Top benefits of ending neglected diseases

Parasitic worms in a human intestine. PHOTO | SHUTTERSTOCK

Anita, a mother of two children in Western Kenya discovered that the health of her seven-year-old son was rapidly deteriorating.

"He kept complaining about abdominal pains and would refuse to eat, yet he was growing thinner by the day. This made him weak and sickly all the time. At some point he could not even go to school," she notes

When Anita finally made the decision to take her child to hospital, doctors discovered that he was suffering from intestinal worms. The condition is medically known as Soil-Transmitted Helminths (STH). It is caused by roundworms, hookworms or whipworms.

If left untreated, intestinal worms can be catastrophic. They cause malnutrition by depleting essential body nutrients which causes anaemia, low immunity, stunted growth and sub-optimal brain development in children. They can also block intestines leading to death in severe cases.

The intestinal worm infections are part of a broader group of ailments known as Neglected Tropical Diseases (NTDs) that largely affect people living in impoverished communities where access to clean water and proper sanitation facilities is scarce.

According to the Ministry of Health (MoH) statistics, about 25 million Kenyans are at risk of getting one NTD or the other.

Yet, these diseases cause devastating health, social and economic consequences that are a stumbling block to the country's attainment of the Sustainable Development Goals (SDG) targets.

The most prevalent or common NTDs in sub-Saharan African nations like Kenya are intestinal worm infections and schistosomiasis (bilharzia) that are both caused by parasitic worms. These two diseases are estimated to cause the loss of about 2.1 million healthy life years in the continent annually.

According to the World Health Organisation (WHO), NTDs are considered 'neglected' as they are almost absent from the global health agenda.

Even today, when the focus is on Universal Health Coverage, experts are concerned that the diseases have very limited resources and are almost ignored by global funding agencies.

They note that the neglect is not inherent to the diseases but rather to people that are vulnerable to the adverse effects of NTDs such as children, women of reproductive age (including pregnant mothers and those breastfeeding) as well as all adults living in impoverished communities without clean water and sanitation facilities.

"In truth, it is not the diseases that are neglected. It is the people. The people who have to endure lifelong pain and disability. And who are ultimately robbed of the opportunity to reach their full potential," noted Susan Mochache, the MoH Principal Secretary, at the ongoing global learning summit on ending NTDs that is happening in Nairobi (May 29 - June 1, 2022).

"The impact of these NTDs is huge and goes beyond health with effects extending to almost every other development challenge that we face - water and sanitation, maternal and child health, education, infrastructure, economic opportunity, gender equality and so many more,” she said.

In its NTD Roadmap (2021-2030), the WHO emphasises the need for committed and concerted efforts among countries, to end the neglect of these diseases and eliminate them.

Economic experts note that such efforts are worth prioritising and they will bring huge benefits for countries with a high burden of NTDs like Kenya.

Indeed, a recent study by The Economist Intelligent Unit shows that meeting the WHO's goal of eliminating intestinal worm infections and bilharzia in Kenya, will lead to productivity gains of US$1346 million (Sh 157.2 billion) in purchasing power parity (PPP) terms between 2021 and 2040.

This is because adults can work and contribute to the economy at a greater extent without these diseases.

The study further notes that children who are worm-free, could attend school more regularly and concentrate more, potentially leading to more years of schooling and boosting their earning potential.

This is projected to result in US$275million (Sh 32.1 billion) PPP in greater earnings over the same period for the impacted children.

"The evidence is overwhelming, and these figures clearly show that efforts aimed at ending NTDs are worth the effort and investment," said Ellen Alger, the Chief Executive Officer of the End Fund, which mobilises resources to facilitate the roll-out of interventions aimed at eliminating and ending NTDs.

She notes that investment in the mass distribution of treatment and prevention drugs (deworming tablet) can go a long way in eliminating and reducing the burden of intestinal worms and bilharzia among children and other at-risk populations in the country.

Research has shown that children who received regular deworming treatment throughout their childhood, earned 13 percent higher incomes and had significantly higher chances of working in jobs that pay well and offer more growth opportunities.

"It is therefore important for the national government as well as county governments to set aside resources for the sustainability of these deworming programmes as well as other NTD interventions," says Ellen.

Dr Sultani Matendechero, the Head of the Kenya Public Health Institute stated that heightening public awareness on the causes of NTDs and how they can be effectively prevented, managed or treated is equally important.

He notes that the knowledge will go a long way in empowering communities and encouraging them to embrace healthy behaviours.

For instance, good hand hygiene (washing hands with soap and water) and the use of proper sanitation facilities like pit latrines is a key prevention strategy for intestinal worms.

This is because they are usually transmitted by eggs present in faeces of infected individuals, which end up contaminating the soil in areas where open defecation is practiced.

When children play in these contaminated soils and put their fingers in their mouths or eat food without washing their hands, they end up being infected.

Improved sanitation facilities can also prevent faeces and urine containing eggs of bilharzia- causing parasitic worms from contaminating surface waters.

These parasites usually penetrate human skin and get into the body as people wade or swim in polluted water bodies. They can cause multiple organ failure with late diagnosis and delayed treatment.

"For all these to happen, we need to improve access to clean and safe water, as well as proper sanitation facilities in high-risk communities," said Dr Matendechero.

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