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Deworming Initiatives
The World Health Organization (WHO) estimated that in 2016, more than 836 million children were at risk of parasitic worm infections worldwide. This is more than 11 percent of the earth’s population, but it can be prevented. These parasitic worm infections are very easily transmitted in places of poor sanitation, often found in places of open defecation.

The two most prevalent infections, Soil-transmitted helminth (STH) and schistosomiasis, are found in populations exposed to parasitic worms and pose serious threats to both the physical and mental health as well as the overall quality of life of those infected. These diseases have been linked to cognitive dysfunction, malnutrition, anemia and impaired mental and physical development.

Though not as life-threatening, about 1.5 billion people are infected with soil-transmitted helminths (STH) worldwide. According to the World Health Organization, STHs affect the poorest, most deprived communities. Whereas with Schistosomiasis, more than 200 million people worldwide are infected, and it is the second most devastating parasitic disease. Schistosomiasis, like STHs, is often found in the poorest communities, most often in places of poor water quality and sanitation since infection can occur when skin comes in contact with contaminated water.

What can be or is being done about this?

The best way to clear those infected with these parasites is to ‘deworm’ them. This is done through an inexpensive and noninvasive method of ingesting medication orally in order to rid the body of the parasites. Yet, the cost of diagnosis is more than it costs to administer the pill to all. According to Evidence Action, to run the tests and diagnose individual people costs four to ten times the amount it costs to just administer the pill to everyone. Moreover, the medication is safe for those not infected, thus making mass deworming the easiest and most cost-effective solution.

Many deworming initiatives have been created and heavily endorsed by various nonprofits, such as The Bill and Melinda Gates Foundation, Evidence Action, The World Health Organization and World Bank. Most advocate for school-based deworming initiatives because they target children and help to ensure that all are being treated. This method of treatment was unanimously endorsed by the World Health Assembly in 2001 and is ongoing today.

Many of these programs aim to work directly with governments to establish high quality deworming programs within schools. Take Evidence Action for example; in 2016, their ‘Deworm the World Initiative,’ which supports governments in India, Kenya, Ethiopia, Vietnam, and Nigeria, helped to treat more than 196 million children. Furthermore, thanks to the combative efforts of these nonprofits, 68 percent of children at risk were treated for parasitic worms, and this number is rising.

In short, school-based deworming initiatives are effective in ending the endemic of parasitic worm diseases in impoverished countries. There are over 835 million children in the areas where these diseases are most intensely transmitted, and all of them can be treated at an average of less than $0.50 per child. Though there is a long way to go to ensure the end of these curable diseases, improvements have been seen and will continue to be seen with the help, initiative and work from nonprofits.

– Isabella Agostini
Photo: Flickr

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

The Debilitating Effects of Schistosomiasis-TBP
Among neglected tropical diseases, few are harder to pronounce than Schistosomiasis, a parasitic infection spread through fresh water. Fewer still are more deadly. According to the Center for Disease Control, “In terms of impact, this disease is second only to malaria as the most devastating parasitic disease.” Currently, Schistosomiasis infects more than 200 million people worldwide.

Found mostly in Africa and parts of South America and Asia, Schistosomiasis, or bilharzia, is quite an unpleasant disease. It spreads through parasitic blood flukes, also known as schistosomes, which live in certain types of fresh water snails. These schistosomes are tricky creatures and infect their victims with their larvae simply through skin contact in contaminated fresh water.

Once inside the victim’s body, the larval schistosomes mature over the course of several weeks into adult flatworms. These worms then make their way to the victim’s blood vessels where they reach full maturity and mate, producing eggs. The eggs then exit the body through the victim’s urine and stools. From there, the cycle begins again.

Oddly enough, it is not the worms themselves that cause problems but the body’s reaction to the eggs. On their way out of the body, many of the eggs become stuck in the intestine and bladder, which leads to inflammation and scarring of vital organs.

While the short-term symptoms of bilharzia are similar to that of the flu, its long term effects cause much more damage. Chronic bilharzia can cause bladder cancer, infertility and the enlargement of the liver and abdomen. It remains unknown as to how many die annually from the disease but estimates range between 20,000 and 200,000 people.

However, most victims of this neglected tropical disease continue to live for years with it. For chronic sufferers, life becomes increasingly difficult. In fact, the economic consequences of bilharzia rival its health complications. Sufferers often are too debilitated to support themselves and essentially become disabled. It has the greatest impact on children. Youth that suffer from chronic bilharzia experience stunted growth and learning difficulties, which can lead many to drop out of school. Unsurprisingly, due to its economic burden, researchers have linked instances of Schistosomiasis with poverty.

Fortunately, an effective treatment called praziquantel can rid the body of the parasite and cure the disease. Best of all, it is cheap. One treatment of praziquantel costs about 20 to 30 cents and is often available free of charge in some heavily afflicted regions of Sub-Saharan Africa. In 2012, 35 million people were treated for bilharzia with this drug.

With such a cheap and effective drug, the primary strategy of the World Health Organization (WHO) is that of mass treatment without even an individual diagnosis. These mass treatments focus on vulnerable communities like those that live and work near fresh water sources and also school children. In some areas with lower levels of transmission, many officials believe that they can eradicate this disease.

Other methods of prevention involve stopping bilharzia at its source: its freshwater snail hosts. Some efforts have aimed to focus on killing the host snails by using chemical treatments on fresh water sources. However, this has negative effects on surrounding animals and also must be continued to prevent snails from returning. Beyond medicine, the best form of prevention is simply adequate hygiene and sanitation.

While the victims of bilharzia have begun to receive more treatment, a large amount of work still remains. According to a recent WHO epidemiological record, about 40 million people received treatment for Schistosomiasis, which represents only 12.7% of the population requiring preventative treatment measures for Schistosomiasis globally. With medicine so effective, it is tragic that so many should go untreated.

– Andrew Logan

Sources: CDC, The End Fund, NCBI, WHO 1, WHO 2
Photo: Carter Center

5 Most Common Neglected Tropical Diseases
Neglected tropical diseases (NTDs) affect 1 billion people, or one out of every six individuals, every year. Half a million people die from NTD related effects, the majority of whom are impoverished children, women and persons with disability. Although methods of prevention and treatment are available, these diseases remain extremely common in parts of Africa, Asia, Latin America and the Caribbean.

The following list of NTDs represents approximately 90% of the global NTD burden, along with methods of treatment and prevention.

1. Onchocerciasis

Also known as “river blindness,” this disease is transmitted via black flies carrying the onchocerca volvulus parasite. The parasite causes debilitating itching and upon reaching the eyes, visual impairment and eventually blindness. It is the second leading cause of infection-induced blindness, behind Trachoma, with 37 million people infected with the disease.

A single, annual dose of Mectizan controls the disease and relieves symptoms. Some countries in Latin America successfully eliminated disease transmission after administering the drug for twenty years which lends hope to its possible elimination in the African continent.

2. Trachoma

One of the oldest infectious diseases known to mankind and the leading source of global blindness, is caused by the bacterium Chlamydia trachomatis. Eye-seeking flies transmit the disease from an infected person’s eye discharge to uninfected hosts.

Repeated infections result in a scarred interior eyelid thereby forcing eyelashes to turn inward thus scratching the cornea, all of which is followed by blindness. It affects about 21.4 million people, of whom 1.2 million are blind.

It is hyperendemic in remote poor rural areas of Africa, Central and South America, Australia and the Middle East.
The World Health Organization (WHO) recommends the SAFE strategy (Surgery, Antibiotic treatment, Face washing and Environmental changes) to limit its spread.

3. Schistosomiasis

Or, snail fever, is a parasitic disease transmitted by freshwater snails to bathing or swimming humans. Urniary schistosomiasis progressively damages the bladder, ureters and kidneys. Intestinal schistosomiasis enlarges the liver and spleen, damages the intestines and creates hypertension of the abdominal blood vessels. It affects 200 million people, and in children can impair growth and cognitive development.

A single dose of praziquantel with repeated community distribution treats and controls the disease.

4. Soil-transmitted helminthes

Affects more than 880 million children around the world. The intestinal worms may result in diarrhea, abdominal pain, anemia, general malaise and severe infection can impair growth and cognitive development.

Improved sanitation, health education and the periodic administration of anthelminthics to at-risk groups limits the rate of transmission.

5. Lymphatic filariasis (LF)

Also known as elephantiasis, is a mosquito-borne disease which results in painful swelling of the limbs and genitals. Over 120 million people are currently infected and nearly 1.4 billion people are at risk in 73 countries.

The WHO recommends yearly large-scale Mectizan and albendazole doses for four to six years to interrupt transmission.

This information was compiled from the Neglected Tropical Disease NGDO Network, World Health Organization and the Center for Disease Control.

Emily Bajet

Sources: Neglected Tropical Diseases (NGDO) Network, WHO, WHO Programmes, Center for Disease Control and Prevention(CDC)
Photo: Bullion Street