Monday, 17 September 2012

WaterAid lead WASH sessions at NTD NGDO Network meeting

Over the past year, WaterAid has increasingly engaged in initiatives for the control and prevention of NTDs. Among other activities, WaterAid has joined the UKCNTD, attended the meeting of the Global Alliance for Elimination of Trachoma by 2020 in Washington DC, and is part of a consortium led by Sightsavers and ITI for trachoma mapping.

In early September, WaterAid Australia joined the meeting of the NTD NGDO Network in Sydney , during which it lead a plenary session on water, sanitation and hygiene (WASH) and NTDs. The session included presentations on the links between WASH and NTDs, an overview of the role of WASH in NTD control strategies, and examples of co-implementation of WASH and NTD programmes, as well as key supply and demand approaches for sanitation and hygiene. The session provided an opportunity to discuss the necessary steps to deepen and scale up collaboration between WASH and NTD actors for successful and sustainable elimination of WASH-related NTDs.

Sunday, 16 September 2012


Disease specific NTD meetings (onchocerciasis/LF; trachoma; schistosomiasis/STH)
Where:                        World Bank, Washington DC
When:             Friday, 16th November

Reception:     Evening, Friday, 16th November

NTDS 2020 – Building Momentum following the London Declaration
Where:            World Bank, Washington DC
When:             Saturday, 17th November and morning of Sunday, 18th November

7th meeting of the Global Alliance to Eliminate Lymphatic Filariasis
Where:            World Bank, Washington DC
When:             Afternoon, Sunday, 18th November and Monday, 19th November

Additional details including registration regarding all the above will be posted as soon as available.

Friday, 14 September 2012

SAFE Strategy Helps Reduce Intestinal Parasites

A 2011 investigation shows that after five years of implementation of the SAFE strategy for trachoma con­trol, the prevalence of intestinal parasites in children ages 2–15 years has decreased in 10 woredas (districts) of South Gondor, Ethiopia. The SAFE strategy refers to surgery, antibiotics (Zithromax, donated by Pfizer), facial cleanliness, and envi­ronmental improvement. Distribution of albendazole also may have played a role in the decline. In addition, the frequency of protozoan infections warrants an investiga­tion of water quality.

The bloody urine of this Nigerian boy indicates
that he suffers from schistosomiasis.
Photo: E. Staub/The Carter Center
A total of 2,338 stool specimens were collected from randomly selected children in 99 communities. (All selected children were offered deworming treat­ment regardless of participation.) The specimens were processed and linked to survey data from a total of 2,657 children (88 percent response). The mean age of children providing specimens was 6.8 years (SD 3.6), and 46.8 percent of the specimens were from boys. The zonal-level prevalence of roundworm (Ascaris), hookworm, whip worm (Trichuris), and any of these three infec­tions was 10.6 percent, 9.8 percent, 2.5 percent, and 20.1 percent, respectively.

The prevalence of intestinal schisto­somiasis was 2.0 percent, but the propor­tion of children infected with schistoso­miasis by community ranged from 0–52.4 percent. Intense helminth infections (≥100 eggs per gram) were observed for roundworm only (16.4 percent of infec­tions) and no other helminth infection. The prevalence of infection with any protozoan was 78.1 percent, and 23.0 percent of children had Giardia cysts in their stool.

Figure 1 shows the improvements in household-level sanitation and water access that have occurred in South Gondar zone since 2000 prior to any SAFE interventions. SAFE interventions were piloted in a few areas until 2003, and by 2006 the implementation of SAFE activities was at scale in all woredas within the zone. Cumulatively, 339,913 household latrines have been constructed, increasing household ownership from 1 percent to 44.4 percent.

Prevalence of worm infections has reduced significantly since a previous survey in 1995 (see Figure 2). While the proportion of children infected with hookworm was not significantly lower than in 1995, none of the current infec­tions were intense. Ascaris and trichuris are transmitted through the fecal-oral pathway, which is affected by the pres­ence of hygiene and sanitation, whereas hookworm is transmitted percutaneously through the feet. In rural Ethiopia, chil­dren are often barefoot, making them more susceptible to this type of infection. A total of 945,991 doses of mebendazole or albendazole were distributed within the zone to preschool-age children in 2005–2011, yet the proportion of this target population that reported taking this medicine was 33.0 percent (24.4–41.5 percent).

Improvements in sanitation and perhaps recent albendazole distribution among preschool-age children have played a role in the observed decline in intestinal helminthiasis. In addition to continued promotion of hygiene and household-level sanitation through the SAFE strategy, expansion of the cur­rent deworming program to school-age children should be considered accord­ing to guidelines of the World Health Organization. The frequency of protozoan infections suggests poor water quality or unsanitary water collection and storage practices, calling for further study.

The Carter Center assists the Amhara National Regional State Health Bureau to eliminate blinding trachoma through the implementation of the SAFE strategy (surgery, antibiotics, facial cleanliness, and environmental improve­ment). The aim of the F component is to reduce contamination of fingers, flies, and fomites by keeping faces free of infectious discharge. The promotion of facial hygiene involves face and hand washing to prevent transmission of C. trachomatis, which also prevents transmission of other infections spread by contact with infec­tious material. The E component aims to improve access to water and sanitation and encourages water use for hygiene purposes. The combined effects of the F and E aspects of SAFE should have an indirect benefit on intestinal parasites, respiratory tract infections, and diarrheal diseases.

Article originally appeared in the August 2012 issue of Eye of the Eagle, a biannual newsletter published by The Carter Center.

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