Africa: Neglected Tropical Diseases Persist in the World’s Poorest Places – Four Reads About Hurdles and Progress

It’s sobering to reflect that “neglected tropical diseases” are referred to as “neglected” because they persist in the poorest, most marginalised communities even after being wiped out in more developed parts of the world.

A variety of pathogens, including viruses, bacteria, parasites, fungi and toxins, cause neglected tropical diseases, which include dengue, chikungunya, leprosy, lymphatic filariasis and yaws.

They inflict tremendous suffering because of their disfiguring, debilitating and sometimes deadly impact. Patients often experience stigma, social exclusion and superstition.

The good news is that there is reason for hope as some African countries have made significant progress in eradicating these diseases.

We have put together some essential reads from The Conversation Africa over the past year highlighting a scourge that still affects more than 1 billion people today.

Patients’ beliefs about illness matter

Would you take medication for an illness you didn’t believe you had? Or if you disagreed with healthcare workers about the cause of your condition?

This is the dilemma of many people who live in rural areas of Ghana where a mosquito-borne disease called lymphatic filariasis, often referred to as elephantiasis, continues to spread. Researchers found that only 18% of respondents understood lymphatic filariasis as a disease. Fewer than 7% believed it to be a disease spread by mosquitoes.

Instead, people held a range of alternative beliefs attributing the condition to spiritual causes (curses, witchcraft, evil spirits), cold or rainy weather, and other illnesses.

The team of experts, that carried out the research, suggest that understanding patients’ belief systems would help healthcare workers treat patients more effectively.

Read more: Patients’ beliefs about illness matter: the case of elephantiasis in rural Ghana

100 million Nigerians are at risk

A quarter of the people affected by neglected tropical diseases in Africa live in Nigeria. An estimated 100 million Nigerians are at risk for at least one of these diseases and there are several million cases of people being infected with more than one of them.

There has been progress, writes Uwem Friday Ekpo. By January 2023 the country had eradicated Guinea worm disease and two states had eliminated onchocerciasis.

One of the interventions was door-to-door visits by volunteers to administer medicines. Teachers also played a similar role when medicines were distributed in schools.

Read more: 100 million Nigerians are at risk of neglected tropical diseases: what the country is doing about it

Leprosy, scabies and yaws: Togo’s neglected skin diseases

Skin conditions caused by some bacteria, viruses, mosquitoes or mites are common neglected tropical diseases.

Research in schools and rural areas in Togo, west Africa, found a large number of these infections including scabies, leprosy, yaws and Buruli ulcer.

These are stigmatised and can be difficult to diagnose. There are typically few, if any, dermatologists in areas where they are common. Children with these diseases often refuse to go to school.

Michael Head, Bayaki Saka and Palokinam Pitche suggest authorities make the treatment of these diseases free of charge. Health promotion and education are also critical.

Read more: Leprosy, scabies and yaws – Togo’s neglected tropical skin diseases need attention

Reasons for hope

Togo did have reason to celebrate though. In 2022 it became the first country in the world to have eliminated four neglected tropical diseases. The country stamped out Guinea worm disease in 2011, lymphatic filariasis in 2017, sleeping sickness in 2020 and trachoma in 2022.

It achieved its milestone through a combination of measures. These included door-to-door mass drug administration, training of healthcare staff, sustained financing and strong political support.

Other African countries also made significant progress in tackling neglected tropical diseases in 2022. Benin, Rwanda and Uganda managed to eliminate sleeping sickness. Malawi eliminated trachoma and the Democratic Republic of Congo eliminated Guinea worm disease.

But the global health community and African governments cannot rest on their laurels. There is still a long way to go, writes Monique Wasunna.

Read more: Eliminating neglected diseases in Africa: there are good reasons for hope

Nadine Dreyer, Health & Medicine Editor

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