NOTRE DAME, Ind. (WOMENSENEWS)-For 60-year-old Velouse Casseus, September’s Hurricane Matthew brought fears for the future in addition to death and damage to her community in Leogane, Haiti. She is now concerned about getting another disease, especially since she already has lymphatic filariasis.

“I feel so vulnerable to any disease because of the conditions I am living in,” she said through a translator using WhatsApp messaging. “I am seriously affected by the disastrous cyclone on the country. My conditions were already complicated, so I am in extreme need.”

Aid organizations, including CRUDEM Foundation, were also concerned that there could be an increased risk for lymphatic filariasis after Hurricane Matthew. The disease is caused by a parasite transmitted by mosquitos and the standing water in post-hurricane Haiti leaves more places for mosquitoes to lay their eggs.

Lymphatic filariasis, more commonly known as elephantiasis, is one of the seven neglected tropical diseases (NTDs), named as such because they tend to impact populations in poverty and are usually easily treatable. Affecting over 2 million Haitians, lymphatic filariasis damages the lymphatic system and causes areas of the body to swell.

Antionette Saint Fabre, who lives in Haiti and also suffers from the disease, said she has seen “so many negative impacts on the area affecting people with lymphatic filariasis,” including increased lesions for people already suffering from symptoms.

Minimal Impact

Despite the concerns, Thomas Streit, a professor at the University of Notre Dame who founded the school’s Haiti Program, which focuses on treatment and research, is hopeful that the impact this time around will be minimal overall. He has published several papers evaluating how to eradicate the disease and said that while mosquito populations could go up in the area, the disease should not restart since it was locally wiped out.

“The area where the hurricane hit the most, which is the southwest of Haiti, we had pretty much already licked – we were done with filariasis,” he said.

Even though an increase in lymphatic filariasis cases may not be a concern, this disease and other NTDs, such as onchocerciasis (river blindness) and schistosomiasis (“snail fever” that leads to internal bleeding), are far from being eradicted globally.

NTDs are easily preventable in the more than one billion people around the world who have one of these diseases, according to the World Health Organization. It costs about 50 cents to treat one person for a year from the most common NTDs, and companies such as Eisai, GlaxoSmithKline and Merck & Co. are willing to donate drugs. The difficulty lies in getting the treatments to people. Since many of the countries where lymphatic filariasis and the other NTDs are endemic are poor, they lack infrastructure to effectively deliver and educate the population about the diseases.

Lifelong Implications

While lymphatic filariasis is not deadly, it does carry lifelong implications for those affected. Streit described the disease as a “tax” since it impacts people physically, socially and economically. “Because these diseases affect so many people, they become a burden at the national level for a lot of countries,” he said.

Streit said that lymphatic filariasis in particular is a disease that discriminates. While men tend to get swelling in their genitals, women’s swelling generally occurs in their legs, which is more noticeable. Even though the disease can’t be transmitted from person to person, people prefer to keep symptoms hidden since there’s a social stigma against those who have it.

Streit said the diseases impact women particularly as caregivers. “Women are the health care providers in the world,” he said, “so they are the ones who get the extra burden of work whenever anyone in the family has one of these NTDs.”

Saint Fabre, also from Leogane, has had symptoms of lymphatic filariasis for 26 years.

“Stigmatization is a factor of my relationship with my neighborhood, which makes me sad,” she said. After being diagnosed, she “was so ashamed to take part in social activities like walking in the street, the public market and even church.”

She noted that her life changed dramatically, however, with the Filariasis Program staff at a local health clinic. She now works for the clinic and can play a role in “encouraging those living with lymphatic filariasis and advising them to visit the clinic.” This treatment includes taking medicine and learning to care for the inflamed areas.

For Casseus and others living in post-hurricane Haiti, caring for themselves is a top priority. Casseus said now that she knows basic cleanliness principles, she practices them daily to avoid more diseases.

This story was funded through a generous grant from Say it Forward in support of our teen journalists.

Source: Feedzy Read More

Enlarge this image

Boys at the L’Ecole Les Freres Clement elementary school in Jacmel, Haiti, line up to take deworming pills that protect against elephantiasis.

Maggie Steber for The Washington Post/Getty Images

hide caption

toggle caption

Maggie Steber for The Washington Post/Getty Images

Haiti has finally carried out a nationwide campaign to get rid of the parasitic worms that cause elephantiasis.

Haiti has waged other campaigns against the condition, characterized by severe disfiguration of the legs and arms. But until now, it has never managed to adequately reach residents of the chaotic capital Port-au-Prince.

The latest effort by the Haitian Ministry of Health now puts the country on track to wipe out elephantiasis within the next four years, says a study published in the Morbidity and Mortality Weekly Report.

Enlarge this image

Two women with elephantiasis wait at a hospital in Leogane, Haiti, in May 2012.

Maggie Steber for The Washington Post/Getty Images

hide caption

toggle caption

Maggie Steber for The Washington Post/Getty Images

Elephantiasis — officially called lymphatic filariasis — is a cruel condition. Parasites invade your lymphatic system and cause grotesque swelling, primarily of the legs, but also, at times, of the arms and scrotum.

In some parts of the world, lymphatic filariasis is called “big foot.” But even this term downplays the extent of the disfiguration it creates. Elephantiasis can cause massive folds of excess flesh to hang from a person’s hips, thighs and calves and sag toward the ankles. It can make a man’s scrotum swell to the size of a basketball.

People are the only known host for the roundworms that causes elephantiasis. The fight against the disease focuses on mass deworming campaigns. In Haiti that means getting everyone to swallow two pills. The idea is that if you can get 65 percent of the population dewormed for several years in a row, the parasites can no longer survive in the community, and they disappear for good.

Until now, Haiti hasn’t been able to reach the 65 percent threshold in Port-au-Prince, a metropolitan center with more than 2 million people. The mass distribution of deworming pills will have to continue for another four years before health workers are confident that the parasite has been eliminated from Haiti.

The University of Florida’s Dr. Madsen Beau de Rochars has been treating Haitians with elephantiasis for nearly two decades. He says the condition can be devastating. “It’s a big burden economically and physically for that person,” says Beau de Rochars, who worked on the current study. People with the illness are often ostracized.

Haiti is one of just four countries in the Americas where elephantiasis remains endemic. It’s also still found in parts of Brazil, the Dominican Republic and Guyana.

The successful deworming campaign in Haiti is a major step forward not just for the country but for the whole region, says Patrick Lammie, an immunologist with the Centers for Disease Control and Prevention, who also contributed to the current study.

“If a country like Haiti, with all of the challenges that they’ve faced over the last few years, is able to achieve full national coverage, I think that is as an important example for other countries, which are struggling to scale up their programs as well,” he says. Eliminating elephantiasis in Haiti would also help the Dominican Republic control the disease.

Beau de Rochars is confident that Haiti will wipe out elephantiasis eventually. “I had a dream back in 1995 when I first started working in lymphatic filariasis,” he says. “And my dream is to see the certification of elimination [of lymphatic filariasis] in Haiti. This is my dream. I’m a Christian and I believe God will help me to see that.”

Source: Feedzy Read More

(L-R): Rev. Thomas Streit, founder and principal investigator of the Notre Dame Haiti Program; Dr. Florence Guillaume, the Haitian Minister for Public Health and Population; Earl Carter, managing director of the Haiti Program; Sophia Martelly, the first lady of Haiti; and Joseline Marhone Pierre, director of the Office of Nutrition, MSPP.

In partnership with the Haitian Ministry of Public Health and the Population (MSPP), the Congregation of Holy Cross and other partners, the University of Notre Dame Haiti Program dedicated a new fortified salt production plant Monday (Dec. 8) in Delmas, Haiti. Several administrators were in attendance, including Sophia Martelly, first lady of Haiti.

The new facility, which will supplement an existing facility at Cite Militaire, will be used to expand the production of clean, iodized salt for the Haitian population by providing the nation’s first brine-wash facility. This equipment, which should be fully operational in early 2015, will allow local Haitian salt to be cleaned to food-grade quality prior to being fortified and packaged for consumption by the Haitian people.

Since 2005, and in coordination with MSPP, the Notre Dame salt project has sought to eliminate iodine deficiency disorders in Haiti and stop the transmission of Lymphatic filariasis through ongoing mass drug administration efforts. Iodine deficiency causes several health problems, including goiter and intellectual impairment in children. Filariasis, also known as elephantiasis, is a parasitic disease that causes enormous swelling of the limbs and genitals.

Contact: Earl Carter, 574-631-5404, Earl.Carter@nd.edu

Source: Feedzy Read More

Hispaniola is the last malaria endemic island in the Caribbean. On World Malaria Day, Haiti declares it is ready to beat malaria – malaria elimination in the Caribbean is within reach.

Port au Prince (April 25, 2018) – Today, the First Lady of Haiti Martine Moise and more than 300 government officials, civil society representatives, scientists and technical partners of the global health and development community gathered to celebrate World Malaria Day and increase awareness of Haiti’s commitment to eliminating malaria, a preventable yet deadly disease that threatens half the world’s population and kills a child every two minutes.

In addition to causing severe illness and death, malaria has a negative impact on Haiti’s already fragile economy, exacerbating poverty, decreasing productivity, slowing progress in a country where more than half of the population already lives on less than U.S. $2.44 per day.

Yet, Haiti and its partners are committed to eliminating malaria by 2020. With the right resources, partnerships and momentum, the Caribbean can be a malaria-free region, thus bringing the world one step closer to global elimination.

“I am passionate about Haiti’s goal to keep our people safe from malaria,” said Martine Moise, First Lady of Haiti and Chair of Global Fund to Fight AIDS, Tuberculosis and Malaria’s Country Coordinating Mechanism. “Haiti is committed to working together with partners to eliminate malaria to protect every Haitian family from this disease.”

“We have the tools today to beat malaria in Hispaniola and know that the benefits of creating a malaria-free Caribbean far outweigh the costs,” said Dr. Dean Sienko, vice president of health programs for The Carter Center, a member of the Malaria Zero Alliance. “It is also important to work together with other vector-borne disease programs such as lymphatic filariasis, zika, and dengue, to maximize information and resources.”

To commemorate World Malaria Day, a special malaria health education video was created by the Haitian Ministry of Public Health and Population (MSPP) together with The Carter Center, as part of the Malaria Zero Alliance of partners. This video, titled “Malaria Alanba” (Malaria Go Down) brings together seven of the top performers in Haitian popular music and airs on television and radio stations across Haiti today. Earlier this month, Haiti’s MSPP Minister Dr. Greta Roy Clemen appointed musician and “Alanba” contributor Mr. Michael Benjamin, aka Mikaben, to be the country’s first Goodwill Ambassador for Health. The health promotion music video can be viewed here.

Hispaniola, which includes Haiti and the Dominican Republic, is the only remaining island in the Caribbean where malaria is still endemic. According to the Pan American Health Organization (PAHO/WHO), Latin America and the Caribbean have made significant progress in curbing the burden of malaria since 2000. Currently 20 of the 21 malaria endemic countries in the region have committed to end this disease for good. Today, 109 million people in the Americas are still at risk of contracting the disease, and approximately 7 million are at a high risk.

“Elimination in Hispaniola is within reach,” said Margaret Reilly McDonnell, Executive Director of the United Nations Foundation’s Nothing But Nets campaign. “Increased focus and funding on global elimination is critical, and we applaud the efforts of the country of Haiti toward ensuring that no one dies from a mosquito bite.”

Bi-national cooperation is crucial to achieve island-wide malaria elimination. Last year, a binational project to eliminate malaria in Hispaniola, spanning border communities of Ouanaminthe (Haiti) and Dajabon (DR) received the Malaria Champion of the Americas award by PAHO/WHO for its “outstanding achievements” and creative response using innovative technologies that involve the private sector and community and traditional health workers to improve surveillance, diagnosis and treatment of malaria in both countries.

“Haiti’s progress toward malaria elimination demonstrates its commitment to saving lives,” said Josh Blumenfeld, Managing Director for Global Policy and Advocacy, Malaria No More. “Eliminating malaria from Haiti would be an enormous victory, freeing the country from the burden of this disease, and accelerating elimination in the Americas. On this World Malaria Day, we are inspired by Haiti’s leadership and the collaborative efforts from all partners working to rid Haiti of malaria.”

Building upon the binational project success, the Malaria Zero Alliance, led by the MSPP’s Programmes Nationaux de Malaria et de Filariose Lymphatique (PNCM) in Haiti, is focusing efforts in Grand’Anse. Malaria Zero has prioritized Grand’Anse due to its disproportionate burden of malaria transmission, accounting for more than 50% of malaria cases nationwide. Activities to ensure all cases of malaria are tested, tracked and treated are now underway in five initial communities (Les Irois, Anse d’Hainault, Dame Marie, Chambellan, and Moron) and anticipated to expand to the entire department in 2019.

“Haiti’s leadership in the battle against malaria has moved the elimination effort to a critical point where the path is clear for achieving a historic milestone in the Americas region — a malaria-free Haiti and Caribbean,” said Dr. Michelle Chang, Director of Malaria Zero, and CDC Medical Epidemiologist. “Country leadership, coupled with strong partner commitment and innovative strategies, has resulted in the ability to pinpoint the exact locations of malarial infections, rapidly cure them and stop onward transmission. These novel approaches could be used elsewhere in the global fight against malaria.”

Great strides have been made toward malaria elimination; success in Grand’Anse will significantly reduce the overall malaria burden in Haiti and lessons learned will serve as a guide for Haiti to reach its goal of a malaria free Haiti by 2020.

“Haiti is ready to reach zero deaths and no more local transmission by 2020. Between 2010 and 2017, reported cases of malaria at the national level decreased from 84,153 cases to 18,983 cases,” said Dr. Jean Frantz Lemoine, PNCM’s Coordinator. “Malaria testing in the population has increased steadily since 2015 due to Rapid Diagnostic Tests and community-based care — more than tripling community case detection between 2016 and 2017. This proves Haiti can end malaria for good in the coming years.”

Today’s event was co-hosted by United Nations Foundation’s Nothing But Nets campaign and Malaria No More, in close collaboration with the Malaria Zero Alliance. Nothing But Nets and Malaria No More have partnered with Malaria Zero to mobilize additional resources and momentum to end malaria in Haiti and the Dominican Republic.

More partnerships and resources are required to end malaria for good. For more information about malaria elimination efforts in Haiti, visit http://www.malariazeroalliance.org.

Contact

Ryland Devero, Nothing But Nets: rdevero@unfoundation.org, + 1 202.854.2350

Michal Fishman, Malaria No More: Michal.Fishman@MalariaNoMore.org, +1 504.220.2792

About Nothing But Nets

Nothing But Nets is the world’s largest grassroots campaign to save lives by preventing malaria, a disease which claims the life of a child every two minutes. Inspired by sports columnist Rick Reilly, hundreds of thousands of people have joined the campaign that was created by the United Nations Foundation in 2006. Nothing But Nets has raised over $65 million to help deliver 12 million bed nets to families in need, along with other crucial malaria interventions. In addition to raising funds for its UN partners, Nothing But Nets raises awareness and voices to advocate for critical malaria funding for the U.S. President’s Malaria Initiative and The Global Fund to Fight AIDS, Tuberculosis and Malaria. It only costs $10 to help save lives from this deadly disease. Visit www.NothingButNets.net to defeat malaria.

About the United Nations Foundation

The United Nations Foundation builds public-private partnerships to address the world’s most pressing problems, and broadens support for the United Nations through advocacy and public outreach. Through innovative campaigns and initiatives, the Foundation connects people, ideas, and resources to help the UN solve global problems. The Foundation was created in 1998 as a U.S. public charity by entrepreneur and philanthropist Ted Turner and now is supported by global corporations, foundations, governments, and individuals. For more information, visit www.unfoundation.org

About Malaria No More

Malaria No More envisions a world where no one dies from a mosquito bite. More than a decade into our mission, our work has contributed to historic progress toward this goal. Now, we’re mobilizing the political commitment, funding, and innovation required to achieve what would be one of the greatest humanitarian accomplishments – ending malaria within our generation. For more information, visit www.malarianomore.org

About Malaria Zero Alliance

Malaria Zero is an alliance of partners with one bold goal: to accelerate elimination of malaria from the island of Hispaniola. Malaria Zero partners are implementing innovative, evidence-based strategies, including identifying and fine-scale mapping of areas of high transmission and risk, and piloting novel, targeted approaches to elimination. Malaria Zero was made possible by a $29.9 million grant from the Bill & Melinda Gates Foundation, but at least twice as much more is still needed to ensure that our team of technical experts is able to implement island-wide strategies to achieve malaria elimination. For more information, visit http://www.malariazeroalliance.org

Source: Feedzy Read More

The public health infrastructure in Haiti has somewhat improved since the 2010 earthquake and the massive cholera outbreak that followed, but there’s still a big shortfall in resources to improve the country’s water and sanitation systems enough to eliminate the disease from the country, according to a report today in Morbidity and Mortality Weekly Report (MMWR) from the US Centers for Disease Control and Prevention (CDC) and Haiti’s health ministry.

In related news, a trial in Haiti of an oral cholera vaccine showed similar protection as in India.

Cholera progress

Cholera cases have dropped from more than 352,000 in 2011 to just over 15,000 in 2014 through October.

To address the weak water and sanitation services that helped fuel the outbreak in the country, health authorities hired and trained more than 250 rural water and sanitation technicians. Chlorination programs have been implemented in 107 of 500 rural water systems so far, according to a recent survey, says the report.

Though Haiti’s health ministry and its partners have made progress with tasks such as malaria testing, lymphatic filariasis elimination, and disease surveillance, progress is fragile, and funding sources for ongoing public health programs remain uncertain.

Vaccine testing

In another cholera development, a case-control trial in Haiti to test the effectiveness of an oral inactivated bivalent whole-cell vaccine against the disease and assess the likelihood of study bias found that the vaccine provided protection against cholera for 4 to 24 months, similar to its effectiveness in India, where the disease is endemic. The team of American and Haitian researchers published their findings in the March issue of Lancet Global Health.

The study took place between Oct 24, 2012, and Mar 9, 2014, and involved 89 people who presented with acute watery diarrhea. Forty-seven were identified as cases in the vaccine-effectiveness (VE) part of the study and 42 as cases in the bias-indicator analysis.

Twenty-seven (57%) of the 47 case-patients had received certified vaccinations, compared with 147 (78%) of 188 controls, for a VE of 58%. Neither self-reported nor verified vaccinations were associated to a significant degree with noncholera diarrhea.

The researchers concluded that vaccination is an important tool for controlling cholera.

Experts weigh in

In an accompanying commentary, Francisco Luquero, MD, MPH, an epidemiologist with Epicentre in Paris, and David Sack, MD, with Johns Hopkins Bloomberg School of Public Health, wrote that Haiti has included cholera vaccines in its national strategy for eliminating the disease, and earlier reports suggest that their use is feasible in the country.

The authors noted that the new findings suggest the vaccine’s effectiveness in Haiti is comparable to that in endemic countries of Asia and Africa.

Some issues still need to be worked out, such as dosing and storage, but cholera vaccines, used along with other control measures, seem likely to play a role in driving down disease levels more quickly than strategies without vaccines, they wrote.

See also:

Feb 19 MMWR report

March Lancet Global Health abstract

March Lancet Global Health editorial extract

Source: Feedzy Read More