless to live in, President Johnson Sirleaf simply put up walls around the cemetery in 2007 to keep them out. Just a few months later, however, people had already breached the walls to live in the cemetery once again. Now the walls serve to better hide the dwellers and their activities rather than keep them out.

Prostitution has also become commonplace behind the cemetery’s walls. Some women and girls are only able to survive through sex work. They are afforded no protection from the police, who often rape them themselves. Unwanted births are commonplace.

Many diseases also run rampant. Ebola was just another problem to add to a list of illnesses that included ones such as tuberculosis and diarrhea.

Hope may yet be around the corner for these cemetery residents. Last year, the British charity organization, Street Child, began to work with them, setting up counseling sessions, schools and rehab centers. However, many roadblocks stand in the way of their progress. It is extremely difficult for many residents to even consider weaning themselves off their dependency on drugs. Sometimes, drugs make them aggressive and hostile, which makes it hard for people from Street Child to engage with them.

The outbreak of Ebola also set back efforts. Schools were banned, as were public gatherings. Street Children also started redirecting efforts to the 2,000 children orphaned because of Ebola. Officials have been hostile to Street Children’s efforts in cemeteries, calling their residents a “lost cause.”

Now that Ebola has largely disappeared in Liberia, Street Children is ready to make a renewed effort to help the cemetery dwellers. To the charity organization, small successes have boosted their belief that these people can be saved from a lifetime of poverty and dependency.

– Radhika Singh

Sources: Independent, BBC 1, BBC 2
Photo: Independent

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Potential to Cure Parkinson’s Disease Found in Existing Drug

Potential to Cure Parkinson’s Disease Found in Existing Drug

In a recent report, researchers found that the current drugs Chloroquine and Amodiaquine, two common anti-malaria drugs, could also provide treatment for Parkinson’s disease.

Parkinson’s disease itself is a disease caused by a loss of cells in a part of the brain called the subtantia nigra. This loss of cells causes the reduction of the neurotransmitter called dopamine, or the chemical in the brain that regulates movement and mood.

One of the study’s authors, Dr. Yoon Ho Sup, stated, “Our discovery brings hope for the millions of people suffering from Parkinson’s disease, as the drugs that we have found to have worked in the laboratory tests have already been used to treat malaria in patients for decades.”

Dr. Sup continued, “Our research also shows that existing drugs can be repurposed to treat other diseases and once several potential drugs are found, we can redesign them to be more effective in combating their targeted diseases while reducing the side effects.”

This monumental breakthrough could lead to an inexpensive alternative treatment to many individuals who suffer from Parkinson’s on a daily basis. Creating the new treatment would be beneficial not only from a financial standpoint but also because many of the current treatments involve a varied concoction of many drugs and surgery.

Another of the study’s authors, Professor Kwang-Soo Kim stated, “…[existing] pharmacological and surgical treatments address the patient’s symptoms, such as to improve mobility functions in the early stages of the disease, but the treatments cannot slow down or stop the disease process.”

With the current research and backing of scientific evidence, these drugs are seen to be a potential drug target to treat Parkinson’s itself.

The researchers hope that the drugs can be further modified to continue to better treat Parkinson’s and hopefully slow and stop the process.

– Alysha Biemolt

Sources: Spring, WHO, PNAS
Photo: Medical Press

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Deworming Rwanda

Deworming campaign Improving School Attendance in Rwanda
Unquestionably, one of the most effective weapons fighting global poverty today is education, and in Rwanda, a small country in central eastern Africa, it’s essential. Absence is commonplace however, with children suffering from abdominal pain, diarrhea and nausea. Attendance in school is difficult for children with soil-transmitted helminth infections.

In collaboration with Ministries of Health, a campaign to combat the disease was launched by the World Health Organization (WHO) and has shown success in getting students back in school.

According to WHO, soil-transmitted helminth infections are among the most common infections worldwide and affect the poorest and most deprived communities. They are transmitted by eggs present in human feces, which contaminate soil in areas where sanitation is poor. The disease is easily contracted by walking barefoot on contaminated soil or eating contaminated food.

The main species that infect people are the roundworm (Ascaris lumbricoides), the whipworm (Trichuris trichiura) and the hookworms (Necator americanus and Ancylostoma duodenale).

Soil-transmitted helminth causes a spectrum of health problems, from the indiscernible to the severe, which can includ abdominal pain, diarrhea, blood and protein loss, rectal prolapse and physical and mental retardation. The severity of infection is directly related to the worm burden.

The disease, one of the most common parasitic ailments in the world, affects approximately 2 billion people, nearly two thirds of the world’s population, and it is estimated that 4 billion others are at risk.

In Rwanda, illnesses can be extraordinarily bad. According to WHO, ninety-five percent of school aged children living in the Musanze District were suffering in 2007, one of the highest rates in the country.

There, soil-transmitted helminth is contracted mainly from dirty water, fetched from nearby Lake Ruhondo and those who use the stagnant water from the former banks of the Mukungwa River. Open defecation is still practiced in the area and sanitation is almost non-existent.

In 2007, whole families were getting sick. Parents stayed home caring for sick children, which prevented them from being able to work, and children were too sick to go to school or earn a menial income raising livestock or growing vegetables.

Worldwide, the WHO has been working tirelessly to control the spread of soil-transmitted helminth by facilitating wider access to preventive medicine such as albendazole and mebendazole. According to Dr. Antonio Montresor, Medical Officer for WHO in the Department of Control of Neglected Tropical Diseases, the deworming campaign reached more than 395 million children in 2014, making it one of the largest global public health interventions.

In the Musanze District of Rwanda, the WHO provides the necessary medications to local schools, which are then disseminated to the population. Since the program started, the rate of children with intestinal worms has been reduced by nearly 20 percent.

Education is essential in alleviating global poverty. Every day a child is absent from class, the likelihood they can break the endless cycle disappears a little more. The WHO is striving to keep students in school and families healthy, making a chance to prosper a reality.

– Jason Zimmerman

Sources: WHO 1, WHO 2
Photo: TheGuardian

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Can the Infectious Disease Yaws Be Eradicated?

Can the Infectious Disease, Yaws, be Eradicated SoonYaws is a relatively unknown disease in the developed world, but in poor tropical areas of Africa, Asia, Latin America and the Western Pacific, it is common and can lead to disfigurement and disability.

Yaws is the most common endemic treponematoses, a group of bacterial infections that also includes nonvenereal syphilis and pinta. All of these infections are transmitted through non-sexual contact with an infected person. They can cause skin lesions, bone pain, bone lesions, nose deformities and the thickening or cracking of a person’s hands and soles of the feet. The World Health Organization (WHO) estimates that 75% of infected people are under 15 years of age, with most cases seen in children aged 6 to 10. Gender is not a determining factor of infection.

Yaws is spread through skin-to-skin contact, usually after a small injury occurs, something common when children play. Yet, WHO states that “overcrowding, poor hygiene and socioeconomic conditions facilitate the spread of the yaws.”

The disease is not life-threatening, which is likely why it became a neglected disease in the scope of global disease work. But if left untreated, a person can become permanently disfigured and disabled. Such a diagnosis is bad for anyone infected with the disease, but since mostly children suffer from yaws, it becomes a life-long issue if not resolved quickly. When a child contracts yaws, their ability to go to school is jeopardized. If left untreated, absenteeism rises among children and their future employment, especially feeding their families through farming, is impacted.

It has long since been thought that yaws could be a disease that can have complete eradication since humans are the only carriers of the disease. Previously, initiatives to eradicate yaws were undertaken with almost complete success. But the mass effort was prematurely lifted and the disease returned, though not quite on the same scale as before.

Recently, the idea of complete eradication has come back up. The two most effective antibiotics to treat yaws are azithromycin and benzathine penicillin, both of which can be given with relative ease. Even though no vaccine is available for yaws, if early diagnosis is achieved, treatment with the antibiotics can occur and sanitation can be improved to help stop the spread of the disease. With the steps, the end of yaws is in sight.

There have already been cases of previously endemic countries achieving complete eradication, including India. The Yaws Eradication Programme (YEP) was launched in India in 1996 with the goal to have complete eradication in the country. In 1997, 735 cases of yaws were reported; in 2004, the country was considered to have achieved “Zero Case.” Because not all cases of yaws are reported, only time will tell if complete eradication can be sustained, but right now all signs are pointing to success.

With great things already happening in India and a plan in place to achieve more success globally, yaws should be eradicated from remaining endemic countries by 2020.

– Megan Ivy

Sources: PubMed.gov, WHO 1, WHO 2
Photo: Chacha

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Mind Over (or at Least on Par with) Matter for HIV Patients

HIV_Patients
HIV-positive individuals face enormous challenges, in terms of both size and quantity, and the psychosocial aspect of their plight is often underestimated.

Living with the stigma of being someone who is “infected” can interfere with opportunities, relationships and one’s overall position in society. Many individuals living with the diagnosis face issues ranging from anxiety to suicidal thoughts, from personality disorders to substance abuse.

Feeling the reality of mortality, along with the sudden ostracism from the community that a person once belonged to due to the stigmatized nature of HIV, is enough to bring up these issues for anyone.

While the war against the physical symptoms and spread of the diseases is in full force, the psychological issues faced by sufferers are just as important to address.

While these “side effects” are not always taken into consideration as a priority, the World Health Organization itself “recommends that attention to the psychosocial needs of people with AIDS should be an integral part of HIV care,” according to a National Institutes of Health (NIH) study. Globally, there are many cases where it is being done with great effectiveness.

Microcredit programs provide small loans to people who, due to their life-threatening diseases and discrimination (despite legislation seeking to prevent it), are hard-pressed to receive them from other places. In the case of the Positive Partnership Program in Thailand, loans are provided for partnerships between one HIV-positive and one HIV-negative person.

Infected individuals who received loans through this program reported feeling a greater sense of self-efficacy, increased acceptance in the community and an overall improved outlook on life. HIV-negative individuals who participated in the program reported an increased understanding of HIV and decreased levels of anxiety, fear and discomfort toward HIV-positive individuals.

Programs like this one are exemplary in the move toward integrating HIV-positive individuals into the rest of society. This is on top of the opportunity they offer them to reach and prove their full mental and economic potential, as, in the study’s period of 2004-2006, 91% of the loans given were repaid on time.

Projects similar to this one include a study of a cognitive-behavioral-group program for HIV-positive men in Hong Kong, and another done in rural Uganda using interpersonal psychotherapy. Both of these studies showed that psychosocially-based programs were effective in reducing symptoms of depression and increasing overall mental health.

In truth, the efforts of groups that work to reduce stigma and increase quality of life are incalculably important. As lecturer in ethics and HIV prevention Bridget Haire says, “showing the nation how people living with HIV are a vibrant, vital and productive part of our community cannot be overestimated.”

Perhaps even more poignant are the words spoken by one of the participants in the Thai Positive Partnership Program: “Life is much improved. My social life is back. I may have HIV, but I am still a human being. I have my self-esteem, and my honor.”

– Em Dieckman

Sources: UNAIDS, NCBI, The Conversation
Photo: Flickr

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Improving Vaccine Shelf Life

Vaccine-Shelf-LifeIt is hard enough to find vaccines for the world’s deadliest diseases, but scientists also grapple with another concern: shelf life.

In order for vaccines to remain potent, they must be kept within a range of suitable temperatures. For instance, they are rendered useless in excessive heat.

The effects of such temperature fluctuations can be substantial. According to the global health nonprofit PATH, the cholera vaccine Dukoral has a shelf life of 36 months when stored at temperatures between 2-8 degrees Celsius. If stored at 27 degrees Celsius, the vaccine will only last 14 days.

This poses a problem for those performing vaccinations in the developing world; in countries near the equator, the heat can be stifling. That means vaccines could expire when they are needed most.

Compounding the problem is the lack of electricity in certain regions. With high temperatures and no reliable way of keeping supplies cold, many vaccines go to waste.

At Intellectual Ventures Lab, scientists are developing a new device to keep vaccines at the ideal temperature, as part of their Global Good program. The Arktek, a passive vaccine storage device, is able to keep vaccines cold for a month with no electricity. It uses the same techniques to remain protected from extreme temperatures as employed by spacecrafts.

The device was put to the test during the recent Ebola outbreak. When health care workers started to test Ebola vaccine candidates, they needed a way to keep them cold during transport and storage.

The vaccines were required to be kept between -60 and -80 degrees Celsius, well below the usual temperature range of the Arktek device. However, with some quick modifications and carefully conducted tests, the container was modified to support such low temperatures.

That meant scientists could prolong the shelf life of experimental Ebola vaccines, if only for a few days longer.

– Kevin McLaughlin

Sources: Intellectual Ventures Lab, PATH, World Health Organization
Photo: Science Museum

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Breeding Superbugs

SuperbugsResearchers have been tracking the increase of the global spread of antimicrobial-resistant infections, also known as superbugs. But the reason for this increase surprised the researchers — drug co-pays seem to have increased superbugs.

Superbugs are defined as “strains of bacteria that have changed (or mutated) after coming into contact with an antibiotic. Once this happens, these bacteria are ‘resistant’ to the antibiotic to which they have been exposed, which means the antibiotic can’t kill the bacteria or stop them from multiplying.”

Many individuals may suggest going back to a doctor and receiving a new prescription for a different antibiotic. But in the developing world, many individuals cannot afford the co-pays for multiple doctor visits, let alone the cost of multiple antibiotic prescriptions.

With the rising costs of prescriptions, many individuals are turning to informal or black markets for their prescriptions. The pills that they buy from black markets may be lower quality, prescribed inappropriately or dosed incorrectly. All of these factors can lead to the spread of superbugs.

According to an analysis of data from 47 countries published in the Lancet Infectious Disease Journal, the amount people spend out-of-pocket on healthcare has turned out to be a better predictor of antibiotic resistance than poverty, sanitation or livestock production.

In the first major report last year, the World Health Organization (WHO) has called antibiotic resistance “a growing public health threat.” This report, which tallied the level of antibiotic resistance in each country, warned that “many of the available treatment options for common infections in some settings are becoming ineffective.”

According to the Centers for Disease Control, each year superbugs cause 2 million people in the United States to become sick, killing 23,000. With the advanced healthcare available in the United States, what effects do superbugs have on the developing world?

With the WHO report in mind, researchers from Stanford University in California and Gandhi Medical College & Hospital in India set out to determine whether the levels of resistance in low and middle income countries were linked to the direct healthcare costs that patients pay.

The researchers found that in countries where patients paid a higher share of healthcare costs, there was a higher level of antibiotic resistance. But this was also only evident in countries that charge co-payments for prescriptions.

While this data does not prove that higher prescription costs cause greater antibiotic resistance, it does show that the two are linked.

Co-payments are usually used to discourage people from seeking unnecessary healthcare but are currently having the opposite effect. With higher co-payments, patients that cannot afford the cost must look elsewhere for their prescriptions: the black market.

Not only are patients endangering themselves with unknown prescriptions and doses, but they are also enabling antibiotic resistance. There needs to be a change so that patients are able to receive needed antibiotics at a reasonable price. If not, antibiotic resistance will become a major problem in the future.

– Kerri Szulak

Sources: ABC Health & Wellbeing, Bloomberg Business
Photo: Live Science

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Ascariasis: A Major Health Problem in the Developing World

Ascariasis

Throughout the developing world, one kind of disease remains more common than any other: worms. In fact, according to The Huffington Post, recent figures have suggested that nearly every person residing in a developing country has some form of worm infection, due to the abundance of worm larva in soil all over the world.

While there are a variety of these infections, one in particular called ascariasis, or ascaris, has become so widespread that, according to the Center for Disease Control, it “account[s] for a major burden of disease worldwide.” In total, 807 million to 1.2 billion people around the world are infected with this parasitic illness, which is also classified as a neglected tropical disease.

It is caused by the consumption of its eggs, which reside in contaminated soil. This happens when fingers that have touched contaminated soil are put in the mouth or if produce has not been properly washed, cooked and peeled.

After ingestion, the eggs make their way to the intestine, where they hatch into larva. The freshly spawned larvae then wait to develop into fully mature worms. An adult female worm can grow up to around 30 cm in length while in the intestine, all while producing eggs that will then return to the soil via the host’s feces.

Upon reaching maturity, these adult worms wiggle through the intestinal wall and make their way towards their host’s lungs through the blood stream. This is where things get even more disgusting. Once near the lungs, they reside by the back of the throat, where they once again lay their eggs and continue the cycle.

Sufferers often do not experience any symptoms, but some of the most common signs of the disease are abdominal pain, coughing, difficulty breathing and fever. In more severe cases, excessive worm growth can cause intestinal blockages. As the worms migrate to the lungs, they are also one of the most common causes of Asthma in the developing world.

Ascariasis can stunt the growth of young children and this age group is also its most common target. When children play in the soil they expose themselves to risk of infection when putting their fingers in their mouths afterward. While usually not lethal, ascaris takes the lives of 60,000 annually, most of which belong to children.

In order to combat this disease, the World Health Organization and many other international aid organizations have attempted mass de-worming efforts. Using the two drugs albendazole and mebendazole, these groups have made progress by treating whole communities.

Another effective way of preventing ascaris does not involve drugs at all and instead relies on health education. These campaigns teach those in afflicted areas how to keep a sanitary kitchen and how to consume food safely, without the risk of catching the disease.

While treatment efforts are ongoing, less than 40 percent of the world’s children in need of treatment have not actually received any. This accounts for more than 850 million children worldwide and stands as one of the largest public health issues in the world. In order to improve the lives of millions, deworming campaigns must carry on.

– Andrew Logan

Sources: The Center for Disease Control, The Deccan Herald, The Huffington Post, The New York Times, The World Health Organization
Photo: Flickr

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India Pushes to Eliminate Elephantiasis Epidemic

Elephantiasis
Lymphatic Filariasis (LF), better known as Elephantiasis, is a painful and profoundly disfiguring disease and yet is a fairly common occurrence in poverty-stricken India. In fact, nearly half of India’s population, about 553 million people, is at risk of contracting LF.

In recent years there has been a mass drug administration (MDA) to people living in the poorest communities of the country. This initiative has been created to stop not only LF, but also many other preventable, chronic and debilitating infections known as neglected tropical diseases (NTD).

However, LF is still one of the most particularly challenging NTDs India has yet to face. Although almost half of India’s population is at risk of becoming infected, LF is one of the easiest NTDs to prevent. This could potentially lead to India eliminating LF within the next few years, and the government has increased efforts by launching the largest MDA in the world.

Yet, there has been little change, for most of the members of the poor Indian communities have been unwilling to take the free medicine. This unwillingness is due to little education, lack of disease awareness and risk perceptions, coupled with general public suspicion of the government distribution program.

Over the last 10 years, advances have led to new diagnostic and treatment tools, along with control strategies for dealing with LF. In October 2014, the Indian Ministry of Heath and Family Welfare (MOHFW) launched a communications campaign known as “Hathipaon Mukt Bharat” or “Filiaria Free India” to create and spread awareness about LF and the new tools to diagnose, treat and prevent the spread of the disease.

The initial campaign was a success, leading to a significant spike in people taking the medicine. With nearly 200,000 health workers in 14 of India’s states providing the information and medicine, the MOHFW was able to reach out to over 300 million people.

Today, India has revitalized its efforts with MOHFW’s Hathipaon Mukt Bharat campaign and has continued to work toward eliminating the LF issue. Recently, the Hathipaon Mukt Bharat initiative won a Silver Lion at the Cannes Lions International Festival of Creativity, earning it national praise for the work it has achieved and will continue to achieve within India.

– Alysha Biemolt

Sources: Impatient Optimists, WHO, JPGM Online, MedInd
Photo: Imagekb