NTDs Soil Transmitted Helminths and Development by Dr. D Addiss

7/31/2019 NTDs Soil Transmitted Helminths and Development by Dr. D Addiss

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Neglected Tropical Diseases, Soil-

Transmitted Helminths, andDevelopment

May 30, 2012

Disclaimer: The views expressed in this paper/presentation are the views of theauthor and do not necessarily reflect the views or policies of the AsianDevelopment Bank (ADB), or its Board of Governors, or the governments theyrepresent. ADB does not guarantee the accuracy of the data included in thispaper and accepts no responsibility for any consequence of their use.Terminology used may not necessarily be consistent with ADB official terms.


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Effects of NTDs

Human suffering Chronic morbidity

Stigma

Unrealized potential Health

Nutrition

Education

Development China targeted schistosomiasis and filariasis in

its 1956 agricultural development act

Cycle of poverty


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Soil-Transmitted Helminths(intestinal worms)

A case study

Ascaris(roundworm)

1 billion Trichuris(whipworm)

795 million

Hookworm 740 million


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Soil-Transmitted Helminths (STH)

(intestinal worms)

Transmission Fecal contamination of the environment

(soil)

Poor sanitation

Inadequate hygiene


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Why Treat? Benefits of Deworming

Physical Growth

Learning and education Long-run economic benefits


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Weight gain in children after one round ofdeworming: Cochrane review results

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Learning and Education Benefits

Treated children improved in cognitive scoresover those who remained infected (Source:Nokes, McGregor, and Bundy, 1992)

The longer the school deworming wasmaintained, the greater the improvements incognitive skills and the quicker mastery of theskills (Source: Grigorenko et al. 2007)

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Deworming decreased absenteeism by 25%

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Long-Term Benefits of DewormingKenya Life Panel Survey (1998-2009)

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7,530 people in baseline deworming sample

By 2007-2009 survey round, most 20-26 years old

85% effective tracking rate among those still alive

Source: Baird et al. 2011


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Long-Term Benefits

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Self-reported health improved

Primary school participation, 1998-2001, increased by0.13 years (p


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The troubling return of infection and morbidityover 24 months

Hatz, et al., AJTMH 1998


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STH Control Strategy

Preventive chemotherapy treatment

School-age children: school-based MDA

Preschool children: child health days,

immunizations, vitamin A distribution Sanitation and hygiene prevention

Availability of sanitation facilities wasassociated with significant protection againstSTH infection (OR=0.54, 95% CI 0.44-0.61)

Ziegelbauer et al, PLoS Medicine2012


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Johnson & Johnson MebendazoleDonations

2007-2012 (in millions)

20.732.7 31 31.2 30.7

6710.75

31.8

0

1020

30

40

5060

70

80

90

100

2007 2008 2009 2010 2011 2012

Original Countries New Countries

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11

88

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Expanded Drug Donations for STH inSchool-Age Children

2010

J&J expanded mebendazole donation forSTH from 30 million to 200 million peryear

GSK pledged 400 million doses ofalbendazole per year for STH

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The WASHEDApproach

Water - Access to potable water

Sanitation - Sanitary latrines

Hygiene Education - Personal andenvironmental hygiene

Deworming - Deworming with broad-

spectrum anthelminthic drugs

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Safe Water Supply MDG and equity


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Neglected tropicaldiseases

or

Diseases of neglected

people?


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London Declaration

On January 30th, 2012, representativesof countries, development partners and

pharmaceutical companies renewed andexpanded a partnership to eliminateNTDs

World Health Organization roadmap


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Pharmaceutical companies have agreed todonate the drugs needed

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Merck & Co.: Onchocerciasis and LymphaticFilariasis

GlaxoSmithKline: Lymphatic Filariasis andintestinal worms in school-aged children

Pfizer: Blinding Trachoma

Johnson & Johnson: Intestinal worms inschool-age children

Merck-Serono: Schistosomiasis


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World Bank committed to strengtheninghealth systems to combat NTDs in Africa

January 30, 2012

Extended World Bank financing (IDA / HSS TrustFund) and technical support to help countriesbuild stronger community health systems that willintegrate NTD elimination and control

Pledged to work with other partners to expandthe trust fund of the African Program forOnchocerciasis Control (APOC) to support theelimination or control of NTDs in Africa


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2016 Elimination GoalsAsia Pacific NTD Programme

Lymphatic filariasis - 18 countries

Blinding trachoma - 6 countries

Schistosomiasis - 4 countries

Yaws - all 5 countries

Leprosy 3 countries

Leishmaniasis - 5 countries Morbidity due to soil-transmitted helminths in

school age-children 16 countries

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hank you!

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NTDs Soil Transmitted Helminths and Development by Dr. D Addiss