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Addressing Rabies in Developing Countries

Rabies in Developing CountriesRabies is a vaccine-preventable disease that causes tens of thousands of deaths yearly. Although present in over 150 different countries, rabies is most common in developing countries, with 95% of cases occurring in Asia and Africa. Canines cause 99% of rabies infections, accounting for 40% of human rabies infections in Asia and Africa among children aged 15 and under.

Rabies Vulnerability in Developing Countries

Rabies is an extremely dangerous disease with a 99% fatality rate. Vaccination of animals and humans with high exposure rates is possible, but once infected there is little to stop the infection other than immediate treatment of multiple fast-acting shots and vaccines to help fight off the virus are administered with continuous wound washing.

The issue is that many people who live in poverty lack immediate access to these treatments and vaccinations. Even if these treatments are available, they come at a hefty price. Rabies post-exposure prophylaxis (PEP) costs an estimated $108 per treatment not including travel and shipping costs, according to the World Health Organization (WHO). Not only is treatment expensive and often unavailable, but developing countries also have limited diagnostic facilities and almost no rabies surveillance, according to the Centers for Disease Control (CDC).

The vaccination of stray dogs would greatly prevent the infection of humans, but this also comes with a steep cost and risks burdening public health resources even in the most stable countries. Globally, the burden of rabies costs around $120 billion.

Ethiopia Takes Action

Ethiopia is one of the most affected countries when it comes to rabies with an estimated death rate by rabies of about 2,700 deaths yearly. Ethiopia’s canine vaccination rate is far behind the 70% rate necessary to control the disease. Ethiopia suffers from the same limitations as other developing countries regarding inaccessible vaccinations and PEP treatments. As of 2019, 68.7% of Ethiopia’s population is multidimensionally poor.

Despite Ethiopia’s challenges, it still implemented many programs to fight against rabies infections that plague the country due to its high poverty rates and increased vulnerability. Rabies experts from the CDC have been working closely with Ethiopian leaders to determine the best way to safely take on the issue. Local animal surveillance officers and veterinarians get training on the capturing, vaccinating and releasing of stray dogs to control the source of infectors safely and effectively.

Public awareness and methods of youth education are also being implemented to protect young people from becoming infected due to canine exposure. The University of Mekelle has been providing awareness sessions to more than 7,000 children in schools across Ethiopia. However, a large portion of Ethiopian children is still at great risk due to high levels of multidimensional poverty which leads to a large number of children who do not attend formal school programs. With programs that target a larger community-based audience, more people could benefit from education and interest in participating in safe response protocols such as immediate wound washing and PEP administration.

Vaccination centers located in precise locations based on the high canine population have been recommended by the CDC and are expected to bring about positive coverage results. These are all necessary steps in the control of rabies in developing countries.

Looking Ahead

Ethiopia is setting the standard for the control of rabies in developing countries. With the improvement of educational sources, health services and animal control services rabies contraction in humans could be under control. However, as long as multidimensional poverty persists it is unlikely that rabies and other neglected diseases will be able to decrease.

– Leah Smith
Photo: Flickr

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What Are the World’s Deadliest Diseases?

What Are the World’s Deadliest Diseases?
In 2015, the top five of the world’s deadliest diseases accounted for more than 23 million deaths. The top two deadliest, heart disease and stroke, have been the two leading causes of death in the world since 2000 and account for 65 percent of the 23 million deaths.

The world’s deadliest diseases can be either communicable or non-communicable. Communicable disease are contagious and threaten the population with the spread of the disease. Common communicable diseases include respiratory infections and diarrheal diseases. Non-communicable disease are not contagious.

In 2015, as compared to 2000, there are fewer communicable disease in the top global causes of death. This means that medical treatments are working and more people have the ability to access treatments and preventive measures for those diseases.

The World’s Deadliest Diseases as of 2015

  1. Heart disease
    The risk of heart disease comes from both genetic and lifestyle factors. While genetic factors cannot be controlled, changing unhealthy habits to lower the risk of heart disease can be life-saving.
  2. Stroke
    Stroke is caused by a temporary disruption of blood flow to the brain, depriving it of oxygen. That oxygen deprivation can lead to long-term brain damage or death. Education about the warning signs of stroke can lead to life-saving early identification.
  3. Lower respiratory infections
    These infections, such as pneumonia, are contagious but treatable. Greater access to medical care will lead to early diagnosis to prevent their spread among the population and antibiotic treatments that can help lower their prevalence.
  4. Chronic obstructive pulmonary disease (COPD)
    COPD is an inflammatory lung disease that killed more than three million people in 2015. It is caused by exposure to irritating gases, most often from cigarette smoke or burning fuel. Ensuring healthy environments and education on the harms of tobacco can decrease COPD.
  5. Lung cancers
    This includes trachea and bronchus cancers as well, most often caused by smoking or exposure to secondhand smoke. Avoiding smoking and being in the presence of others smoking is the most effective way to prevent lung cancer from developing.

Even though these are the world’s deadliest diseases, diseases do not affect the entire population equally. In countries of lower economic status, the diseases most likely to harm the population differ due to varying access to life-saving resources, such as healthcare and knowledge of best health practices.

In low-income economies, the prevalence of communicable diseases is higher and affects the population more severely. In these countries, the top two killers are lower respiratory diseases and diarrheal diseases. Also in the top 10 deadliest diseases in low-income economies are HIV/AIDS, tuberculosis and malaria, all of which are communicable.

Even though these communicable diseases currently threaten the populations of low-income countries, they are all treatable diseases. With appropriate access to healthcare, healthy environments and knowledge of health practices, the spread of these diseases can be slowed. Preventing these diseases would greatly increase the average lifespan for citizens of low-income countries.

Globally, access to healthcare is important in preventing and treating any of the world’s deadliest diseases. Even though they are the diseases most likely to kill, they can often be avoided with healthy lifestyles and increased access to medicine.

– Hayley Herzog

Photo: Flickr

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Top 10 Causes of Death in Developing Countries

Top 10 Causes of Death in Developing Countries
According to the World Health Organization (WHO), less than a quarter of the population in developing nations lives to age 70. In addition, almost a third of deaths in those countries occur among children younger than 14. These are the top 10 causes of death in developing countries as listed by WHO.

Top 10 Causes of Death in Developing Countries

  1. Coronary Heart Disease
    The most common of all the causes of death in developing countries is coronary heart disease (CHD). In 2015, CHD was responsible for approximately 7.4 million deaths; an estimated three-quarters of these deaths took place in low and middle-income countries. CHD is the disease of the blood vessels supplying the heart, and is caused by poor dieting habits, physical inactivity and excessive drinking or smoking, according to the National Heart, Lung and Blood Institute.
  2. Lower Respiratory Infections
    Lower respiratory infections, such as pneumonia and bronchiolitis, cause more than 1.5 million deaths annually, 42 percent of which occur in developing countries. As stated in a paper published by the National Center for Biotechnology Information (NCBI), these infections are the leading cause of death in children under five and are caused by poor living conditions.
  3. HIV/AIDS
    In 2016, HIV/AIDS caused one million deaths. As stated in a Business Insider article, for many years, HIV/AIDS was the leading cause of death in Africa; however, this is no longer the case due to increased education on prevention and treatment.
  4. Perinatal Conditions
    Of the 133 million babies born each year, 2.8 million die within the first week of life. This is called perinatal mortality; it refers to the death of a mother or her child in the time during and following birth. These deaths could be prevented by improving the quality of health care for pregnant women, especially during delivery.
  5. Stroke and Other Cerebrovascular Diseases
    Five million people die from stroke each year. As noted in a paper published by the NCBI, prevention tactics include eliminating smoking, improving dietary habits and increasing physical inactivity.
  6. Diarrheal Diseases
    According to WHO, approximately 525,000 children under the age of five die from diarrheal diseases each year. These diseases can be prevented by drinking clean water and practicing good sanitation habits.
  7. Malaria
    More than one million people die from malaria each year. According to CDC, malaria is most prevalent in Africa due to a mosquito, Anopheles gambiae complex, which transmits the disease. Young children and pregnant women are most at risk in Africa due to undeveloped or decreased immunity.
  8. Tuberculosis
    There were 1.7 million deaths from tuberculosis in 2016. According to the Health Sector Priorities Review from the World Bank, tuberculosis is treatable, but without chemotherapy, the death rate is 50 percent.
  9. Chronic Obstructive Pulmonary Disease (COPD)
    WHO estimates that in 2015, 3.17 million deaths were caused by COPD, 90 percent of which occurred in low or middle-income countries. As noted in an NCBI paper, cigarette smoking has increased in developing countries, causing a rise in smoking-related diseases, such as COPD.
  10. Traffic Accidents
    More than 1.25 million people die each year from road traffic accidents, 90 percent of which occur in low- or middle-income countries. According to WHO, causes of road traffic accidents include unsafe vehicles, inadequate law enforcement, drivers under the influence and speeding. The 2030 Agenda for Sustainable Development has set the target of halving the number of deaths and injuries caused by crashes by 2020. Possible prevention methods include better education and safer roads and vehicles.

All of these causes of death in developing countries are preventable or treatable. WHO reported that the U.S. spends $8,362 per person per year on health, while Eritrea, a country in Africa, spends $12 per person per year on health. In this way, improving healthcare services in developing nations will substantially decrease the number of deaths.

– Olivia Booth

Photo: Flickr

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The PMI Expansion and Its Five New Countries

PMI expansionThe President’s Malaria Initiative (PMI) aims to help reduce malaria in countries all over Africa. As of 2018, the PMI plan has expanded to five new countries, bringing the total to 24 countries receiving help. Some of the countries that have already been receiving aid are Ghana, Ethiopia and Benin. The five new countries that were added to the expansion of PMI are Burkina Faso, Cameroon, Cote d’Ivoire, Niger and Sierra Leone, all in West Africa.

 

Burkina Faso

Of Burkina Faso’s 19 million residents, 80 percent live in rural areas and are at the highest risk for poverty and poor health. The end goal of PMI is to completely eliminate malaria by 2030. Currently, the National Malaria Control Program (NMCP) strategy for 2015-2020 is to reduce malaria death rates and reduce malaria incidence rates by 40 percent each. The PMI expansion into Burkina Faso is also working on 10 focus areas for the NCMP, such as monitoring, evaluation, emergency management and prevention in pregnant women.

 

Cameroon

In Cameroon, 22 million people are at high risk of contracting malaria, especially pregnant women and children. With the PMI expansion, the Cameroon National Strategic Plan (NSP) included six strategic plans that focus on:

  • Prevention
  • Case management
  • Communication
  • Training and research
  • Surveillance, monitoring, evaluation and epidemic response
  • Program management

The stated mission of the NSP is to make malaria care, prevention and treatment efficient and affordable, even for the individuals who are the most marginalized. By 2018, the goal of the NSP is to reduce both malaria morbidity and mortality by 75 percent.

 

Cote d’Ivoire

As of 2016, almost half of all children living in Cote d’Ivoire were infected with malaria. The National Malaria Strategic Plan (NMSP) for 2010-2017 aims to reduce malaria mortality to one death per 100,000 and reduce malaria cases by 75 percent. The revised plan is also working to increase the number of people that are sleeping under an insecticide-treated mosquito net (ITN) from 33 percent to 80 percent with help from the PMI expansion. The end goal for pregnant women is to have 85 percent sleeping under an ITN and 100 percent of all malaria cases in pregnant women to be treated as quickly as possible.

 

Niger

Twenty million people live in Niger, and of those 94 percent are at risk of contracting malaria. According to the PMI, more than 56 percent of all deaths in pregnant women are caused by this disease. However, in 2017, 80 percent of women received three doses of malaria treatment and prevention medication and slept under ITNs. The NMSP goal is to reduce malaria mortality rates and the incidence of malaria by 40 percent. One expected result for NMCS is for 80 percent of Niger’s population to be sleeping under long-lasting insecticide-treated mosquito nets by 2021. All of these goals are more than attainable thanks to the PMI expansion.

 

Sierra Leone

About 6.5 million people in Sierra Leone are at risk of contracting malaria, and about one million children under five years old receive outpatient care because of malaria. Between 2015 and 2020, the primary goal is to reduce malaria morbidity and mortality by 40 percent. The NMCS objective for Sierra Leone is for 80 percent of the population to have access to prevention and treatment for malaria, and that by 2020 a minimum of 95 percent of health facilities will routinely report to the malaria program.

According to the Institute for Health Metrics and Evaluation, in four out of these five countries, malaria is the number one cause of death. In all five countries, malaria was the number one cause of premature death in 2016. The goal of PMI in all countries is to reduce malaria mortality by one-third and reduce malaria morbidity by 40 percent. All of these programs, goals and objectives have the chance to be hugely successful because of this ongoing work and the PMI expansion.

– Amber Duffus

Photo: Flickr

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WHO Confirmed: The Elimination of Measles in Bhutan and Maldives

Elimination of Measles in Bhutan and Maldives
Measles is a highly contagious viral infection that spreads through air and direct contact. It is characterized by symptoms lasting from four to seven days, including a red rash, fever, cough, conjunctivitis and white spots inside the mouth.

Despite being a vaccine-preventable disease, measles continues to be the leading cause of deaths among young children worldwide. Since 15 percent of vaccinated children do not develop immunity from the first dose, one of the main reasons behind the high death rates associated with the disease is incomplete vaccination doses received by children.

The WHO collaborated with the ministries of health of low-income countries, U.N. agencies and local NGOs to stop the occurrence of measles outbreaks and unite multidisciplinary efforts to eliminate measles at a global scale. For instance, Bhutan and Maldives launched their Expanded Immunization Programs during the late 1970s, and have since exerted tremendous attempts to increase immunization services to the population.

Last year, the WHO confirmed the elimination of measles in Bhutan and Maldives, an achievement that labeled the two countries as the first two nations in the WHO South-East Asia Region capable of interrupting the endemic measles virus transmission ahead of the 2020 regional target.

 

WHO Praises the Successful Elimination of Measles in Bhutan & Maldives

Poonam Khetrapal Singh, the Regional Director of WHO South-East Asia, acknowledged the dedication and hard work of these two developing nations by describing it as a “momentous public health achievement.” She stated that the elimination of measles in Bhutan and Maldives should provide hope and guidance for other low-income countries suffering from high mortality and morbidity rates caused by the infection.

Additionally, Singh praised both countries for the establishment of strong surveillance systems in collaboration with laboratories in order to conduct detailed case investigations and tracking for every identified measles case.

 

Effective Actions Toward the Elimination of Measles in Bhutan and Maldives

The Ministry of Health in Bhutan accredits this noteworthy achievement to the various initiatives implemented to get rid of the disease. One of the essential strategies that has contributed to the elimination of the disease in both countries was the introduction of childhood immunization plans and the Measles Immunization Coverage in 1985.

The ministry’s health secretary, Ugen Dophu, announced that Bhutan was able to immunize 98 percent of children, a high rate that exceeds the WHO’s childhood immunization recommendation of at least 80 percent. He also highlighted the important role played by parents in the process of eliminating measles in Bhutan and Maldives — parental cooperation and understanding led to the attainment of higher immunization rates among children.

 

Future Plans to Sustain the Fight Against Measles

The health ministry has designed various plans and strategies to prevent future measles outbreaks and ensure the sustainability of efforts toward the elimination of measles in Bhutan and Maldives.

Dr. Dophu asserted that the health ministry will also collaborate intensively with the WHO to carry out a mass measles immunization campaign, This effort should increase accessibility and affordability of the vaccine among children and adults up to 40 years of age.

Moreover, new health screening systems will be installed at each of the country’s entry points to urge people to complete the screening procedures, and subsequently, protect the public health at large.

– Lea Sacca

Photo: Flickr

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Major Efforts Toward Fighting the Cholera Crisis in Africa

cholera crisisThe Eastern and Southern countries in Africa face a serious cholera epidemic. This epidemic displays the lack of public sanitation as well as neglect from the government that many African countries face.

Cholera

Cholera is a diarrheal illness caused from an infection of the intestine with bacteria called vibriocholerae. The symptoms of the illness include: diarrhea, vomiting and leg cramps, and such loss of body fluid can lead to dehydration and sometimes shock. Oftentimes, death can occur within only hours without treatment.

Since the start of the New Year, there have been over 2,009 cases and 22 deaths in the countries in Africa facing the cholera crisis. Zambia, one of the countries in southern Africa, faced the worst of the epidemic, with more than 74 deaths since October of 2017. The main area where Zambia’s impacted with cholera is in their capital, Lusaka. The government banned street food from vendors in the capital to reduce the number of cases, but in return, caused violent protests from the vendors.

Cholera Causes

The government, along with the World Health Organization, states the cause of the cholera crisis is poor waste management and lack of personal hygiene. These factors cause the contamination of food and water, which in turn, can spark the epidemic.

To help with the cholera crisis, the government has sent in the army to control measures, clean the markets and unblock drains. An oral vaccine program was also launched with the goal of immunizing one million people, and since its implementation, the number of cholera cases have dropped.

Cholera Effects

The effects of the cholera crisis have not just been deadly, but also have forced public places to close. Many schools, churches and workspaces are deferred until they can contain the outbreak. This impediment puts citizen jobs, payment and education on hold.

The World Health Organization (WHO) suggests the prevention of cholera consists of clean water, sanitation and reminding communities of basic hygiene behaviors that includes hand washing with soap after using the bathroom, before eating or touching food.

The WHO also suggests there should be media regarding health education messages for these reminders, and the implementation of routine antibiotic and immunizations if available.

– Chloe Turner

Photo: Flickr

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US-Backed Public Health Programs in India Reduce Risk of Disease

US-Backed Health Programs in India Reduce Risk of Disease
India has a population of approximately 1.3 billion, making it the second-highest populated country in the world. With the exception of the Himalayan foothills and deserts in the northwest, a majority of the country sustains a very high population density that straddles the country’s river valleys. Due to its population density and sanitation conditions, Indian citizens face a high risk of infectious disease with the most common being bacterial diarrhea, hepatitis A & E and typhoid fever.

Public Health Programs

Because of the risk and occurrence of infectious diseases, public health programs in India continue to work with the United States Agency for International Development (USAID) as well as many other U.S backed organizations to decrease the risk of a disease pandemic.

Historically, U.S. public health programs in India foster positive health outcomes. For instance, because of World Health Organization (WHO) and Center for Disease Control (CDC) treatments in the 1990s and early 2000s, India is now polio-free.

In the early and mid-2000s, CDC and USAID programs identified the monsoon seasonality of influenza and shifted their recommendations to vaccinate before India’s monsoons occur, greatly benefiting civilian populations. Between 2009-2015, U.S. backed public health programs in India even developed 65 HIV reference laboratories certified under the CDC training programs, therefore increasing the access to effective testing and treatment programs.

Emerging Pandemic Threats Program

More recently, the United States developed USAID’s Emerging Pandemic Threats Program (EPT), a global health initiative that works in countries that are most vulnerable to the outbreaks of pandemics. This branch of USAID launched in February 2014 and maintains a growing partnership with over 50 nations, international organizations and non-governmental stakeholders to ensure that the country reduces the risk of infectious disease threats.

EPT in India

The Emerging Pandemic Threats Program in India strengthens the subcontinent’s capacity to detect threats of infectious disease through an early intervention approach. USAID works alongside WHO to fight antimicrobial resistance (AMR), which is defined as virus and bacteria’s ability to become resistant to already known and utilized antibiotic treatments.

Antimicrobial Resistance

Antimicrobial resistance occurs due to natural genetic changes viruses and bacteria undergo when they are initially exposed to an antibiotic. AMR is complicating the fight against the spread of tuberculosis, HIV and malaria, by making some current treatments ineffective.

EPT programs in India combat AMR by conducting targeted surveillance of key wildlife and livestock species, as well as those who handle the animals to identify harmful bacterias and viruses and develop new treatments against them.

Also, EPT programs in India collaborate with WHO to identify unknown harmful viruses in nature and better understand its biological characteristics. Through early monitoring of viruses and bacterias, public health professionals can more quickly develop working vaccines as well as preventative community health preparations to lower risk factors in India’s vulnerable populations.

Public Health Programs in India

EPT programs in India also work closely with the Food and Agriculture Organization of the United Nations (FAO) and the World Organization for Animal Health (OIE), encouraging a multi-sectoral response system to food safety hazards and educating farmers and food preparers of sanitary food and livestock keeping practices.

While India’s population density makes public health efforts difficult to perfect, U.S. efforts, as well as United Nations efforts, are working hard to decrease the risk of infectious disease and limit pandemic potential within the country.

– Danny Levy

Photo: Flickr