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Ghana Eradicated Trachoma, a Disease That Left Millions Blind

Ghana Eradicated Trachoma, a Disease That Left Millions Blind
On June 13, 2018 the World Health Organization (WHO) confirmed that trachoma, an infectious and painful disease of the eye that may potentially lead to blindness, is no longer a public health concern in Ghana.

Trachoma and Ghana

Ghana sits on West Africa’s Gulf of Guinea and is a home to 28 million people — 2.8 (or 15 percent) of which were at risk of trachoma in 2000. The WHO attributes the success to a collective effort between local and regional communities and international collaboration.

Trachoma is caused by Chlamydia bacterium and is spread by flies, a lack of sanitation and lack of access to clean water. When a person has the disease, the inside of the eyelids become scarred and curl inwards, causing the lashes to scrape against the lens of the eye, eventually destroying it if left untreated.

The disease was once common in the west, but has since been reduced to areas of the world where people do not have the resources to fend off the disease, usually attacking the world’s poor and leaving them unable to properly carry out their daily tasks.

Trachoma of the Past, Present and Future

Often described as a sensation of “thorns” in the eyes, trachoma is an extremely uncomfortable and serious disease. The disease is ancient, and dates as far back as the time of the pharaohs and ancient Greeks and Romans. Even prominent figures across ancient history such as St. Paul, Cicero, Horace and Galileo were believed to have suffered from the disease.

In 2000, the Ministry of Health and Ghana Health Service put in place a national Trachoma Elimination Program. This program involved putting the Surgery for Trichiasis, Antibiotics to Ward Off Infection (SAFE) strategy into action.

Surgery for trichiasis, the condition in which the eyelashes grow inward, was provided free of charge for more than 6,000 patients, and the pharmaceutical company Pfizer donated 3.3 million doses of Zithromax antibiotics to help avoid infection.

Pfizer also has plans to continue to donate Zithromax globally to help other trachoma-endemic countries. The importance of hygiene and facial cleanliness was promoted throughout the community during events, school health education and radio messages — while Ghana’s Community Water and Sanitation Agency worked towards environmental improvements.

Number Seven, Ghana

Ghana is the seventh country to have officially wiped out the disease, along with Oman, Morocco, Mexico, Cambodia, Laos and Nepal — and it is the only sub-saharan African country to have done so. In spite of this brilliant success, up to 200 million people are still at risk of contracting trachoma in 41 countries, many of which are on the African continent.

Experts are hopeful for the future eradication of the disease considering the ways in which Ghana eradicated trachoma. WHO Director-General Dr. Tedros Adhanom Ghebreyesus expressed his optimism saying, “Although there’s more work to do elsewhere, the validation of elimination in Ghana allows another previously heavily-endemic country to celebrate significant success.”

– Camille Wilson

Photo: Flickr

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How an App to Treat Malaria is Working in Mozambique

App to Treat MalariaFor the people of Mozambique, malaria is a familiar and deadly part of life. As one of the world’s leading victims of the disease, Mozambique sees thousands of its citizens die as a result every year. Global initiatives have fought hard to treat and prevent malaria, including awareness campaigns and insecticide-treated nets. Since 2015, though, Mozambique has used an innovative resource: a smartphone app to treat malaria.

Mozambicans in rural areas often receive their health care from government-funded community health workers. These community health workers (agentes polivalente elementare, or APEs) are trained to diagnose and treat Mozambique’s most ubiquitous diseases, including malaria. Seeing a need to improve treatment, APEs in Mozambique have been provided with the CommCare app, created by the Malaria Consortium’s inSCALE research project and funded by the Bill & Melinda Gates Foundation.

The CommCare app allows APEs to better treat their patients through a number of means. It teaches better consultation methods through images and audio. It also creates better communication between APEs and their supervisors and functions, so medical records can be uploaded anywhere. App users in Mozambique have reported that it provides for clearer and more accurate treatment. New methods for recognizing and treating malaria are more easily transmitted to remote areas. The app to treat malaria has given community health workers better tools, communication and resources to assist in their vital work.

The entire population of Mozambique is at risk for malaria infection, typically spread by insects. The disease presents itself through flu-like symptoms and can be fatal if left untreated. Prior to 2010, there are no official figures for the number of deaths due to malaria. Since 2010, deaths to malaria have decreased and, in 2015, dipped to an all-time low.

On a morose but encouraging note, malarial confirmations have risen concurrently with the decreasing deaths. This suggests that malaria is being recognized, diagnosed and treated in Mozambique.  

Malaria is a relatively easy disease to treat. With early diagnosis, antimalarial medications can clear out the parasite and cure the patient. African countries are prone to malaria because of several factors: mosquitoes are rampant, medical clinics are scarce and preventative measures are often difficult to come by.

Because early diagnosis is so vital to a malaria victim’s odds of survival, Mozambique has taken steps to bridge the gap between rural areas and medical treatment. Aside from preventative measures, Mozambicans in remote areas rely on APEs to treat the country’s deadliest afflictions. The CommCare app gives APEs the resources to more accurately diagnose malaria and treat it appropriately.

Mozambique is seeing a positive trend in recent years. There are more diagnoses and fewer deaths. Eradication of the disease is still far off; however, using technology such as the CommCare app to treat malaria is guiding Mozambique in a positive direction. Countries around the world would be served well by adopting the same approach to the fight against malaria.

– Eric Paulsen

Photo: Flickr

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Malaria Box May Hold the Key to Defeating Malaria

Malaria Box May Hold the Key to Defeating Malaria
In order to jump-start research on drug treatments, the Gates Foundation, the Medicines for Malaria Venture and GlaxoSmithKline put together a “Malaria Box” in 2012. The Malaria Box is a collection of 400 different compounds that are known to combat malaria in some way.

More specifically, 200 of the compounds are supposed to act like drugs and would directly be used in developing more effective oral drug treatment. The other 200 act more like biological probes that, if applied correctly in malaria research, could allow researchers to make important observations about the behavior of malaria.

Malaria is a widespread disease to which nearly half the world population is at risk. There were about 214 million cases in 2015, resulting in 438,000 deaths. Of this group, young children were particularly susceptible.

More effective drug treatments for malaria are imperative. Current treatments involve prescribing many drugs to be taken over a number of days. Sometimes patients are not able to receive the full treatment of drugs. Not only does this lead to continuing infection, but an incomplete treatment also contributes to the rise of multi-drug resistant malaria. The fact that malaria parasites continue to evolve poses an obstacle to developing drugs that will consistently work in the future.

The Malaria Box was given as part of a grant to 17 research projects in order to accelerate malaria research. After a few years, these research teams yielded positive results in the battle against malaria. Some researchers have tried to identify weak points to attack in the malaria parasite. For example, Dr. Jacquin Niles of MIT is trying to isolate genes particularly susceptible to attack by conducting tests on genetically modified parasites.

Dr. Jake Baum of the Imperial College of London is studying compounds that could block malaria transmission. He is researching whether molecular compounds that do not remain in the bloodstream for as long as other anti-malaria drugs can still effectively combat malaria.

After the success of the Malaria Box, other projects to distribute sets of compounds have been started. The ReFRAME library at the California Institute for Biomedical Research contains more than 10,000 compounds that are known to combat various diseases. Giving researchers access to these sets of compounds provides them with a strong and focused starting point from which to conduct their studies.

– Edmond Kim

Photo: Flickr

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Disease Prevention: Polio in Africa is Nearly Eradicated

Disease Prevention: Polio in Africa is Nearly Eradicated
After a 28-year-long effort, polio in Africa is nearly eradicated. In August, the World Health Organization launched an intensive investigation into all of the continent’s collected data. The results already indicate one of the greatest public health victories of the century.

Only two cases of polio, both of which occurred in Nigeria, have been reported in the last two years. While these couple of cases prove that more work is needed, the global health community has made incredible strides in eradicating polio in Africa and throughout the rest of the world.

Polio is a highly infectious virus that progressively destroys the central nervous system. Initial symptoms include fatigue, headache, fever, vomiting, pain in limbs and stiffness of the neck. In some cases, it only takes several hours to cause total paralysis of the entire body. The virus spreads person to person or by way of a contaminated vehicle, contaminated drinking water or food are a couple of examples. Children are most susceptible and have been the focus of large-scale vaccination efforts for decades.

When the Global Polio Eradication Initiative launched in 1988, the disease was present in over 125 countries. More than 350,000 people were paralyzed every year. Since then, cases have dropped by 99% and universal vaccination has protected over 13 million children from potential paralysis.

Today, polio was eradicated throughout most of the world. According to the CDC, the U.S. hasn’t seen a single case since 1979. For countries whose health care delivery systems lack funding, infrastructure and political support, polio eradication is an astonishing victory.

Pakistan and Afghanistan are the only two countries where polio transmission has never been interrupted. Even so, the two nations have joined forces to improve vaccination efforts. Pakistani and Afghan leaders have pinpointed their shared border as the focal point of their synchronized effort, establishing 14 new vaccination points.

Recognizing this victory in context reminds us that long-term disease control is possible given the cooperation of stakeholders at the local, regional, national and international levels.

– Jessica Levitan

Photo: Flickr

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Reducing the Prevalence of The Top Diseases in Morocco

Top Diseases in Morocco
Although modern in many respects, Morocco remains a traditional country that struggles to combat certain diseases. The country with a population of 33,680,000 has a life expectancy of 71, which is right at the world’s average. Although there are a good number of physicians and medical centers available, the rural population still experiences difficulty accessing these facilities and safe drinking water. Here are the top diseases in Morocco:

Hepatitis

Hepatitis A, B, C, and E are all prominent in Morocco, but currently, hepatitis A and B are the only forms that can be prevented through a vaccine or medication. Regardless of where you are staying or what food you are eating, there is a high possibility of obtaining hepatitis A in Morocco due to contaminated food and water. It is also transmitted through person-to-person contact.

Hepatitis B, which is transmitted via blood and bodily fluids, is another dangerous disease. Activities such as intercourse with the local population, intravenous drug use, contaminated tattoo and piercing equipment or exposure to blood may yield hepatitis B. Symptoms usually include nausea, fatigue, dark urine, abdominal pain and jaundice.

Hepatitis C is a viral infection that inflames the liver. This form of hepatitis is similar to the others because it can be transmitted person to person and through activities that expose one to blood and other bodily fluids.

Hepatitis E is extremely endemic in Morocco and also inflames the liver. Water contaminated with fecal matter and foods that contain raw or undercooked meats, may result in exposure to hepatitis E.

Rabies

Rabies, which is found everywhere, is another prominent disease in Morocco. One can obtain rabies through mammal bites, especially from dogs, cats and bats.

Typhoid

Common in areas with poor sanitation, Typhoid Fever is a gastrointestinal infection that is transmitted from person to person. It’s found in Southeast Asia, Africa, Central and South America and Western Pacific countries. Symptoms include headaches, lack of appetite, enlarged liver and constipation. Similar to hepatitis E, ensuring that one’s food is thoroughly cooked is an easy way to avoid typhoid.

Schistosomiasis

Schistosomiasis, a disorder that has become more prevalent due to irrigation, is characterized by the inflammation of the intestines, bladder, liver and other organs. It was first detected in Morocco in 1914, but reached its peak post-independence when the new government was constructing numerous irrigation systems across the country.

Almost as dangerous as malaria, it is a serious parasitic infection that affects nearly 200 million people in Africa, Asia, South America and the Caribbean. The lack of clean water makes schistosomiasis easily attainable because worms that carry the parasite can be found where people work, bathe or swim.

Although the top diseases in Morocco are affecting not only the population but those who visit the country, there is ample aid given to reduce the prevalence of these diseases. Organizations such as USAID and the World Health Organization (WHO) funnel money to provide more portable water, vaccinations and access to medical personnel and facilities. The U.S. planned to give $33,500,000 to combat top diseases in Morocco.

The country has been open to implementing strategies that lead to impressive differences. For example, Morocco started using azithromycin on a large-scale, the first country to do so, in an attempt to control trachoma.

Overall, Morocco has also made great strides towards eliminating other diseases including eradicating malaria, which it accomplished in 2010.

– Ashley Morefield

Photo: Flickr

Top 5 Diseases that are Nearly Eradicated

Top 5 Diseases that Are Now Nearly Eradicated
For many years, life expectancy of humans was around 40 to 50 years old. Once modern medicine advanced, these numbers changed drastically. Thanks to vaccinations and better medical understanding of diseases, people all over the world can rest a little easier knowing some life-threatening diseases are now nearly eradicated.

Smallpox

Smallpox has been responsible for an estimated 300 million to 500 million deaths in the 20th century alone. This horrifying disease was characterized by small, painful bumps which appeared all over a patient’s body. Smallpox was particularly scary because it affected people of all ages. When scientist Edward Jenner noticed that individuals who had been exposed to cowpox were seemingly immune to this disease, an idea struck. Since the invention of the small pox vaccine in 1796, the world has seen a rapid decrease in the number of cases. In fact, smallpox is the only disease that is considered to be 100 percent eradicated throughout the entire world.

Polio

At its prime, polio was known to be one of the most feared diseases in the world, mainly because it primarily affected young children. It sent hundreds of thousands of children to the hospital. When Dr. Jonas Salk invented a vaccine against it, the world rejoiced. Although this vaccine has not yet been spread throughout the world, with help from organizations such as the Bill and Melinda Gates Foundation, polio is on its way out. Hopefully within the next few years, polio will have been eradicated throughout the entire world and parents will no longer have to fear for the lives of their children.

The Plague

The Black Death killed over 50 million people in Europe, accounting for about 60 percent of the population at the time. The disease was spread through infected rats and other small animals. Once infected, people were highly contagious. This disease was characterized by horrible blisters called “boobos” that would emerge and fester on an ill persons’ body. While doctors did not know how to prevent this disease at the time it has since disappeared from the world as sanitation and medical practices have become much more elaborate. While there may be one case every decade, it looks like the plague is gone for now and, hopefully, will never make another appearance.

Tetanus

Tetanus has long been considered a disease of filth, something one can catch by touching rusted metal or using an infected needle. It affects thousands of people each year and causes muscle spasms, lock-jaw and a whole host of other horrible symptoms. Nowadays, most developed nations such as the United States no longer have trouble with this disease, as children are regularly vaccinated against it. In developing nations doctors can administer emergency tetanus shots and have seen great success with this. It is imperative that doctors begin to vaccinate more patients in third world countries as these are the most at-risk individuals. Although this disease has not yet been eradicated, the number of cases has drastically dropped.

Rabies

Rabies has long haunted the big screen throughout the world, with visions of Old Yeller foaming at the mouth sending audiences to tears everywhere, but this image is a reality for many individuals who live every day surrounded by stray animals. Rabies is a virus which is contractible by almost any mammal and is characterized by over excitation, confusion, paranoia, fear of water and the tell-tale foaming at the mouth. Rabies can be transferred through a bite from an infected animal and can have devastating effects once the virus takes root. Thankfully, vaccines have been developed to prevent the disease from taking hold. Whenever an individual is bitten by an animal, it is mandatory that they get a rabies shot; these regulations have allowed doctors to monitor and significantly reduce the amount of rabies related deaths in the United States. Many other nations such as India and parts of Africa are beginning to adapt these procedures and are currently making key decisions about the lives of their stray furry friends.

Thanks to the care and dedication of many scientists and researchers, we now live in a safer and happier world. Hopefully more innovation can lead us down a path of true health and happiness.

– Sumita Tellakat

Sources: MNN, UNICEF

Photo: My NYC Doctor

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India Aims to Eradicate Lymphatic Filariasis

Lymphatic_FilariasisNeglected tropical diseases, or NTDs, are preventable illnesses that impact the poorest regions of the world. The NTD Lymphatic Filariasis (elephantiasis, LF) threatens millions of people across India today. The disease causes intense pain and physically disfigures the bodies of those it plagues.

LF, like other NTDs, is preventable. In many cases across the world NTDs infect millions in extremely poor regions because there is no treatment available.

In India this is not the case; treatment is being made widely available. The Indian government has recently launched an ambitious goal of eradicating LF, providing treatment to around 460 million people in 17 different Indian states.

The reason LF remains present in India today is due to lack of disease awareness and education surrounding the disease. There is also a general suspicion towards pharmaceuticals distributed by the government or by large organizations. For these reasons, people simply do not consume the pills they receive.

Almost half the population of India is at risk of contracting LF. LF takes around eight to ten years to begin visibly showing its damage; and this delay often makes people forget about the danger of this NTD. Prevention of LF, despite the public’s hesitancy toward it, is extremely easy. It requires only the consumption of pills.

To raise awareness about LF and prevention and to try to persuade Indians to take the pills they receive, The Indian Ministry of Health and Welfare along with the Global Network for Neglected Tropical Diseases has created a public service campaign called “Hathipaon Mukt Bharat” or Filaria Free India in the hopes of eradicating LF through education on the disease and the importance of pill consumption.

The creative campaign includes three TV and cinema videos in 10 languages; radio, newspaper and print, cellphone, and online advertisements are also a part of the campaign. The goal is to create awareness and a shared sense of nationalistic determination to unite all and help eradicate the disease.

Research indicates that in advertisements, audiences react much more strongly to positive messages. And the campaign is simple and uplifting, that LF pills are safe and free, and together India can overcome LF. Powerful imagery also captures the audience’s attention; a man in late stages of LF stands disfigured at a small hospital clinic. He explains to children how he “never thought it would happen to me.”

India is a diverse country, celebrating over 780 languages. The background music of the campaign is in Sanskrit,the language of ancient India that many religious texts are written in. It is not spoken today and only a few scholars and religious people know how to read it. It unites the country with its rich history. The lyrics translate to “Every sign or indication leads us to the path of knowledge. And the journey across that path of knowledge leads us to absolute truth.”

Over 200,000 health workers in 14 Indian states were involved in the initial campaign drive. They helped expose over 300 million people in India to information on LF.

“India has made great strides over the last decade to eliminate lymphatic filariasis in endemic states and we are now on the verge of reaching elimination targets nationally. However, the last mile of the journey is often the most difficult. We are employing a wide range of new communications tactics and partnerships that will help us encourage all people at risk from this disease to consume their free dose of medicine during our annual mass drug administrations” explained Mr. C.K. Mishra, Additional Secretary and Mission Director of the National Health Mission at the Ministry of Health & Family Welfare.

– Margaret Anderson

Sources: WHO, Impatient Optimists, Sabin
Photo: National Geographic

Myanmar Launches Vaccination Campaign

vaccination_campaign
In January 2015, the Myanmar government launched the first stage of the largest national campaign to eradicate and control Measles and Rubella by the year 2020.

The second stage took place in February 2015. Initially, these beginning stages were concentrated on Measles, but from May 2015 onward, the national campaign will offer the Measles and Rubella vaccine jointly.

The campaign is supported by the WHO, GAVI, American Red Cross, the U.N. Foundation, the U.S. Centers for Disease Control and Prevention and UNICEF. The goal is to reach 94 percent of the population through vaccination teams of 12,000 health care professionals. The aim is to reach 17 million children between nine months and 15 years in 65,000 villages and 45,000 schools.

Myanmar has remained committed to vaccinating its population against fatal and debilitating diseases. In 2013, a polio immunization campaign was launched and 370,00 children under five years were vaccinated using the oral drops method. In early 2014, Myanmar, along with many other states in Southeast Asia, was declared polio-free.

Health care is reported to be expensive, of a poor quality and has difficulty in providing attentive care toward patients in Myanmar.

This vaccination campaign is also incredibly important because the population has been neglected in terms of health care due to the ongoing conflict and political issues. There are 587,000 internally displaced persons. There are 800,000 living in the western state, Rakhine state, who are stateless and 140,000 who have fled from their homes. Nevertheless, this campaign is attempting to reach those living in Rakhine state, which has been in an increasingly violent conflict-ridden state since 2012 as there are numerous clashes between Muslims and Buddhists. The vaccination campaign aims to reach populations in this region at a higher rate to match the national level.

While there are political hurdles to achieving an overall better health care system, the coordination of efforts between the state, local and international bodies in regard to vaccination is successful. This vaccination campaign is a major stride for Myanmar investing in the betterment of its people.

– Courteney Leinonen

Sources: Global Polio Eradication Initiative, Reliefweb, WHO, BBC, Salon
Photo: Measles & Rubella Initiative

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Using Satellite Technology to Eradicate Polio

satellite technology
To date, there have been eight attempts to eliminate polio, along with a score of other infectious diseases around the world, but only the elimination of smallpox has been successful. Using modern day smartphone and satellite technology, however, the World Health Organization (WHO) can better locate remote areas where polio is still a threat.

Polio has been eradicated in all but three countries: Nigeria, Afghanistan and Pakistan. The disease is spread by direct person-to-person contact, as well as indirect contact. Insecurity, poor health care and lack of proper sanitation are all reasons as to why these countries still struggle with a preventable disease that is only a distant memory to many countries around the world.

Polio is an disease that can lead to paralysis and even death if not treated. Unfortunately, there is no cure for polio once the infection takes hold, only treatment to make living with it more bearable. However, 100 percent of cases are preventable if every child under the age of five receives a vaccination. In countries like the U.S., the polio vaccine is mandatory.

In order to locate remote communities in Nigeria, Afghanistan and Pakistan, WHO workers use geographic information systems (GIS). GIS involves transmitting satellite images to a computer in order to map an area. In the past—as little as ten years ago—those who wanted to map an area of land would have to fly over it and take pictures. GIS is an improvement on this, as it is remote and allows for more land to be mapped more quickly.

By using GIS, those at WHO can determine the location of extremely rural villages where children need to be vaccinated for the first time, or maybe even the fourth or fifth time, as certain remaining strains of polio are stronger and require multiple vaccinations.

This technology can also be connected to WHO members’ smartphones and allow the organization to track the location of employees, volunteers and patients. This has allowed for an increase in the number of vaccinations, as well as better supervision on the part of the WHO. It is extremely difficult for volunteers to slack off or lie when the operation is being monitored so closely.

Before this collaboration of satellite imaging and smartphones, it was extremely difficult to know which households had been vaccinated and educated on polio prevention and which had not. But since 1988, polio has been reduced by 99 percent, with cases down from more than 350,000 a year to only 406 in 2013.

However, 99 percent is not 100 percent. Technology and dedication may not be enough to completely eradicate the disease, as distrust of western medicine instigated by propaganda from groups such as the Taliban have made it difficult for workers to administer the vaccine.

– Taylor Lovett

Sources: Information Week Health Care, Global Polio Eradication Initiative, World Health Organization
Photo: Lasker Foundation

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What is Uniject?

uniject
Uniject is a revolutionary new injection method. The idea behind Uniject is that it would be so simple to use, that even untrained health workers would be able to safely and effectively give injections. This idea would allow for prepackaged, low-cost syringes. Not only would Uniject provide a safer and more cost efficient method of administering vaccines, it would also cut down drastically on the amount of wasted vaccines. The new syringes would not be able to be reused, also eliminating the chance of HIV transmission.

Uniject is an autodisable injection system created by PATH in Seattle. It is essentially a small bubble of plastic connected to a needle that contains whatever vaccine is desired. Health workers would be able to learn how to use this within two hours of training. The plastic bubble contains exactly one injection of vaccine, ensuring the correct dosage every single time.

PATH developed Uniject through funding from the US Agency for International Development. The idea has since been licensed to BD, which is the largest producer of syringes in the world. As part of this agreement, the technology must be given to pharmaceutical producers at preferential pricing for use in developing country programs. The development of Uniject has taken twenty years.

While Uniject was developed with the idea of providing low-cost effective syringes for use of vaccinations in developing countries, it also has the potential to help reduce poverty in other ways. Uniject could, down the road, also be used for other life saving drugs, as well as a potential contraception delivery method. The use of Uniject to deliver contraception could have an immense effect on the developing world and provide an extraordinarily important outlet for female empowerment and family planning in the developing world.

-Caitlin Zusy 
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