Essay on Neglected Tropical Diseases

Neglected tropical diseases (NTDs) includes various group of communicable diseases that have prevalence in the subtropical and tropical environment and affects over billion people worldwide. According to World Health Organization (WHO), Department of Neglected Tropical Diseases, NTDs include ulcer, fever, Buruli Chagas disease, dengue, cholera, dracunculiasis, filariasis, human African trypanosomiasis, leprosy, leishmaniosis, lymphatic, onchocerciasis, soil-transmitted Helminth, schistosomiasis and trachoma ((Epidemic & Pandemic Alert, 2009). NTDs have become a major problem especially to developing economies as they are very heterogeneous and cost billions of dollars every year. In addition, they poor people who do not have adequate sanitation and have close contact with domestic animals and livestock, and infectious vectors. DR Congo has the highest numbers of cases of several high-prevalence NTDs, including lymphatic filariasis, intestinal helminth infections, and schistosomiasis. The high cases can be explained by large tropical forest population of wild primates and actual and potential animal reservoir hosts. There lacks surveillance on NTD diseases which increases the threat. To effectively control against NTDs public health approaches have to be put in place. Interventions are best guided by local epidemiology and through appropriate local detection, prevention and oversight strategies

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Nature and Magnitude of the Problem:

In 1998, the number of reported cases of human African trypanosomiasis (HAT) in DR Congo reached 26,000 which is the highest ever recorded in the world. The country accounts for 31 million cases of hookworm infections, 15 million schistosomiasis cases, 23 million ascariasis cases, 26 million trichuriasis cases, 17,000 human African trypanosomiasis cases and 3,621 leprosy cases among other minor cases (Hotez & Kamath, 2009).

Affected Populations:

NTD are most evident in DR Congo constituting the highest number of causes of illness among the adult with a high prevalence in children. High cases have been associated with poverty or low income. The highest affected population include those who cannot access clean water and quality sanitation, those who lack quality housing that is far from NTD vectors, those who live in environments conditions that can be meant as some of the intermediaries to NTDs. More cases of NTDs in DR Congo have been reported by those who are poor as poverty causes low income, inability to afford basic services and potential susceptibility to unexpected health costs. Congo has also experienced unstable political leadership leading to refugee cases. Human migrants are at least half of all cases of NTDs in DR Congo because they are exposed and vulnerable to pathogens in new risk zones. In addition, they lack or have inadequate health care services. Children between the age of two and five years as well as aged people are most affected due to their low body immunity.

Risk Factors:

The most common risk factors are characterized by drug treatment, host-related risk, developmental challenges, disease risks, social health risk factors, climate and environmental change risk factors and disease control problems. NTDs is mostly negatively affected by economic impacts where the afflicted poorer rural communities in DR Congo face high morbidity and mortality.

As NTDs are primarily zoonotic, its prevention of spread highly depends on strategic integrated vector control strategies. Most of the affected population in DR Congo lack access to effective and safe treatment (Hotez, Molyneux, Fenwick, Kumaresan, Sachs, Sachs & Savioli, 2007). The other problem is the low economic level of the country where the community lacks the needed health care delivery facilities back integrated treatment and prevention approaches. For instance, Congo health sector requires screening, case management, diagnosis and treatment facilities. There is need to improve and fund, clinics, community health centers, and health care institutions that would investigate, prevent and treat the affected in its endeavor to decrease the risk and aid in reducing the occurrence of NTDs

Economic and Social Consequences:

There is high relationship between the economic growth of a country to the NTDs prevalence. NTDs need significant investment in research which is costly because the field it covers is wide especially in low-income countries such as DR Congo. The other economic issue is on the treatment cost of these diseases where some like Buruli ulcer, can spend over double the yearly earnings of a normal household in DR Congo. The high financial costs lead to deferral of treatment as well as the financial ruin to the affected family. The diseases equally cost the DR Congo government through health care and lost employee productivity due to shortened life spans and high morbidity (Conteh, Engels & Molyneux, 2010). In DR Congo, a deworming program is projected to improve average adult income by 40 percent while untreated cases of Trachoma are estimated to cost over US$100 in lost productivity. In Congo, the government has been conducting large-scale prevention education to improve agricultural production and education levels.

Several NTDs, including leprosy, is associated with causing severe deformities which stigmatize the victims. Those stigmatized end up in marriage denial and inability to work. Studies have shown that support groups for such patients would increase their quality of life, self-esteem, and social relations by managing their illness (Weiss, 2008). In Congo, men are socially stigmatized in a detrimental way that affects their economic posterity while women are affected in the areas of family and marriage

Priority Action Steps

NTDs sets a major burden to communities and population groups in low economy nations. To successfully control NTDs there necessitates to be a global evaluation, studies that describe local differences in the epidemiology, sociocultural and environmental factors concerning the diseases. Social determinants such as housing and clustering, water and sanitation, environment, poverty, conflicts and disasters, migration, and gender and sociocultural factors have effected the priority of action steps (Aagaard-Hansen & Chaignat, 2010). At the intervention, there is need to improve the level of accessibility of various social amenities and facilities. This will would focus more on preventive and promotive measures instead of curative service provision. The action steps include addressing sanitation, water and household factors, environmental risk factors reduction, improving migrating populations health, gender and sociocultural inequity reduction, poverty reduction in NTD-endemic populations and setting up risk assessment and surveillance systems. These action steps would be supplemented by efficient, curative tools for NTDs. In addition, new research should be embraced to monitor the adapted measures and as well as establish innovative methods to address the social and economic elements of the NTDs. As NTDs are closely associated with inequity in health, innovative ideas would significantly contribute to evening up the difference. A concerted effort by WHO and the government to address the social elements related to NTDs would be a significant contribution to having an able public health in DR Congo (Epidemic & Pandemic Alert, 2009).

References

Aagaard-Hansen, J., & Chaignat, C. L. (2010). Neglected tropical diseases: equity and social determinants. Equity, social determinants and public health programs, 135.

Conteh, L., Engels, T., & Molyneux, D. H. (2010). Socioeconomic aspects of neglected tropical diseases. The Lancet, 375(9710), 239-247.

Hotez, P. J., & Kamath, A. (2009). Neglected tropical diseases in sub-Saharan Africa: review of their prevalence, distribution, and disease burden. PLoS Negl Trop Dis, 3(8), e412.

Hotez, P. J., Molyneux, D. H., Fenwick, A., Kumaresan, J., Sachs, S. E., Sachs, J. D., & Savioli, L. (2007). Control of neglected tropical diseases. New England Journal of Medicine, 357(10), 1018-1027.

Weiss, M. G. (2008). Stigma and the social burden of neglected tropical diseases. PLoS Negl Trop Dis, 2(5), e237.

World Health Organization, Special Program for Research, Training in Tropical Diseases, World Health Organization. Department of Control of Neglected Tropical Diseases, World Health Organization. Epidemic, & Pandemic Alert. (2009). Dengue: guidelines for diagnosis, treatment, prevention and control. World Health Organization.