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Top Diseases in Chad
Since its independence from the French in 1960, the northern Central African nation of Chad has faced political instability in addition to harsh desert climates in the north. Due to complex political and environmental situations, Chad is ranked 185 out of 187 countries on the 2014 UNDP Human Development Index.

Health resources in Chad are low as a result of its poverty and politics, compared to the rest of Africa. Chad has a large refugee population of over 380,000 and 80 percent are Sudanese. With a deficit of proper resources and infrastructure to combat against communicable diseases, here is a list of the top diseases in Chad.

Hepatitis

Hepatitis is an infection in the liver and is identified through five different hepatitis viruses. Chad is at risk for hepatitis A, B, C and E. Hepatitis A and E are spread by contaminated food or water and human waste. Chad’s hepatitis A and E risk is correlated with its sanitation and water practices. About 44 percent of Chad’s population does not have access to clean water.

While hepatitis A and E are endemic because of contaminated food or water, hepatitis B and C are spread through blood, semen and bodily fluids. Hepatitis is resolved after four weeks of medical treatment.

Vaccines are recommended for children as hepatitis can develop without symptoms during childhood. Vaccines for hepatitis B are more prioritized since it’s transmitted from person to person. In 2015, WHO-UNICEF estimated only 55 percent of people were vaccinated for hepatitis B, compared to the government’s estimate of 92 percent.

Some solutions to solve hepatitis include more coverage of hepatitis B vaccines to prevent people from infecting others. Improving water conditions and sanitation would eliminate hepatitis A and E.

Meningococcal Meningitis

Meningococcal meningitis is a bacterial form of meningitis and infects the meninges in the brain membrane. The potentially fatal disease can cause brain damage and deafness. Outbreaks are prevalent during the dry season in the Sub-Saharan meningitis belt.

The Sub-Saharan meningitis belt is a wide region of countries with high risk to the disease, stretching from Senegal in the west to Ethiopia in the east. During the 2012 outbreak, there were 2,828 cases of meningitis in Chad and 135 deaths.

There are many campaigns supporting meningitis vaccine coverage in the belt. In 2014, meningitis epidemics reached their lowest levels. After Chad’s campaign, meningitis cases dropped by 94 percent.

Typhoid

Typhoid is a gastrointestinal infection transmitted from one infected person with poor hygiene to another person when handling food and water. The bacteria can multiply and enter the bloodstream and cause high fevers and fatigue. Typhoid is common in countries that have poor water and improper sanitation. Typhoid vaccines are highly recommended for travelers visiting Chad.

Malaria

Chad has a very high risk of malaria, with a greater incidence rate over 85 percent of plasmodium falciparum malaria. Because of the high amount of malaria cases, Chad is receiving help for malaria prevention.

While progress for adopting preventative therapy for children is slow among WHO member states, Chad is the only country that adopted the recommended policy for infants.

There still is a lot of progress needed for top diseases in Chad to be completely combated against and its health resources to be improved. However, solutions are available to prevent most of these top diseases in Chad.

Taameen Mohammad

Photo: Flickr

What is Meningitis?
Meningitis is an infection that causes the membranes around the brain and spinal cord, also called the meninges, to become inflamed, which in some cases leads to damage of the nerves and the brain.

Neisseria meningitis is the one with the potential to cause large epidemics. There are 12 serogroups of N. meningitis that have been identified and 6 of them namely A, B, C, W, X, and Y can cause epidemics. It is reported that the geographical distribution and epidemic potential differ according to serogroup.

According to the NHS, there are “two types of meningitis namely: viral meningitis and bacterial meningitis.”

Whilst the viral meningitis is caused by viruses that can be spread through coughing, sneezing and poor hygiene, the bacterial meningitis is caused by bacteria such as the Neisseria meningitides or Streptococcus pneumonia and through close contact.

Bacterial meningitis is the most severe. The NHS, urges that this form of meningitis should “be treated as a medical emergency.” If left untreated, it can cause severe brain damage and infect the blood.

Viral Meningitis on the other hand, though most common especially in children, is less serious. It is reported that, it is difficult to estimate the number of viral meningitis cases because symptoms are often so mild that they are often mistaken for flu.

According to WHO, “meningitis tends to hit Africa in cycles. Cases of meningitis C have risen since 2013, first in Nigeria 2013 and 2014, and then in Niger in 2015.” Between 2011 and 2012, there were around 2,350 cases of bacterial meningitis and septicaemia in the U.K.

In terms of treatment, viral meningitis is reported to usually get better within a couple of weeks with plenty of rest to treat the headache and anti-sickness medication for vomiting. With bacterial meningitis, treatment normally involves intravenous antibiotics as well as admission into the hospital.

It is advised by healthcare centers that, the best way to prevent meningitis is to get a vaccination.

In order to ensure development and growth of nations, it is imperative that diseases such as Meningitis are prevented. Being proactive and preventing meningitis not only saves lives but it also saves costs associated with treatment.

Vanessa Awanyo

Sources: Web MD, NHS, WHO
Photo: Flickr

Meningitis-Epidemic-in-Niger
On June 2, 2015, the World Health Organization (WHO) reported 8,234 cases of meningitis with 545 deaths in Niger. It is not the numbers that are alarming because it is the meningitis season in Africa, and Niger is in the meningitis belt.  But this season, the outbreak in Niger is unusually alarming for five major reasons.

Every year from December to June, the meningitis belt, which consists of 21 countries in sub-Saharan Africa that extend from Senegal in the west to Djibouti in the east, is hit by more meningitis cases than anywhere else in the world. This meningitis epidemic is due to Nesisseria meningococus serotype C. Until this meningitis season, serotype C was a type of meningitis common in the U.S., Canada and Europe. The other major serotypes associated with this deadly disease are A, B, C, Y, and W-135. It is type A that has been ravaging Africa for over 100 years.

According to WHO,  this is the largest outbreak of serotype C recorded in any country in Africa’s meningitis belt. It has affected 13 districts in Niger. Sixty-five percent of the cases are located in 4 out of 5 districts in the capital city, Niamey.

There are four conditions in the meningitis belt that make it ripe for recurrent meningitis epidemics in general: the drought and dust storms, impoverished living conditions/overcrowded housing, large population displacements and the immunological susceptibility of the population.

While the outbreak started slowly, it is now spreading quickly across the region. The number of cases has tripled during the first two weeks of May—near the end of the meningitis season. Doctors Without Borders reported that 350 meningitis patients a day were admitted to the hospital in Niamey during the first two weeks of May. Patients had to be discharged early and continue their treatment plan at home in order to make room for incoming cases. Doctors Without Borders also had to add an additional medical team.

Because serotype C meningitis has never been a major threat in Africa, efforts have been focused on eradicating epidemics of serotype A. From 2010 to January 2015, over 217 million people in 15 African countries had been vaccinated with MenAfriVac. MenAfriVac is a new vaccine developed by the Meningitis Vaccine Project coordinated by WHO and PATH to be affordable and effective in Africa. It has long lasting effects and has been so successful that serogroup A epidemics are expected to be eliminated from this region, according to WHO’s Weekly Epidemiological Record published on March 27, 2015.

Because this is the first large outbreak of serotype C in the meningitis belt, there has not been enough vaccine available to fight it. The vaccine is also not affordable for the people and the governments in Africa. The vaccine that prevents serotype C meningitis is often combined with vaccines that prevent the other types of meningitis producing a multivalent polysaccharide vaccine. It is available in the U.S., Canada and Europe, where type C has been most prevalent. Furthermore, due to the success of MedAfriVac, the need for the multivalent polysaccharide vaccine has diminished and has only been used in emergencies—not for prevention.

Although WHO and the International Coordinating Group on Vaccine Provision for Epidemic Meningitis Control requested 1.5 million doses of multivalent polysaccharide vaccine and 1.5 million doses of MenAfriVac to prepare for the 2015 meningitis season, one manufacturer had production problems and could not completely fill the request. Fortunately, GlaxoSmithKline in Britain, Instituto Finley in Cuba and BioManguinhos in Brazil provided most of the requested amount of the polysaccharide vaccine. WHO and ICG continue to stockpile the vaccine to combat future outbreaks in Africa’s meningitis belt.

This current meningitis epidemic in Niger peaked after the first few weeks in May, and by May 21 about 100 patients a day instead of 350 patients a day were being admitted to the hospital according to Doctors Without Borders. The Disaster Relief Emergency Fund has requested to extend its operation by six weeks to June 30 in order to reach 71,000 more beneficiaries in eight new districts.

– Janet Quinn

Sources: WHO—Africa, CDC, Doctors Without Borders, Relief Web, Reuters, WHO, WHO, WHO, Outbreak News Today
Photo: Doctors Without Borders

meningitis
Nearly 1,153,000 people were reached with meningitis vaccines in eastern Guinea during a campaign by the Guinean government, United Nations Children’s Fund, World Health Organization and other partners.

The campaign lasted six days, finishing over the weekend of June 14, and vaccinated over 95 percent of the people between the ages of 1 and 29 in the affected areas of Mandiana and Siguiri.

Guinea is located in the “meningitis belt” which stretches west from Senegal to Ethiopia in the east, and has the highest rates of meningococcal meningitis.

Since January of 2014 there have been 539 suspected cases of meningitis and 52 deaths in Guinea, with an estimated 400 cases last year. The vaccination campaign was completed in hopes that it will end the outbreak that has emerged in the eastern region of Guinea.

Meningitis is a disease that mostly affects children, teens and young adults, and is transmitted from person to person through respiratory or throat secretions. When contracted, the disease causes the protective tissue around the brain and spinal cord, known as the meninges, to become inflamed.

The bacterial form, meningococcal meningitis, affects the brain membrane, which has the potential to cause serious brain damage, and if untreated, is fatal in 50 percent of cases. The most notable symptoms are high fever, stiff neck, headaches, sensitivity to light and vomiting.

Spokesman for UNICEF in Guinea, Timothy La Rose, stresses the value of community education and awareness about the importance of receiving vaccines. Through rural radio and community sensitization, UNICEF educates the population about the dangers that meningitis poses to children and where vaccination centers are located.

UNICEF hopes to provide another set of vaccinations later this year to continue to keep the outbreak under control and protect the children and young adults of Guinea.

— Kim Tierney 

Sources: Voice of America, UNICEF, WHO

sahel_dust
Recent research carried out in Niger by Columbia University’s International Research Institute for Climate and Society (IRI) will hopefully allow scientists to be able to forecast meningitis outbreaks in sub-Saharan Africa, and thus prevent potential casualties of the disease.

The research was done by IRI in partnership with the NASA Goddard Institute for Space Studies. They found that environmental and climatic factors such as wind and dust conditions have an incredibly strong correlation with meningitis outbreaks in what is called the “meningitis belt,” stretching across the Sahel from Senegal to Ethiopia.

Bacterial meningitis occurs throughout the world but rates of meningitis in the Sahel and the rest of the belt are much higher. The African Meningococcal Carriage Consortium (MenAfriCar) reports that death rates of the disease are between five and 10 percent. However, long-term effects often ensue, including blindness, hearing loss and brain damage.

The outbreaks occur in the dry season and taper off with the first rains, and researchers have often believed that the mineral dust irritates the epithelial cells lining the nose and throat, allowing for easy passage of the bacteria into the bloodstream.

In the initial phases of the study, researchers collected a number of dust samples from Ghana, Niger and Senegal, examining the dust’s characteristics in order to see which properties might be influencing the spread of the disease.

Along with this information, the researchers also looked into environmental factors such as temperature and humidity and social factors such as reduced ventilation. A number of variables are being taken into account to understand how dust is affecting people’s vulnerability to meningitis.

The hopes of the study are that these climatic factors will help public health researchers to forecast meningitis outbreaks and develop vaccination strategies earlier in advance.

One of the lead researchers in the study, Carlos Perez Garcia-Pando, stated, “We’ve known that the disease is associated to climate and environmental issues for a long time, because it’s very seasonal. The idea was to try to use models and observations from satellites and all kinds of data on potential (climate-related) parameters that might be affecting the disease, and try to use that information to provide advance warning.”

Currently in the Sahel, a new vaccine has been distributed which has decreased the outbreak of meningitis. However, vaccination drives are still delivered in districts that are already suffering outbreaks, and they often come too late.

This study has shown that environmental factors can greatly impact the effectiveness of vaccination programs, and this has great implications for the future of meningitis control strategies across the globe.

– Mollie O’Brien

Sources: Irin News, The Guardian
Photo: National Geographic

MenAfriVac-vaccine-meningitis
Meningitis is an infectious disease that causes the swelling of the protective membranes that surround the brain and spinal cord. The symptoms involve severe headache, stiffness of the neck and a sensitivity to light. In 2009, 88,000 people in Sub-Saharan African were infected with meningitis and more than 5,000 died. To alleviate this problem, the Bill and Melinda Gates Foundation have helped develop MenAfriVac.

Paired with the Meningitis Vaccine Project, a nonprofit organization, the Bill and Melinda Gates foundation have assisted in developing this new vaccine which costs less than 50 cents per dose. The vaccine is manufactured by the Serum Institute of India and has dramatically reduced deaths from the disease in many countries in the “meningitis belt” – a region of Sub-Saharan African where cases of meningitis are very high.

The most significant development in the MenAfriVac vaccine is the ability to store the drug. MenAfriVac can be stored at a temperature of 40 degrees Celsius for up to four days before use. This, paired with its low cost, has made the vaccine extremely effective in treating meningitis in the parts of the world that suffer the most from the disease.

In addition, the vaccine can be used to immunize infants. Immunizing children with MenAfriVac represents a huge development against the spread and contraction of meningitis in Sub-Saharan Africa.

– Pete Grapentien

Sources: News24,   WHO
Photo: Meningitis Vaccine Project

MenAfriVac immunization

Providing vaccines for children in Africa may be easier if vaccines created for Europe or the U.S. were redesigned for Africa. In 2001, the World Health Organization (WHO) and the Program for Appropriate Technology in Health (PATH) took the first step with the Meningitis Vaccine Project (MVP). The aim of MVP was to eradicate the meningitis epidemic internationally, with a particular focus on the African countries that had received financial aid from the Gates Foundation.

MVP developed the MenAfricVac vaccine. The Serum Institute of Indian Limited then produced and tested MenAfriVac on people between the ages of 1-29 in the meningitis belt, which includes countries like Mali, Gambia, Senegal and Ghana.

MenAfriVac was determined to protect people from ages 1-29 from meningitis caused by meningococcal A. It also was found to be the first vaccine that could be kept for up to 4 days at 40 degrees, and is currently priced at $0.50 a dose.

“This is the first time that a vaccine intended for use in Africa has been tested and submitted to regulatory review and approved for this type of use. And we expect this announcement to build momentum for applying the concept to other vaccines and initiatives, allowing us to save more lives in low-income countries,” said Michel Zaffran, director of Project Optimize, the PATH-WHO collaboration.

PATH and WHO believe vaccines against yellow fever, hepatitis B, HPV, rotavirus and pneumococcal disease could all be kept at higher temperatures than the typical 2-8 degrees prescribed by the manufacturers.

“We’re now working with one manufacturer to re-label hepatitis B,” said Simona Zipursky from the WHO. “It’s something people have become more and more aware of as possible, but as an immunization community we have been a little bit afraid.”

Evenly Adda, the Acting Municipal Health Director of the Kessena Nankana East, said the outbreak of meningitis has reduced significantly since MenAfriVac was introduced. Last year only one out of the six people diagnosed with meningitis died.

But, MenAfriVac remained unable to protect children under 1 year old.

This has been fixed with the Navrongo Health Research Centre’s (NHRC) discovery of a new conjugate vaccine which protects children under 1 year old from meningitis.

The new conjugate vaccine was created through the efforts of NHRC’s research team, health centre staff, district health management team, regional health directorate and with the help of collaborators that include WHO, UNICEF, MVP, and the University of Sienna.

The Principal Investigator of the Research, Dr. Abraham Hodgson, said the new conjugate vaccine will be available at EPI in 2015. He also said that the Centre is working on the development of a vaccine that can fight various types of meningitis.

– Kasey Beduhn

Source: The Guardian
Photo: Meningitis Vaccine Project