Neglected diseases finally get global recognition

The Neglected Tropical Diseases (NTD) have now joined the list of ailments with special days dedicated to their commemoration.

During the launch of the first NTD Day by the World Health Organisation last week (30th January), experts were delighted and optimistic that the historic milestone will play a key role in the elimination of the diseases, which pose a huge economic, health and social burden to affected communities and countries.

"The inaugural World NTD Day reminds us all of the many neglected diseases that deserve more attention and investment. I have seen many throughout my career and it's not acceptable that their impact be ignored because they affect poor marginalised populations," said Dr Matshidiso Moeti, the World Health Organisation (WHO) Regional Director for Africa.

"The World NTD Day is all about creating awareness and giving an annual global platform to these diseases of poverty," said Thoko Elphick-Pooley, the director for the Uniting to Combat NTDs organisation.

In Kenya, such global days provide an opportunity to mobilise greater attention, action and investment geared towards addressing challenges of public health.

In line with its Kenya National Breaking Transmission Strategy (BTS) blue print, the Ministry of Health (MoH) seeks to control and eventually eliminate four NTDs within five years, by 2023.

They include trachoma, schistosomiasis (bilharzia), lymphatic filariasis (elephantiasis) and soil-transmitted helminthiasis (intestinal worms).

A 2016 study conducted by Erasmus University shows that the country can save over Sh193 billion by 2030 through elimination of the diseases. This feat would save populations at risk from ill health, disability and early death linked to the ailments.

All the four NTDs can be treated effectively with recommended medicines through mass distribution. But the treatment approach alone is not enough to halt their spread.

"If we don't address the causes of NTDs, then we will treat people, only for them to become infected once more with the same diseases," said Dr Sultani Matendechero who heads the division of vector borne and NTDs at the Health ministry.

To tackle the root causes, he notes that Kenya should address the water, sanitation and hygiene challenges facing rural and marginalised populations that are disproportionately affected by NTDs.

In the case of intestinal worms for instance, the use of pit latrines as well as hand washing with soap after visiting the toilet can go a long way in tackling the challenge.

This is because the worms (tapeworm, roundworm or hookworm) are transmitted by eggs present in human faeces that contaminate soil and water sources in places where communities practice open defecation.

When people handle food after visiting the toilet using unwashed hands tainted with faeces, they ingest the eggs, which hatch into worms in their stomachs.

Once in the body, the worms cause a wide range of complications including diarrhoea, abdominal pain, body weakness and chronic intestinal blood loss that may result in anaemia.

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, swim, bath, wash or walk barefoot in polluted water bodies.

Trachoma is the leading cause of preventable blindness globally. It is common in areas with water shortages, poor sanitation and infestation of flies.

The disease is caused by bacteria known as chlamydia trachomatis. It is spread by infected eye seeking flies and via hands, clothes or bedding that have been in contact with the infected people.

If left untreated, repeated trachoma infections can cause severe scarring on the inside of eyelids. This causes the eyelashes to scratch the cornea repeatedly causing pain and discomfort. The scratching eventually damages the cornea, leading to irreversible blindness.

Access to clean water plays a key role in trachoma prevention by making it possible for affected communities to embrace good hygiene practices.

"For instance, sufficient clean water makes it possible for children to have their faces washed at least once daily. Facial cleanliness keeps away the eye seeking flies that spread the trachoma causing bacteria," said Dr Matendechero.

Hand washing with soap after being in contact with affected people's eyes or nose, as well as their contaminated clothes or bedding is also significant for prevention.

In addition, the use of improved sanitation facilities such as pit latrines is a key step in breaking the cycle of transmission by controlling fly populations and breeding grounds.

This is because the eye seeking flies that transmit trachoma preferentially lay their eggs on human faeces lying exposed on soil.

Tackling pollution by keeping home environments clean also helps in the prevention and control of NTDs.

For instance, draining stagnant water in ponds or bushy areas near homes will keep away mosquitoes that transmit parasitic worms, which are responsible for elephantiasis. Use of mosquito bed nets can also come in handy.

The worms usually block people's lymphatic system, hence preventing it from effectively draining waste and toxins from the body.

It leads to a backup of lymphatic fluid, which causes swelling — mostly in the legs and arms, as well as the breasts or genitals. This causes disability that reduces the productivity and life quality of those affected.

To accelerate the fight against NTDs, East Africa is set to host the first ever Global Summit on Malaria and Neglected Tropical Diseases in June this year.

The high level meeting, which will be held in Kigali, Rwanda will capitalise on the presence of heads of state from affected countries — such as Kenya — and other key stakeholders to set the global agenda and take action against NTDs for the next decade.