Rwanda Biomedical Center (RBC), Rwanda NGO Forum On Aids And Health Promotion, and Water, Sanitation, and Hygiene (WASH) partners have launched a campaign to raise extensive public awareness about Neglected Tropical Diseases (NTDs), including their impact on people, mode of infection, and burden on the community, prevention measures, and particularly the 20 diseases affecting 1.7 billion people worldwide.
The campaign that commenced on Monday, January 22 in Gisagara District will run until January 30 on World Neglected Tropical Diseases Day—observed each year to raise awareness about NTDs and promote efforts to eliminate them.
According to Nathan Hitiyaremye, the NTDs-WASH Coordination Officer at RBC, the most common NTDs in Rwanda are intestinal worms (affecting 41 per cent, with a 48 per cent prevalence in adults), bilharzia or schistosomiasis, scabies, taeniasis, cysticercosis, rabies from dog bites, and snakebites.
Eight of the 20 diseases categorised by the World Health Organization (WHO) as neglected tropical diseases affect thousands of people in Rwanda every year. The neglected diseases—termed that way because they are not given the same attention as other diseases—are found mostly in sub-Saharan African countries.
Hitiyaremye mentioned significant progress in combating NTDs in Rwanda through deworming, alongside advancements in water sanitation, hygiene, and awareness. As a result, the prevalence of intestinal worms among surveyed school-aged children dropped to less than 20 per cent from 66 per cent in 2008 and 41 per cent in 2020.
Gisagara is one of the districts affected by NTDs due to poor sanitation as a result of insufficient toilets.
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Theonaste Mudahera, a resident of Gisagara, said several people in the area don’t have toilets and those who have them can’t access them while in the garden as they are far away, thus opting to use gardens, bushes, or swamps to ease themselves.
"This causes worms yet many people do not have access to deworming medication, and also lack knowledge or information on how to access them,” she stated.
However, she said, efforts by residents to use clean water, wash hands before handling anything to eat and after using the latrine, and use footwear (which has averted jiggers in the area) among other healthy measures, are paying off.
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A 2020 report by RBC shows that in November to December of the same year, districts with a high prevalence of intestinal worms were Rubavu at 78 per cent, Rutsiro at 73 per cent, Nyamagabe at 48 per cent, Burera at 64 per cent, Nyaruguru at 64 per cent, Nyabihu at 63 per cent, Karongi at 37 per cent, and Musanze at 22 per cent, among others.
Rubavu District tops others with persistent prevalence of NTDs—its overall prevalence is in school-aged children—in 2007 and 2008, the district had an occurrence of 95.1 per cent, which decreased to 89.6 per cent in 2014 before rising again to 91.9 per cent in 2020.
Why are NTDs cases still high?
Jackson Karima, Director of Health in Gisagara District, mentioned the lack of awareness in communities about disease prevention, insufficient training for healthcare providers on diagnosis and treatment, and low community involvement in addressing NTD transmission.
"There is no formal framework for multi-sectoral collaboration involving public and private sectors towards NTDs elimination, insufficient financial means and lack of a system to monitor WASH interventions towards NTDs and vector control programmes in decentralised health.”
Karima added: "To improve hygiene, we have constructed hand washing facilities in different productive use areas in 23 schools, 15 health centres and one hospital and constructed modern latrines in 11 schools and five health centres.”
Strategies
RBC and its partners will carry out Mass Drug Administration (MDA) twice a year, participating in community gatherings such as deworming campaigns, providing health education messages at health facilities, nutrition, and hygiene campaigns, as well as diagnosing and managing detected positive cases.
Hitiyaremye noted that there was an introduction of MDA and decentralisation of MDA through multi-sectoral collaboration with the Ministry of Education, Ministry of Local Government, and others, adding that RBC has also established podoconiosis treatment centres.
Hitiyaremye said: "NTDs can be eliminated, if the government, non-government organisations, and the general population joined efforts for a rigorous awareness campaign to sensitise the people about using clean water and the best sanitation practices, and more. The diseases can be prevented, reduced, and even eradicated.”
By 2024, Rwanda aims to decrease the prevalence of intestinal worms to under 20 per cent. Reported cases of scabies, taeniasis or cysticercosis, snakebites envenoming, and tungiasis (jiggers) dropped by 25 and 20 per cent respectively. Additionally, Rwanda aims to eliminate schistosomiasis as a public health problem, prevent any deaths from rabies (dog bites), podoconiosis, lymphatic filariasis, trachoma, leprosy, and yaws, according to RBC.