The People makingschistory the Global Fight Agains Schistosomiasis
For the showtime fourth dimension since the pandemic, I am finally able to travel to sub-Saharan Africa. It'southward a region I accept visited frequently for my piece of work fighting neglected tropical diseases (NTDs) that are a significant burden across the region.
Every bit I prepared for this trip, I reflected on a rare upside of the globalized nature of COVID-nineteen: that it has sensitized people around the world to the debilitating impact of infectious diseases on individuals, families, and entire communities. My hope is that this shared experience tin translate into greater back up for combating many other diseases that are interrupting millions of lives every 24-hour interval.
That includes the NTD that was a focus of my recent trip to Republic of ghana. Schistosomiasis is a disease rarely seen in wealthy countries. It's often misunderstood and misdiagnosed even in sub-Saharan Africa, where more than 200 million people are at take a chance. Schistosomiasis is acquired by tiny larvae of parasitic worms found in fresh water. The worms penetrate the peel when a person is in contact with infested h2o and once in the body, mature into adults where they can cause a wide range of bug, including damage to the liver, kidneys, and float.
The worms penetrate the skin when a person is in contact with infested water and once in the trunk, mature into adults
I'grand working on a project called the FGS Accelerated Scale Together (FAST) Parcel project with a coalition of organizations and wellness professionals who focus on a especially terrible manifestation of schistosomiasis called female genital schistosomiasis (FGS), which currently affects nigh 56 one thousand thousand women in Africa. FGS does not just impact the bladder, information technology affects the whole pelvis including the genitals and can produce vaginal discharge, hurting with intercourse, bleeding, and infertility. It can as well lead to an ectopic pregnancy—a life-threatening condition when a pregnancy occurs outside the uterus.
Many symptoms of FGS are similar to symptoms for other conditions. Information technology is routinely misdiagnosed as a sexually transmitted infection (STI) because health-intendance providers are not enlightened of it. This contributes to social stigma and even domestic corruption from husbands who mistake FGS symptoms every bit evidence of adultery.
The high incidence of FGS in African women is linked to the fact that women and girls in resource-poor areas are frequently in charge of laundry and collecting water for the household, activities that increase their exposure to rivers and other freshwater sources that harbor schistosomiasis parasites.
In our FAST workshop, Nurse Ruth Allotey of the Korle-Bu Teaching Infirmary in Accra, Ghana, shared a case that still torments her today. A woman in her mid-thirties came to see her with vaginal discharge, abdominal pain, and irregular haemorrhage. She had sought intendance and handling from a pharmacist shop, pharmacy, her local clinic, an urban clinic, and fifty-fifty an obstetrician-gynecologist—referred from place to place considering her symptoms did not resolve. She spent a lot of money and even lost her task in the process of seeking care. She came to Nurse Allotey for help merely sadly, she also did non know what was wrong. At present, after this preparation workshop, Nurse Allotey recognizes that this was a clear case of FGS that could have been easily treated and she is trying to find the patient to ensure she gets the treatment that she needs and deserves.
Women create action plans for FGS in their local health center in Accra, Ghana. Photo courtesy of Julie Jacobson
Through the workshop and the FAST Projection more generally, nosotros are trying to forbid this tragedy from repeating. But, the fight against FGS brings promise and frustration in equal measure out. There is promise because there is a safety, inexpensive drug called praziquantel that can treat schistosomiasis infections with a unmarried dose, improving symptoms and reducing suffering. In partnership with the World Health System, Merck KGaA donates praziquantel for use in pre-school and school age children. Information technology's provided through mass handling programs in sub-Saharan Africa, almost ordinarily through schools and local health organizations. These programs accept made neat progress using the drug, but this progress has been threatened over the past two years. Targeted efforts to fight schistosomiasis through mass treatment campaigns have experienced meaning disruptions due to the COVID-19 pandemic. This setback is magnified past the many missed opportunities to simply integrate schistosomiasis handling and prevention into existing routine health interventions to reach at-risk women and girls outside of schools.
With pandemic restrictions starting to ease, in that location is an opportunity to do more than than restart mass handling campaigns. We should also embrace cost-effective ways to brand rapid progress by embedding treatment and prevention within programs that target diseases that have a clear connexion to women and girls at risk for FGS. For example, women with FGS are iii to iv times more likely to become infected with HIV and often experience higher HIV viral loads, also. That should make FGS diagnosis and treatment a priority in programs supported past the U.South. President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund.
Programs for cervical cancer prevention and screening—efforts to reach girls for vaccination against Man Papilloma Virus (HPV)—offering another artery. Evidence of FGS tin easily be detected during these screening programs and praziquantel can exist distributed if needed. Interventions that focus on sexually transmitted infections should consider FGS during patient evaluations, especially when infections take not resolved after sexually transmitted infection (STI) treatment. In fact, a single dose of praziquantel should be standard exercise when seeing untreated women and girls in health clinics in areas where the schistosomiasis parasite is common, regardless of whether the patients are currently showing symptoms.
The author (center) and her colleagues look at potential manual hazard factors near the Weija Dam on a field visit in Weija, Ghana. Photograph courtesy of Julie Jacobson
To reverse the tide, there is an urgent need for data campaigns targeting wellness professionals. Physician Hameedat Omoyele-Abdussalam, an OB/GYN in Nigeria, said she was never taught about FGS in schoolhouse. She was proudly part of documenting the first FGS cases in Nigeria in 2016 and is now championing efforts to inform her colleagues and new medical students of the adventure so women and girls are no longer misdiagnosed.
Public education efforts must also reach women and girls, to help them empathise the symptoms of FGS and seek out proper care as soon as possible and participate in mass treatment programs where they are provided. To achieve this goal in Nigeria, physician Ibrahim Rabiu, along with Omoyele-Abdussalam, is launching a new FGS Social club to help prevent and treat FGS across the country, informing health practitioners and sensitizing at-run a risk populations.
FGS has been especially overlooked within the already marginalized world of neglected tropical diseases. WHO Director-General Tedros Adhanom Ghebreyesus referred to FGS as the "silent and neglected scourge in sexual and reproductive health in Sub-Saharan Africa."
Equally we emerge from the worst days of COVID-19 and resume wellness interventions that were slowed or suspended during the pandemic, we need to accept stock of blind spots that existed before the pandemic and move speedily to right them. It's particularly important to target diseases that accept such a significant bear on on women. The link between FGS and HIV risks lonely should be sufficient plenty to warrant more attention, given how African women and girls are disproportionately affected past HIV. A new group is meeting to endeavor to fill the gap and find the opportunities, the FGS Integration Group (FIG)—it links HIV partners, those fighting cervical cancer, and NTD partners to integrate FGS into existing programs to reduce unnecessary suffering.
FGS is depression-hanging fruit when information technology comes to addressing disparities in women's wellness. The handling is cheap and effective, and it tin can exist easily administered anytime a wellness-care provider is dealing with annihilation related to HIV, cervical cancer, STIs or just a routine visit. The biggest barrier is a lack of awareness of the problem. In that sense the cure is not so much a drug. Rather, it'southward seeking a remedy for the somewhat puzzling condition in which a affliction that affects tens of millions of women somehow manages to be hiding in plain sight.
A behemothic 25-meters-long worm represents the parasitic worm that causes schistosomiasis. Pictured on Lake Leman for the Neglected Tropical Diseases Summit, in Geneva, Switzerland, on April 18, 2017. REUTERS/Pierre Albouy
Source: https://www.thinkglobalhealth.org/article/hiding-plain-sight
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