How youth involvement is critical to eliminating neglected tropical diseases in Nigeria

BY BUKOLA AFENI

Neglected tropical diseases are a group of communicable diseases found in tropical and subtropical regions of the world. They are usually classified as neglected because they have received little or no attention in terms of prevention and control for several years.

NTDs include buruli ulcer, chagas disease, dengue and chikungunya, dracunculiasis (Guinea-worm disease), echinococcosis, foodborne trematodiases, human African trypanosomiasis (sleeping sickness), leishmaniasis, leprosy (Hansen’s disease), lymphatic filariasis, mycetoma, chromoblastomycosis and other deep mycoses, onchocerciasis (river blindness), rabies, scabies and other ectoparasitoses, schistosomiasis, soil-transmitted helminthiases, snakebite envenoming, taeniasis/cysticercosis, trachoma, and yaws and other endemic treponematoses.

Most people that are usually affected by neglected tropical diseases live in rural areas, where houses are overcrowded, and basic infrastructure such as water and toilet facilities are not available.

Nigeria carries a particularly heavy burden. A quarter of the people affected by neglected tropical diseases in Africa live in Nigeria. An estimated 100 million people in the country are at risk for at least one of the diseases and there are several million cases of people being infected with more than one of them.
Neglected tropical diseases in some instances had caused disfigurement, malnutrition and cognition problems to those that have the ailment.

With most young people within the productive age, being affected by NTDs, the government and stakeholders in the health sector need to place a high priority on the elimination and prevention of NTDs in Nigeria.

The federal government of Nigeria has been making remarkable progress in eliminating neglected tropical diseases in the country, especially trachoma and onchorcheciasis.

Young people must be informed with critical information that will enable them to prevent the spread of neglected tropical diseases within the productive group. NTDs have a way of reducing the economic power of young people, as those infected with the disease usually experience economic and psychological burdens which may lead to loss of livelihoods.

The World Health Organisation has been advocating for NTD services to be accessible through innovation and cross-sector collaboration and mainstreaming, for stronger country ownership and accountability, to obtain an effective result.

Akpan Nse, the national coordinator, neglected tropical disease programme, disclosed that NTDs always create a high burden in society, especially among young people.

“Since NTDs do not kill instantly we tend to overlook the disease. Some people become disabled due to the outcome of the sickness. Onchonrchesias and trachoma can lead to blindness, though the eye defect may not happen immediately,” he said.

“We need to work towards reducing the burden of NTDs, especially among the youth.”

He highlighted that the effects of NTDs are lifelong and quite devastating, and expressed the need to prioritize the elimination of the disease.

“Those that are disabled cannot contribute to the economy. We need to reduce the burden of NTDs among the active population. We are focusing on creating more awareness such that more people are informed of the longtime impact of the disease,” he said.

“If you are not affected you can be infected, Sometimes people attribute the sickness to village people, especially at the onset of the disease. India is rated first in terms of NTDs followed by Nigeria. All hands must be on deck to eliminate NTDs.”

Nse stated that ignorance among the populace enhances the spread of NTDs, without taking necessary preventive and precautionary measures.

“Snake bites and rabies are also part of neglected tropical diseases. Most people rear dogs in their homes and also keep them for domestic and security purposes. In some instances, the owners do not care if the dogs are infected with rabies. Several zoonotic diseases can be prevented, we do not have to wait till they are fatal,” he said.

“Snakebite is common in  Northern states like Gombe, and  Anambra states. We do not have to take chances with the recent happenings in some communities.
Whenever we suspect any case of neglected tropical diseases, we have to start the treatment immediately.”

The coordinator called for more sensitisation and advocacy from the media to inform more Nigerians about NTDs.

“The media should sensitize the people on how to eliminate neglected tropical diseases, they should play the same role they exhibited during the elimination of Malaria and HIV in the country. The public needs to be involved in critical steps they need to take in the area of lifestyle modification, such as living in a clean and hygienic environment. They should stop thinking that neglected tropical diseases are due to the handwork of witches and evil people in society,” he said.

“The worst side of neglected tropical diseases is that it is not even affecting the rich, it is affecting the poor of the poorest, so they tend to be neglected. It affects people who live in slums and shanties. Those who cannot afford good housing, and a good meal. They often do not have access to good sanitation and hygiene practices. All citizens must be provided with basic infrastructure, good water and sanitation. It is also important to control the vector that is causing the spread of the diseases.”

The Nigerian government launched its 2023 to 2027 master plan on NTDs in the country on January 30 2023.

The master plan is part of the measures of the country at attaining country goals in terms of eliminating NTDs.

Osagie Ehanire, the minister of health, at the launching of the master plan on NTDs in January 2023, disclosed that the country in its collective commitment to partnership for ownership of the strategic document has supported efforts of other disease-endemic nations in contributing to the development of the Kigali Declaration on NTDs.

“The cooperation of all stakeholders is needed to utilise the document as a guide for the attainment of country goals. Nigeria is dedicated to the WHO road map to end NTDs by 2030. Substantial progress has been made in the past decade evidenced by Guinea Worm Disease Eradication in 2013,” he said.

“Onchocerciasis transmission elimination in Plateau and Nasarawa states in 2019, with imminent prospects of Kaduna, Kebbi and Zamfara states, being free of the disease soon, leaving us with fewer endemic states, and over 28 million persons no longer needing treatment.”

Bright Ekweremadu, the country director of CBM, said significant progress has been made in Nigeria towards the elimination of the five PC-NTDs (Onchocerciasis, Lymphatic filariasis, Trachoma, Schistosomiasis and soil-transmitted helminthiasis).

He added that two states (Plateau and Nasarawa) have eliminated the transmission of onchocerciasis, while the transmission is interrupted in eight states (Abia, Anambra, Enugu, Delta, Imo, Kaduna, Kebbi and Zamfara).

“All other states in Nigeria are at various stages of elimination.  Lymphatic filariasis is endemic in 583 LGAs out of the 774 LGAs in Nigeria, as of December 2022, 95 LGAs have stopped mass administration of medicines from 16 states and the Federal Capital Territory,” he said.

He said CBM has been tackling two NTDs which have blinding consequences,  Onchocerciasis and trachoma for many years. We have scaled up support for three other NTDs (lymphatic filariasis, schistosomiasis and soil-transmitted helminths (STH)) which have similar treatment approaches as onchocerciasis and trachoma.

Ekweremadu added that these diseases exhibit a high degree of geographical and social overlap, so integrated control is both technically feasible and cost-effective, making it possible to tackle multiple NTDs simultaneously.

The theme of the 2023 NTD Day is: ‘Act now. Act together. Invest in Neglected Tropical Diseases’. It is aimed at keeping 2030 targets on track with innovative and sustainable financing. The NTD day also re-energises the momentum to end the suffering from these 20 diseases, caused by a variety of pathogens, viruses, bacteria, parasites, fungi and toxins.

The significance of World NTD Day is to renew global and national awareness of the magnitude of NTDs and also present opportunities to highlight progress made, and challenges met in policy direction and advocate support for prevention, control, and elimination efforts.

The elimination of NTDs is critical to the attainment of sustainable development goals, specifically goal 3, which is meant to ensure healthy lives and promote wellbeing.

This article was produced with the support of Speak Up Africa Media Fellowship Program