Information and news about disease category

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Fighting Diseases in Palestine

Diseases in PalestinePalestine includes two non-contiguous territories located in the Middle East: the Gaza Strip and the West Bank. The West Bank is home to 3.2 million people and Gaza to 2.1 million. Since Oct. 7, 2023, continuous warfare between Israel and the resistance of Palestine has resulted in a severe health crisis, highlighted by a rapid spread of infectious diseases and the collapse of essential health care services.

Political and economic instability–worsened by the blockade and fighting– has left the health care infrastructure in shambles, severely impacting the well-being of Palestinians. Both chronic and transferable illnesses, coupled with a rapid decline in mental health, have steadily worsened. However, international and local nongovernmental organizations (NGOs) are working to combat the dire situation.

Crumbling Health Care System

The health care system in Palestine, particularly in Gaza, is on the brink of collapse. The conflict has led to severe shortages of medicines, fuel and medical supplies, making it nearly impossible for hospitals and clinics to function effectively. According to reports, there are around 350,000 patients in Gaza suffering from chronic conditions such as cancer and diabetes, alongside 50,000 pregnant women who are struggling to access necessary care​​.

The World Health Organization (WHO) has reported that nearly two-thirds of health clinics in Gaza are nonfunctional. Furthermore, the United Nations Relief and Works Agency (UNRWA) for Palestine Refugees in the Near East has indicated that fewer than half of its health centers can offer primary care to patients​​. This has left a sizable portion of the population without access to basic medical services, exacerbating the health crisis.

Sanitation and Water Crisis

The water and sanitation situation in Palestine is extremely dire. There is only one shower for 4,500 people and one toilet for more than 200 people. This has led to a significant increase in the spread of infectious diseases in Palestine. The situation is a result of the ongoing conflict, which has forced many Palestinians to seek refuge in overcrowded shelters or relocate to the south, where unsanitary conditions prevail.

Contaminated water supply and poor hygiene are leading to outbreaks of illnesses such as diarrhea, respiratory infections and chickenpox. Up to 70 people are crammed into single rooms, creating an environment ripe for disease transmission​​. Respiratory diseases in Palestine are particularly rampant, with more than 150,000 cases of upper respiratory infections reported, alongside numerous cases of meningitis, skin rashes, lice and chickenpox. The risk of cholera and other epidemics looms large as the health and sanitation infrastructure continues to deteriorate​​.

Efforts to Combat Disease

Despite the overwhelming challenges, various efforts and initiatives are underway to alleviate the health crisis in Palestine. NGOs are spearheading humanitarian aid to mitigate the ongoing situation.

WHO is improving health conditions by coordinating with local and international partners to enhance aid delivery and establish more supply routes. More than a dozen high-risk operations have been conducted to provide supplies to hospitals in Gaza. WHO helped establish two kitchens at Al-Shifa Hospital, which serve 1,200 meals a day. Its distribution of medical supplies currently supports treatment for 1,250 children with severe malnutrition.

The United Nations Children’s Fund (UNICEF) also plays a pivotal role in saving lives. In addition to first aid, it provides 600,000 vaccinations and nutritional supplements to children and expecting mothers. It also provides safe drinking water for 1.3 million people to curb infectious diseases.

While efforts to provide relief are ongoing, the situation remains precarious. However, the resilience and determination of health care workers combined with international support allow for much optimism. Sustained efforts and global solidarity offer hope in paving the way for a healthier future in Palestine.

– Asiya Siddiqui

Asiya is based in Fremont, CA, USA and focuses on Global Health and Good News for The Borgen Project.

Photo: Flickr

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The New Innovative Meningitis Vaccine in Nigeria

The New Innovative Meningitis Vaccine in NigeriaNigeria has the highest meningitis death rate among African countries. The most severe outbreaks typically occur in March and April, when intensified heat and airborne dirt contribute to the disease’s spread. To combat this, Nigeria has introduced an innovative meningitis vaccine to the public in a historic move. This vaccine promises to be more effective in eliminating meningitis and has the potential to significantly improve the lives of many Nigerians.

This achievement in Nigeria aligns with the World Health Organization’s (WHO) “Defeating Meningitis by 2030: A Global Road Map.” This strategy aims to eradicate meningitis outbreaks, reduce the mortality rate from the disease and improve the well-being of those recovering from meningitis.

Meningitis

Meningitis, a fatal illness, causes swelling of the membranes around the spine and brain. Various viruses, parasites and microbes can cause this disease. Bacterial meningitis, the most severe form, can be fatal within 24 hours of infection. It currently poses a significant threat to global health. Approximately one in six individuals who contract bacterial meningitis die and one in five survivors sustain a permanent disability after treatment.

Meningitis Challenge in Nigeria

Sub-Saharan Africa is described as the African Meningitis Belt, as this area is most prone to meningitis. Approximately 30,000 diagnoses are documented in the region annually.

Nigeria, located in the African Meningitis Belt, is highly susceptible to meningitis. Reports indicate that between Oct. 1, 2023 and March 11, 2024, there were 1,742 suspected meningitis cases in Nigeria, resulting in 153 deaths and 101 confirmed cases of the disease.

Introduction of the Men5CV Vaccine

Nigeria has become the first country to implement the Men5CV vaccine to combat meningitis, effectively protecting against the five meningococcal bacteria types—A, C, W, Y and X. This vaccine is a significant improvement over its predecessor, which only offered protection against strain A.

The WHO is assisting Nigeria with the rollout of the Men5CV vaccine for meningitis, including training health providers. The organization anticipates that this vaccine will significantly reduce the rate of meningitis diagnoses and support efforts to eventually eliminate the disease, especially in countries within the African Meningitis Belt. Projections suggest extensive advertising campaigns for the Men5CV vaccine throughout the African Meningitis Belt by 2025.

The Men5CV vaccine could help Nigerians avoid falling into poverty. Treating meningitis can cost a family three to four months of income, potentially pushing them into poverty due to the financial burden. Additionally, long-term effects of meningitis, such as deafness, can make it challenging to secure employment. Therefore, the Men5CV vaccine might reduce the economic impact of treating meningitis.

Optimism For The Future

In response to Nigeria’s significant progress, world leaders will convene at a global conference in Paris in April 2024. They celebrated Nigeria’s advancements and discussed future challenges. The conference will also provide an opportunity for other world leaders to commit to accelerating efforts to eradicate meningitis as a global issue by 2030.

The introduction of the Men5CV vaccine in Nigeria marks a pivotal advance toward eradicating meningitis globally. Dr. Nanthalile Mugala, PATH’s Chief of Africa Region, stated, “The introduction of MenFive [the “Men5CV vaccine”] in Nigeria heralds a transformative era in the fight against meningococcal meningitis in Africa. Building on the legacy of previous vaccination efforts, this milestone reflects over a decade of unwavering, innovative partnerships. The promise of MenFive [the “Men5CV vaccine”] lies not just in its immediate impact but in the countless lives it stands to protect in the years to come, moving us closer to a future free from the threat of this disease.”

– James McAlinden

James is based in Rosehearty, Scotland and focuses on Global Health for The Borgen Project.

Photo: Flickr

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4 Aspects of Global Poverty That Lead to Cholera Outbreaks

Cholera OutbreaksCholera is an acute diarrhoeal disease causing severe diarrhea and dehydration and it can be fatal if left unchecked. With the onset of 2024, the persistence of cholera has become evident. In January alone, across 17 countries in four regions – Africa, the Eastern Mediterranean, the Americas and South-East Asia – 40,900 cases and 775 deaths were reported. Here are five aspects of global poverty that contribute to cholera outbreaks:

Lack of Access to Sanitation and Clean Water

While there have been efforts to address inadequate sanitation through Water, Sanitation and Hygiene (WASH) interventions in the past, there are still challenges. On a positive note, previous studies have indicated that initiatives like extensive media outreach, engagement of community health workers and the provision of essential items such as water purification tablets, soap and oral rehydration solutions have demonstrated efficacy in encouraging behavioral shifts aimed at preventing cholera.

However, the effectiveness of WASH interventions varies across different regions and contexts, especially regarding recontamination. Despite efforts to disinfect water storage containers, a significant percentage of containers are becoming recontaminated at the household level. The distribution of household disinfection kits as an alternative presents the potential to diminish social stigma and empower households to uphold hygiene practices. Yet, additional evaluation is required to confirm their efficacy. Additionally, more research is needed to evaluate the effectiveness of WASH interventions during cholera outbreaks and inform international policy and practice.

Unplanned Urbanization

Unplanned or unmanaged urbanization often refers to the rapid and unplanned growth of urban areas without adequate planning, infrastructure and governance. In the context of public health, the consequences of unplanned urbanization are profound, particularly concerning the spread and impact of infectious diseases like cholera.

It is important to note that cholera outbreaks primarily impact impoverished communities characterized by low socioeconomic status. Particularly vulnerable are individuals living in densely populated regions with restricted access to safe water and sanitation facilities – the overcrowding in these regions is exacerbated by unplanned urbanization.

Therefore, the lack of urban planning often results in disparities in access to health care services, exacerbating the burden of disease on already marginalized populations. Reducing unplanned mass urbanization would require a multifaceted approach that addresses both the underlying drivers of urbanization – including weak governance, unaffordable housing and a lack of investment in infrastructure – and the consequences of rapid and disorderly urban growth.

Food Insecurity

Currently, a negative correlation exists between national food security levels and annual incidences of cholera. In a cross-sectional survey investigating the relationship between food insecurity and cholera in rural Haitian households, it was found that moderate and severe household hunger were significantly associated with a history of cholera. Certain high-risk behaviors were identified as potential mediators of the association between food insecurity and cholera.

These behaviors include the consumption of food and beverages prepared outside the home, the use of antacids and the consumption of leftover non-reheated food items. Household food insecurity was positively associated with these high-risk behaviors, indicating a potential pathway through which food insecurity may increase the risk of cholera transmission.

Interventions targeting food insecurity may help reduce the prevalence of high-risk behaviors and subsequently lower the incidence of cholera in vulnerable populations. Future longitudinal and qualitative research can be done to investigate the relationship between food insecurity, high-risk behaviors and cholera risk further. By addressing and understanding underlying socioeconomic determinants such as food insecurity, public health initiatives can disrupt the transmission dynamics of cholera outbreaks and alleviate the burden of this preventable disease in resource-constrained settings.

Vaccine Shortages

More recently, there was a significant scarcity of Oral Cholera Vaccines (OCV) globally from January 2023 to January 2024, impacting the ongoing cholera response efforts. Within this timeframe, 14 countries urgently requested 76 million doses of OCV, yet only 38 million doses were accessible. The depletion of the OCV stockpile was exacerbated by Shantha Biotechnics’s exit from the market in 2023. 

This left the stockpile solely reliant on EuBiologics, a South Korean company, which faced challenges in meeting the unpredictable demand and low pricing associated with vaccine production. However, EuBiologics aimed to produce 35 million doses of the current vaccine and potentially 15 million more if the World Health Organization (WHO) prequalifies its new vaccine.

Despite the temporary shortage, there are prospects for increasing vaccine production in the coming years, with other manufacturers expected to enter the market. However, achieving the Global Task Force on Cholera Control’s target of reducing cases by 90% by 2030 requires sustained efforts, including long-term preventive vaccination programs and the previously mentioned improvements in WASH infrastructure.

Overall, the devastating impact of cholera outbreaks underscores the urgent need for collective action to address the underlying vulnerabilities and ensure access to essential health care services for affected populations.

– Avery Fuller
Photo: Flickr

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Progress in Zika Virus Treatment and Support in Latin America

Zika Virus TreatmentIn 2015-2016, Latin America faced a formidable challenge with the outbreak of the Zika virus. This mosquito-borne illness sent shockwaves through communities and health care systems. Originating in Brazil, the virus quickly spread across the region, prompting the World Health Organisation (WHO) to declare a Public Health Emergency of International Concern (PHEIC). The declaration lasted for nine months, during which concerted efforts were made to contain the spread of the virus and mitigate its impact, particularly on pregnant women and their unborn babies. According to the National Library of Medicine, the Zika virus epidemic affected more than 400,000 people in Latin America. There has since been significant progress in the treatment of the Zika virus. However, the disease’s lasting effects impact many communities in the region.

Pregnancy Complications

One of the most alarming aspects of the Zika virus was its association with severe congenital disabilities, most notably microcephaly, a condition characterized by an abnormally small head and an underdeveloped brain. Pregnant women infected with the virus faced heightened risks, as it could be transmitted from mother to fetus, leading to potentially devastating consequences for newborns. Centers for Disease Control and Prevention noted that the Zika virus affected 5% of babies whose mothers had contracted the virus while pregnant and that many babies did not receive the recommended care.

Government Responses

In response to the crisis, governments, health care organizations and international agencies mobilized resources and expertise to combat the outbreak. Public health campaigns were launched to raise awareness about the virus and educate communities about preventive measures, such as eliminating mosquito breeding sites and using insect repellent.

Americares, a nonprofit organization based in Stamford, has been supporting affected families by ensuring hospitals are equipped with the appropriate medication and skills to combat the disease. It has also distributed mosquito nets and repellent to many people in Latin America in an effort to prevent transmission. Its family care clinic in El Salvador treats 60,000 patients a year.

Vector control efforts played a crucial role in reducing mosquito populations and curbing transmission rates. WHO created a vector control framework for tackling the Zika outbreak. Interventions ranged from insecticide spraying to community-based initiatives aimed at removing standing water where mosquitoes breed. These efforts, combined with improved surveillance and monitoring systems, helped to identify and contain outbreaks more effectively.

Furthermore, research into the Zika virus accelerated rapidly, leading to a better understanding of its transmission dynamics, clinical manifestations and long-term consequences. This knowledge proved invaluable in guiding public health strategies and informing clinical care for affected individuals.

Present Day Struggles

Despite significant progress in Zika virus treatment, challenges remain, particularly in providing support to families affected by its complications. Children born with microcephaly and other Zika-related congenital disabilities require specialized care and services to address their complex medical and developmental needs. Additionally, families may face social stigma, economic hardship and emotional distress as they navigate the challenges of raising a child with disabilities. BMJ Global Health conducted a study that found that children who were moderately affected by Zika have an economic burden of more than $204 million over 10 years.

Efforts to support affected families have encompassed a range of interventions, including access to medical care, rehabilitation services, psychosocial support and financial assistance. Governments and nongovernmental organizations have implemented programs to provide comprehensive support to affected families, with a focus on promoting inclusion, empowerment and dignity. Children’s National created one of the first congenital Zika virus programs, which provides patients with accurate diagnoses and treatment plans.

Final Remark

While the Zika virus epidemic of 2015-2016 presented unprecedented challenges for Latin America, it also showcased the resilience, solidarity and collective action of communities and stakeholders in responding to public health crises. By building on the progress made and continuing to prioritize support for affected families, Latin America can work toward a future where the impact of Zika is minimized.

The fight against Zika is far from over. However, with continued commitment and collaboration, Latin America can overcome this challenge and build a more resilient and inclusive society for all.

– Lauren McKenna

Lauren McKenna is based in Manchester, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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The Cure Tuberculosis Project In The Kyrgyz Republic

The Success Of The Cure Tuberculosis Project In The Kyrgyz RepublicIn the Kyrgyz Republic, a landlocked country in Central Asia, health officials diagnose 1,400 people with drug-resistant Tuberculosis (TB) annually. It ranks among the nations with the highest rates of drug-resistant TB. This prevalence underscores a significant health challenge across the country. To address this, the Cure Tuberculosis Project has dedicated its efforts to lowering the rates of drug-resistant TB infections and enhancing the treatment for affected patients.

The Struggle with Drug-Resistant TB

TB ranks among the most lethal infections, causing 1.3 million deaths in 2022 alone. It disproportionately affects those in lower-income households, exacerbating the cycle of poverty. Infected individuals often face reduced earning capacity, leading to diminished access to health care and increasing health issues.

In addition, people with TB often spend more time indoors, heightening the risk of spreading the illness among both adults and children. This transmission within households can perpetuate a cycle of poverty across generations. Moreover, drug-resistant TB poses a growing global concern as certain treatments lose effectiveness. In 2022, about 410,000 individuals contracted drug-resistant TB, but only 43% received treatment, highlighting the urgent need for more effective interventions.

The Kyrgyz Republic faces a significant challenge with drug-resistant TB, with 29% of new drug-resistant TB cases compared to the global average of 3.3%, according to the World Health Organization (WHO). In addition, several factors contribute to this high incidence, including ineffective health care services, a shortage of medical resources and widespread difficulties in accessing medication for drug-resistant TB.

Addressing Drug-Resistant TB

The U.S. Agency for International Development (USAID) supported the Kyrgyz people by funding the Cure Tuberculosis Project from 2019 to 2024. This initiative aimed to assist the Kyrgyz government in identifying and treating individuals diagnosed with drug-resistant TB. Additionally, the project focused on ensuring rapid diagnosis for drug-resistant TB patients and facilitating their access to treatment, collaborating closely with the Ministry of Health of the Kyrgyz Republic. Moreover, the Cure Tuberculosis Project focused on four key areas for improvement:

  1. Develop more effective strategies to improve drug-resistant TB detection.
  2. Treat more patients with drug-resistant TB.
  3. Reduce the number of drug-resistant TB infections.
  4. Enhance government legislation concerning drug-resistant TB.

Impacts of the Cure Tuberculosis Project

The Cure Tuberculosis Project achieved success in all four targeted areas.

  1. Develop more effective strategies to improve drug-resistant TB detection: In Batken, Chui and Naryn Oblasts, 12 hospitals successfully screened all patients for drug-resistant TB, ensuring treatment for those diagnosed.
  2. Treat more patients with drug-resistant TB: The project equipped all hospitals and 91 health care services with online medical record management. Furthermore, more than 2,100 patients with drug-resistant TB benefited from mental health assistance and financial support.
  3. Reduce the number of drug-resistant TB infections: The project enhanced infection control in hospitals in Naryn, Batken and Talas, successfully reducing the average hospital stay for patients by 12%. It also sought to change the behaviors and perceptions of patients with drug-resistant TB and their families. This included producing 28 educational films that share patients’ experiences to raise awareness about the infection.
  4. Enhance government legislation concerning drug-resistant TB: The project collaborated with the Mandatory Health Insurance Fund to develop financial strategies to enhance drug-resistant TB treatment. Among these advancements is the facilitation of sputum sample transfers to hospitals for drug-resistant TB testing.

Looking Ahead

The Cure Tuberculosis Project has laid a strong foundation for ongoing efforts to fight drug-resistant TB in the Kyrgyz Republic. This marks a significant stride toward health security and poverty reduction. Furthermore, sustained collaboration and innovation could be essential in consolidating these gains and ensuring a healthier future for the Kyrgyz people.

– James McAlinden

James is based in Rosehearty, Scotland and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Zambia’s Cholera Outbreak: The Battle for Public Health

Zambia’s Cholera OutbreakZambia’s recent cholera outbreak has been the catalyst for significant hardships for its population, with devastating consequences for public health. Since October 2023, there have been more than 10,887 cholera cases, with more than 432 reported deaths.

Cholera is a waterborne illness caused by the bacterium Vibrio cholerae, which produces a toxin in the small intestine, leading to loss of fluids and electrolytes. The bacterium manifests itself in contaminated water, which in turn affects underdeveloped countries lacking resources for proper water supplies and sewage disposal.

Densely populated areas such as Lusaka, with limited or no access to clean water and sanitation, are facing the worst consequences, with a devastating 4,443 cumulative cholera cases since October 2023.

Government Initiatives

In response to Zambia’s cholera outbreak, the Zambian government has taken decisive action through robust initiatives, including the Multi-sectoral Cholera Elimination Plan (MCEP) 2019-2025, with the aim to eliminate cholera by 2025. The MCEP has set six targets, including, but not limited to, improved surveillance of cases, reduction of the overall mortality rate of cholera by 90%, accelerated access to safe drinking water and conduction of oral cholera vaccination campaigns.

According to the World Health Organization and the United Nations Children’s Fund (UNICEF) Joint Monitoring Programme for Water Supply and Sanitation, 39% of Zambia’s population does not have access to basic drinking water services. In comparison, 69% do not have access to basic sanitation services. The MCEP has estimated that in order to reach its targets, Zambia will need to provide basic water supply to 660,000, basic sanitation to 1.16 million and basic hygiene services to 1.46 million people yearly. In order to do so, the MCEP has set a budget for $99,345,493 over seven years, with $67,877,076 dedicated directly to water supply, sanitation and hygiene.

NGOs and International Aid Efforts

In addition to government initiatives, nongovernmental organizations (NGOs) and international aid agencies have played a crucial role in addressing Zambia’s cholera outbreak. For example, Oxfam and the Keepers Zambia Foundation (KZF) are working together to train volunteers to be health promoters. Volunteers help people who fall ill with cholera get oral rehydration therapy, refer patients to the hospital and encourage people to practice good hygiene. Furthermore, Oxfam is working with KZF to provide oral rehydration salts and chlorine to treat unsafe water, as well as providing equipment such as soap and clean buckets to prevent the further spread of cholera.

Another example of international aid efforts comes from WaterAid. The organization calls on global governments and stakeholders to invest funds in sustainable water resources, sanitation and hygiene services to support Zambia both immediately and in the future. Moreover, WaterAid Zambia is working with local Zambian communities to fight against waterborne diseases such as cholera. This includes education on basic hygiene practices and promotion of community-led sanitation initiatives. These are sustainable, long-term changes that address the root causes of the cholera outbreak in order to prevent any possible future outbreaks.

Innovations in Cholera Prevention

There are currently three WHO pre-qualified oral cholera vaccines: Dukoral, Shanchol and Euvichol. All of these vaccines require two doses for full protection. Dukoral requires a buffer solution of 150ml of clean water and protects for two years. Shanchol and Euvichol, however, do not require a buffer solution and protect from cholera for three years.

The latter two are currently available for mass vaccination campaigns in areas with an outbreak through the Global Oral Cholera Vaccine (OCV) stockpile, supported by Gavi, the Vaccine Alliance. Currently, a mix of live, killed and conjugated vaccines are in development with the hopes of long-term protection and easy administration.

Conclusion

Zambia’s cholera outbreak has underscored the critical need for comprehensive public health interventions to address waterborne diseases effectively. While significant progress has been and continues to be made through government initiatives, NGO efforts and international aid efforts, challenges such as limited supplies and heightened demand persist. However, with sustained commitment, investment and community engagement, Zambia can work towards a future where the impact of cholera outbreaks is minimized and public health resilience is strengthened.

– Emily Weir
Photo: Flickr

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Tuberculosis in Kenya

Kenya Battles TuberculosisKenya continues to battle against major communicable diseases, including tuberculosis (TB). With more than 120,000 affected patients each year, the African Institute for Development Policy (AFIDEP) documents the disproportionate rising cases among men from low and middle-income countries such as Kenya. ADIDEP cites how inequalities toward men seeking health, have exasperated due to factors such as poverty, poor environment, housing, food security, lack of education and financial hardship. 

The World Health Organisation (WHO) recognizes common symptoms of TB include prologued cough with blood, chest pain, weakness, fatigue, weight loss, fever and night sweats. In recognition of the 32% undiagnosed and untreated TB patients in Kenya reported in 2023, the Ministry of Health launched the 2023/24 – 2027/28 National Strategic Plan (NSP) for TB, Leprosy and Lung Health. This program aims to put an end to the devastating impact of TB on Kenya’s communities.

Diagnosis and Treatment

Doctors treat tuberculosis with antibiotics. In Kenya, the primary antibiotics improving TB patients’ health are isoniazid, rifampin, pyrazinamide, ethambutol and streptomycin. Patients must take these medications daily for four to six months. WHO advises anyone experiencing symptoms of TB to seek medical attention immediately.

Ministry of Health Support to End Tuberculosis

During its launch, Mary Muthoni, the Principal Secretary for Public Health and Professional Standards, emphasized the 2023/24-2027/28 National Strategic Plan’s commitment to a people-centered approach in addressing tuberculosis in Kenya. In her February 2024 speech to the National Assembly Committee on Delegated Legislation, Mary announced the start of a community-centered Universal Health Coverage (UHC) initiative, to deploy 100,000 Community Health Promoters. This initiative aims to enhance household screenings proactively and strengthen the government’s battle against TB. Furthermore, the program seeks to eliminate TB, leprosy and other lung complications by 2030.

Facilitating Gender Responsive Policies

The Division of National Tuberculosis, Leprosy, and Lung Disease Program (DNTLD-P) has collaborated with the LIGHT consortium since 2020 to enhance the Kenyan government’s efforts in addressing gender discrimination among TB patients. This partnership aims to fill gaps identified in Kenya’s previous NSP for 2019-2023, which lacked initiatives targeting gender-specific barriers to TB care and treatment.

The government has evaluated gender-equality approaches to ensure TB patients in Kenya receive fair treatment, regardless of gender. LIGHT, a global health research program, focuses on supporting TB treatment policies and practices in Kenya, Malawi, Nigeria and Uganda, with an emphasis on gender inclusivity. Its research demonstrates that improved access to TB care for men has decreased TB-related deaths, curbed transmission within communities and reduced the financial strain of TB treatment in Kenya. In response to LIGHT’s policy enhancement efforts, the NSP for 2023/24–2027/28 outlines specific initiatives aimed at assisting male TB patients in Kenya through the following targeted implementations:

  • Addressing socio-cultural barriers that prevent men, women and children from accessing healthcare
  • Creating awareness of TB and reducing stigma
  • Engaging strategically with a range of key stakeholders to ensure research is informed

 A Healthier Kenya

Initiatives like the NSP for TB and the LIGHT consortium’s efforts illuminate the path toward ending tuberculosis by fostering inclusivity and community support. These strategies are poised to transform health and tuberculosis care in Kenya and signal a promising future where access to treatment transcends gender barriers, enabling a united fight against this persistent disease.

– Kasia Flisiuk

Kasia is based in London, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Preventing Chronic Obstructive Pulmonary Disease in Nigeria

Chronic Obstructive Pulmonary DiseaseChronic obstructive pulmonary disease or COPD, ranks as the third leading cause of death worldwide, trailing only behind heart disease and strokes. The condition impedes breathing by damaging the airways and/or lungs. It may cause chronic coughing, mucus and wheezing and permanently disable the affected individual. In affluent countries, one can easily avoid it by self-care, especially by avoiding smoking.

On the other hand, in developing countries, air pollution and the living environment are much more significant factors. Interestingly, estimates suggest that 50% of COPD cases in Sub-Saharan Africa occur in individuals who have never smoked and it often remains undiagnosed. It is a silent killer of so much of the population simply because they are impoverished.

Chronic Obstructive Pulmonary Disease in Nigeria

The lifestyle of the people in Nigeria likely causes chronic obstructive pulmonary disease in the country. Whether or not people smoke tobacco, most African kitchens suffer from poor ventilation due to biomass smoke. Biomass fuel includes anything from a living thing, mostly wood or animal waste. Fires, often fueled by more biomass or kerosene, are also constant for heating or light. Although women are less likely to smoke than men, they have the same amount of COPD cases because they spend far more time inside the house.

COPD prevalence in Nigeria is attributable to factors beyond solely toxic air. Malnourishment at birth is a high-risk factor, potentially leading to weaker or misshapen lungs. Unborn and newborn infants, sharing environmental exposures with their mothers, may also encounter lung defects. Moreover, in economically disadvantaged African communities, high rates of HIV and tuberculosis persist. These diseases, if causing lung damage, contribute to the risk factors for COPD.

Prevention

COPD remains incurable, with survival strategies centered around removing oneself from potential dangers, such as tobacco use, engaging in regular exercise and maintaining optimal lung health. Ideally, addressing this concealed epidemic involves preventive measures to stop it before it begins.

However, the World Health Organization has implemented multiple steps to protect Africans from chronic obstructive pulmonary disease. The first is the WHO Framework Convention on Tobacco Control, approved by 180 countries, including Nigeria, which aims to help protect people from tobacco smoke. The second is the Global Alliance against Chronic Respiratory Diseases (GARD), a network aimed solely at eliminating respiratory illnesses like COPD and asthma in low- and medium-income countries.

Various other proposals have been suggested to prevent illnesses caused by indoor air pollution. One approach involves the construction of homes equipped with chimneys or flues, allowing smoke to exit the living spaces efficiently. Creating infrastructure to provide homes with electricity or gas for cooking could eliminate the use of biomass fuel and its associated smoke.

Enhancing housing conditions goes beyond improving living standards; it has the potential to not only create better living environments but also to save lives.

– Varsha Pai
Photo: Pixabay

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Chagas Disease: Unveiling the Silent Struggle

Chagas DiseaseChagas Disease (CD) is a tropical disease caused by the parasite Trypanosoma cruzi. In 2022, The Bolivian Chagas Network reported that approximately 7 million people are infected with CD and 25 million are at risk of infection. More than one million of these cases stemmed from Bolivia, the country that retained the highest rate of CD in the world.

The Impact of Chagas Disease

There is no vaccine against CD, but if detected in the initial acute phase it can be treated.

The disease mostly spreads as a result of vector-borne transmission. These blood-sucking bugs, called triatomine, bite an infected animal or person and pass the parasites on to humans via feces. These bugs also tend to bite people’s faces, and are therefore referred to as “Kissing Bugs.”

CD can also be transmitted via blood and organ donation as also congenital transmission, from a pregnant woman to her baby. Contraction of CD in the initial phase presents as mild flu-like symptoms and in the later stages can lead to cardiac, digestive and neurological alterations. It has been detected in 21 countries in Latin America and is endemic to this region. In November 2023, The Global Health Innovative Technology Fund reported, that in comparison to all other parasitic diseases in the Americas, CD carried the largest burden of disability-adjusted life years.

The Bolivian Chagas Platform

In 2009, The Bolivian Chagas Platform was formed in a bid to control CD. It consisted of both local and international forces with a strong emphasis placed on promoting trans-nationality to allow research to be shared. Groups involved in The Bolivian Chagas Platform included ISGlobal, CEADES, AECID and the Bolivian National Chagas Program.

Originally piloted in three of Bolivia’s most affected regions, Cochabamba, Tarija and Chuquisaca, a specific strategy was implemented in seven centers to begin with. The four focus areas were: providing care, training health personnel, performing research and engaging with the community.

Due to the success of the pilot program, the operation was scaled up and extended to a further 52 centers.

The results of the Platform have been positive and have improved the care for CD at both national and international levels.

Detecting Chagas Disease

The existence of the Bolivian Chagas Platform centers has facilitated the screening of more patients, resulting in the detection of a greater number of CD cases. CD is often referred to as a “silent disease” as infected patients present either with no symptoms at all or with ambiguous symptoms resulting in misdiagnosis. If treatment is not given quickly, the damage becomes irreversible, and the patient cannot be cured. Therefore, timely detection of CD to ensure early treatment is crucial to save a person’s life. Furthermore, early detection of the CD helps in its control because transmission is prevented.

Increasing Research and Resources Available

ISGlobal reports that, at present, there are two drugs available for treating CD, nifurtimox and benznidazole. Research studies on this disease have been scarce due to limited resources and funding. As a result, the majority of people infected with CD do not have access to treatment.

The Bolivian Chagas Network reported that of the 57,871 people who tested positive for CD, 32.1% were able to be treated as a result of this platform. Furthermore, 67% of health care workers were given CD training, more resources were provided and detailed research was undertaken.

Whilst the two drugs used to treat CD are highly effective, they were developed over 50 years ago, therefore greater updated research is imperative.

Minimizing the Stigma and Promoting Awareness

Despite 10,000 people dying from Chagas Disease every year, it remains largely unheard of by the general public.

The UN has reported the negative consequences of the stigma associated with CD. Largely people view CD as confined to rural and poorer areas, but this is not the case. ISGlobal reported that in Spain, only an estimated 30% of people with CD are diagnosed and treated.

– Heidi Helen Horgan
Photo: Flickr

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The Bolivian Chagas Platform

The Bolivian Chagas PlatformChagas disease, a parasitic disease commonly found in Latin America, has become a global public health concern. Affecting more than six million people annually, Chagas is one of 17 illnesses acknowledged as neglected tropical diseases. Also known as American trypanosomiasis, Chagas is primarily transmitted to humans through the feces of triatomine bugs, also known as “kissing bugs,” when they bite and feed on blood. The disease can also be transmitted through blood transfusions, organ transplantation, contaminated, uncooked food and from mother to child during pregnancy.

Chagas claims more than 12,000 lives each year and is the leading cause of heart disease in the Americas. However, the disease is treatable. While most Chagas patients are infected as children, symptoms often only manifest in adulthood, by which time it is often too late. The majority of cases occur in poor communities in Central and South America, where 99% remain ultimately untreated due to inadequate global Chagas surveillance. Today, Bolivia has the highest worldwide prevalence of Chagas disease.

Bolivia’s Efforts at Disease Control

Although the Bolivian Ministry of Health declared the prevention and treatment of Chagas to be of national interest, lack of resources, management, implementation and regulation of solutions prevented the introduction of treatment until the early 2000s.

In 2009, in conjunction with the CEADES Foundation and the Barcelona Institute for Global Health (ISGlobal), Bolivia established the Platform for the Integral Care of Patients with Chagas Disease. The platform aimed to provide comprehensive care for individuals with chronic infection. It was based on four pillars:

  1. providing care
  2. training health personnel
  3. performing research
  4. engaging with the community

The Bolivian Chagas Platform developed a two-stage plan aimed at addressing the situation. First, the platform implemented a top-down test program to introduce a health care plan using protocols to work closely with local health authorities in seven local centers. From 2009 to 2014, the program was recognized as a successful approach for effectively handling Chagas disease in three of Bolivia’s most affected cities.

In the second phase of the Bolivian Chagas platform, starting in 2015, the model was expanded to 52 primary health care centers. This expansion was achieved through a decentralized and horizontally scaled-up approach. At the end of the second phase in 2018, more than 181,000 people at risk for Chagas received testing, resulting in a 32% increase in diagnoses and considerably improved patient care. Additionally, 67% of health care workers in the intervention area received training specific to the Chagas Platform guidelines. Chagas screening has now been implemented for regulatory health care visits.

Current Situation and the Way Forward

Although Bolivia ranks as the leading country in the global prevalence of Chagas, it fell from first to fourth position in terms of the number of people infected by the disease as of 2015, after the program’s first stage. The global impact of Chagas disease has demonstrated a consistent decrease in the number of cases.

While most are still concentrated in Latin America, the rising numbers in North America and Europe underscore the need to screen high-risk populations and increase awareness of this overlooked tropical disease. Chagas persists today as an endemic disease in 21 countries. With adequate resources, quality of diagnosis, proper treatment and primary health care integration, the effects of the Bolivian Chagas Platform can ensure long-term success.

– Bella Simokaitis
Photo: Flickr