NIGERIA – The effectiveness of water, sanitation, and hygiene practices in the control and elimination of diseases, especially, Neglected Tropical Diseases, NTDs has again been emphasised.
Experts say the prevention and management of NTDs can only be sustained if hygiene practices and necessary WASH facilities are provided for the poor and communities endemic for the diseases.
Neglected Tropical Diseases are a group of 20 disease conditions prevalent in the tropics, associated with poor sanitation, lack of safe water, substandard housing conditions and poor healthcare.
NTD expert, Dr Anyaike Chukwuma, explains that such group of diseases are referred to as ‘neglected’ because they do not receive attention as other diseases and affect mostly the poor.
In Nigeria, medical science is focused on the control and management of Onchocerciasis, Lymphatic Filariasis, Schistosomiasis, Soil-transmitted Helminthiasis and Trachoma, five out of the many NTDs that Nigeria is known to be endemic for.
Dr Anyaike further explains that ‘‘untreated or unmanaged neglected tropical disease conditions often lead to organ damage as infections are mostly chronic and life-threatening’’.
Many of these conditions are further aggravated by ignorance as patients either refuse to seek treatment, have no access to health care or sanitation and are controlled by negative traditional myths and beliefs.
NTDs are known to negatively impact on maternal, newborn and child health; reduces physical and cognitive development in children and leads to low productivity in infected adults.
Unfortunately, 2 out of every 3 Nigerians are at risk of one or more of these conditions, raising the need for the country to seek effective intervention strategies in checking its spread.
The National Bureau of Statistics estimates that Nigeria contributes about 40% to the global burden of NTDs yet continues to enjoy a whopping 80% dependency on donor funds for treatment of patients and control of the disease for its citizens, a strategy experts say may never guarantee elimination.
According to medical research, about 119.8 million Nigerians are at risk of Lymphatic Filariasis or elephantiasis, 51.4 million prone to Onchocerciasis, 28.8 million exposed to Soil-Transmitted Helminthiasis, a total of 26.8 million suffer from Trachoma blindness, while about 23.8 million school-age children are on treatment for Schistosomiasis.
These diseases according to the WHO are some of the reasons achieving Universal Health Coverage in Africa may remain a mirage. The global health body says the access to health for all target in Africa is dependent on eradicating these neglected diseases, as they affect the poor who do not have equal access to improved healthcare.
In the words of Dr Tedros Adhanom Ghebreyesus, the Director-General of the WHO “If we are serious about universal health coverage, we must intensify our efforts and our commitment to control, eliminate or eradicate NTDs by 2020”.
But achieving this may be daunting considering that the outbreak of Coronavirus earlier in the year, diverted attention from other life-threatening conditions prevalent in the country.
However, Water and Sanitation specialists say most neglected tropical diseases can be checked using hygiene since the diseases are the result of lack of sanitation and can be controlled if WASH conditions are improved in endemic communities.
The Executive Director, HEAL Foundation, Mrs Chioma Mong in an interview explained that Nigeria’s focus on treating existing cases with donor sponsored medications have left a huge gap on prevention efforts, a situation the charity is working hard to check.
The public health practitioner emphasised the need for the government to partner with organisations in the grassroots to demystify the religious misconceptions and beliefs around many of the diseases.
‘’There are so many myths that are not being addressed, in some communities where we have gone to teach WASH as a means of preventing NTDs when you see a man with a swollen scrotum, which of course, is lymphatic filariasis or elephantiasis, they say it’s a result of adultery or when you see a man urinating blood, they say it is male menstruation, whereas it is Schistosomiasis or snail fever.’’
‘‘These negative beliefs affect treatment or eradication efforts. Many ignorant sufferers in these communities will never seek treatment, as such spread the infection’’
Though neglected diseases are found across Nigeria, 12 states in the six geopolitical zones are reportedly endemic for one disease or the other.
The Programmes Manager, HEAL Foundation, Angel Mong says creating awareness on the existence of the diseases will ensure policymakers see the need for partnership with foot soldiers in the affected communities.
‘‘We are open to partnerships and funding from other NGOs, there are organisations that can fund these campaigns but can’t go to the grassroots, we are happy to go for them. We need to work together to ensure the control and elimination of these diseases.’’
The Charity now wants the government to use the NTD endemicity to prioritize the provision of safe water sources for communities and also give the diseases the same priority it gives to Malaria or Tuberculosis.