With assistance from the Pan American Health Organisation (PAHO), Guyana’s Ministry of Health will soon develop an action plan with a goal to eliminate five of the 17 World Health Organisation (WHO)-listed neglected diseases by at least 2030, Minister of Health Dr. Frank Anthony has announced.
Listing Leprosy or Hansen’s disease as it is also called, and four parasitic diseases in Chagas, Leishmaniasis, Leprosy, Lymphatic Filariasis, and soil-transmitted Helminths (worms), Anthony said that the MoH recently completed a workshop, setting out different elimination targets for each of the diseases.
“Over the last two weeks we have been working on a plan to eliminate these diseases. There are five that we specifically want to target for elimination before 2030 and I know we can make that happen,” Anthony told Stabroek News yesterday.
He explained that WHO has set a list of 20 neglected diseases that it hopes would be eradicated by 2030 and from that list Guyana has zoomed in on five and will focus heavily on meeting elimination targets set.
But he underscored that it could not be achieved without the help of the public and as such public awareness is key. “We have a number of programmes planned and these include making medications and treatments easily and readily available. There are school programmes, community programmes and those targeted to individuals…,” Anthony said.
The two-day meetings held here were facilitated by International PAHO Consultant, Dr. Alexandra Vokaty and Anthony said it engaged stakeholders from the public and private health sectors, Ministry of Amerindian Affairs, Mayor and City Council, Guyana Food Safety Authority, and other relevant agencies.
“I think it’s very important we know the difference between all of these five diseases…but also, it’s a human right against the discrimination and stigmatization of certain neglected diseases that we are suffering in all the regions. Although there may be many plans in the region, countries face the challenge of financing,” a release from PAHO quoted the PAHO/WHO Representative Dr. Luis Codina as saying, during the two-day conference.
It also noted that in the Latin America and Caribbean (LAC) region, at least 180 million people live below poverty, and it is in this category that these diseases are mostly prevalent. “These impoverished and marginalized populations are often heavily burdened with neglected infectious diseases (NIDs) and other poverty-related infectious diseases. This group of infectious diseases continues to take a measurable toll on families, communities, and nations’ socio-economic development,” the release said.
Anthony said that Guyana has had a plan before and will be using that as it adds more initiatives to ensure objectives set out are not just on paper.
While leprosy is not widely present, according to Anthony, there have been “pockets” of infected persons in some regions. It is why this disease, like the others, were chosen for elimination, since the Ministry of Health believes that with proper edification and treatment of infected persons, the targets set could be met.
PAHO explained that the progress of leprosy is very slow, “with an average incubation period and onset of signs and symptoms of five years.”
“The initial symptoms result in light or darker skin or nodular lesions with loss of sensation. When cases are not treated at the very beginning of the disease manifestation, complications can cause progressive and permanent sequelae, including deformities and mutilations, reduction of the mobility of the limbs, and even blindness. It primarily affects the skin, peripheral nerves, mucous membranes of the respiratory tract, and eyes,” it adds.
It was stated that the disease is not highly contagious and is curable. Scientists have also found that it is transmitted through close and frequent contact with people that have not been treated.
As it pertains to Filariasis, Anthony said that there has already been “mass drug administration” followed by testing to determine the prevalence of the disease here. “That testing will go on for the next three years and once we have low concentration of the filarial parasite, we hope that the WHO will certify us as being filaria free. That one we are hoping to achieve in another three years,” he said.
Like Leprosy, the Minister of Health said that pockets of Chagas and Leishmaniasis have also been detected in Guyana.
Chagas disease, according to the US Centers for Disease Control (CDC), is caused by the parasite Trypanosoma cruzi, which is transmitted to animals and people by insect vectors. It is found only in the Americas, mainly in rural areas.
The CDC explained that initial infection usually does not cause severe symptoms and is often not even diagnosed. “After years of chronic infection, some people develop heart diseases such as abnormal heart rhythms, heart failure, and an increased risk of sudden death. Chagas disease can also cause gastrointestinal problems, such as severe constipation and difficulty swallowing,” it states.
The disease can also be transmitted from mother to baby, through organ transplants, or through blood transfusion.
The CDC says that Chagas disease is one of several parasitic diseases that result in significant illness among those who are infected and is often poorly understood by healthcare providers.
Where Chagas is caused by a bug bite, Leishmaniasis can be contracted if bitten by infected phlebotomine sandflies.
In Guyana, sandflies are prevalent in riverain areas and sandy regions.
There are three types of Leishmaniases, according to the WHO: visceral, which is the most serious form of the disease, cutaneous – the most common and mucocutaneous.
Of the five, one of the most important diseases to be tackled Anthony pointed out was that of Helminths because it is in young children that it is most prevalent.
WHO says that soil-transmitted helminth infections are among the most common infections worldwide and affect the poorest and most deprived communities. “They are transmitted by eggs present in human faeces which in turn contaminate soil in areas where sanitation is poor,” the WHO website states while pointing out that the main species that infect people are the roundworm, whipworm and hookworms).
“In some children under five years old, if they get parasitic worms, the worm technically eats out their food, they can be malnourished. It also causes bleeding and in turn chronic anemia, which we know reduced cognitive (functions). It is very important we target this disease and they are given medications on a regular basis,” Anthony said, while stressing that emphasis will be placed on parents’ understanding the importance of deworming their children.
He said that persons should understand too, that while the common belief is that round worms are found in not properly cooked pork, it is also found in beef.
WHO notes that the strategy for control of soil-transmitted helminth infections is to “control morbidity through the periodic treatment of at-risk persons such as preschool and school aged children, women of reproductive age and adults in certain high-risk occupations such as miners.
“WHO recommends periodic medicinal treatment (deworming) without previous individual diagnosis to all at-risk people living in endemic areas. This intervention reduces morbidity by reducing the worm burden. In addition: health and hygiene education reduces transmission and reinfection by encouraging healthy behaviours; and provision of adequate sanitation is also important but not always possible in resource-poor settings. Periodical treatment aims to reduce and maintain the intensity of infection, and to protect infected at-risk populations from morbidity,” the WHO states.
