The battle against neglected tropical diseases (NTDs) in Rwanda improved particularly through pilot programmes in Bugesera and Ruhango districts, according to officials. Neglected tropical diseases are a diverse group of conditions caused by a variety of pathogens (including viruses, bacteria, parasites, fungi and toxins) and associated with devastating health, social and economic consequences. ALSO READ: NTDs reduction is a long journey but progress is almost 60% – RBC As stakeholders gathered in Kigali, on Thursday, January 16, to validate and discuss findings from a new assessment, it became evident that more targeted interventions are needed. As explained, Bugesera and Ruhango districts were selected due to their unique challenges in NTD transmission, and key areas in the country’s goal of eliminating NTDs by 2030. ALSO READ: World NTDs Day: A look at common diseases in Rwanda The assessment presented by Dr. Vedaste Ndahindwa, a researcher and lecturer at University of Rwanda’s School of Public Health, highlighted progress and challenges in addressing schistosomiasis, an acute and chronic parasitic disease caused by blood flukes (trematode worms), soil-transmitted helminthiasis (STH) which is commonly known as intestinal worms, and the broader state of water, sanitation, and hygiene (WASH) in these regions. ALSO READ: Combating neglected tropical diseases with awareness and action Soil-transmitted helminth infections are among the most common infections worldwide and affect the poorest and most deprived communities. They are transmitted by eggs present in human faeces which in turn contaminate soil in areas where sanitation is poor. The main species that infect people are the roundworm (Ascaris lumbricoides), the whipworm (Trichuris trichiura) and the hookworms (Necator americanus and Ancylostoma duodenale). The survey presented by Dr. Ndahindwa focused on household expenditures, water access, and sanitation practices, revealing gaps between the two districts. Bugesera, in particular, faced more severe challenges in accessing improved water sources compared to Ruhango. A large portion of households in the two districts continue to rely on surface water from rivers, lakes, and marshlands, raising concerns about waterborne diseases. Although most households are aware of hygiene risks, the study pointed to a lack of proper sanitation infrastructure, especially in workplaces where toilets are often unavailable. This challenge in sanitation facilities worsens health issues and contributes to the spread of diseases. Furthermore, many households face difficulties accessing water treatment options, highlighting the need for better systems to address these deficiencies. “Understanding how these diseases spread in these areas is essential for shaping effective national strategies,” Dr. Ndahindwa said. The assessment was part of Rwanda’s broader commitment to eliminate NTDs in line with the Kigali Declaration on Neglected Tropical Diseases, a high-level political declaration that is mobilising political will, community commitment, resources, and action, securing the commitments needed to end the suffering caused by NTDs. Launched by the Uniting to Combat Neglected Tropical Diseases in January 2022, it was the culmination and joint commitment declared at the Kigali Summit on Malaria and NTDs held in Kigali on June 23, 2022. Dr. Albert Tuyishime, the Head of Diseases Prevention and Control Department at Rwanda Biomedical Center (RBC), noted the impact of intestinal worms, which affect nearly half of Rwanda’s population, with children particularly vulnerable. These diseases not only cause absenteeism in schools but also contribute to decreased productivity in affected communities, he added. Dr. Tuyishime noted the role of WASH in combating NTDs, stating: “WASH is integral to our success in addressing NTDs. Without proper water systems and sanitation, we can’t make meaningful progress.” A multisectoral approach is needed to tackle NTDs and WASH-related issues effectively. Dr. Ndahindwa identified social and cultural practices as barriers to the adoption of basic hygiene practices such as handwashing, stressing the need for context-specific solutions that involve local communities and respect cultural norms. Despite these challenges, the assessment offered a clear path forward. One major recommendation is the creation of a joint roadmap to coordinate interventions across sectors. Dr. Eric Niyongira, who oversees the NTDs programme at Rwanda NGOs Forum on HIV and Health Promotion, noted community involvement in designing and implementing solutions. “Local structures are crucial to the success of these programmes. We must involve community members in designing and implementing solutions that they own,” he stated. Dr. Ndahindwa suggested moving beyond awareness campaigns to create practical, hands-on demonstrations that show communities how to adopt good hygiene practices. “We must go beyond awareness campaigns and create hands-on demonstrations that show people how to adopt good hygiene practices. This could include showcasing the benefits of handwashing and making resources like soap and water more accessible to households,” he urged. Another key recommendation from the assessment was to focus on vulnerable groups, particularly those living near water sources or in rural areas where the burden of disease is highest. Special attention is needed for farmers, whose exposure to contaminated water puts them at higher risk of contracting NTDs. Dr. Eugene Ruberanziza, the Senior Director of Programs at END Fund, noted that NTDs are closely linked to poverty, and improving water, sanitation, and hygiene is key to addressing both issues. The END Fund (Ending Neglected Diseases) is a private non-profit organisation dedicated to combating the five most common neglected tropical diseases that cause up to 90% of the NTD burden in Sub-Saharan Africa. “We cannot address NTDs without addressing the broader context of poverty and sanitation,” the public health specialist noted. Dr. Ndahindwa stressed the need for continued engagement with local leaders in implementing solutions. “Local leaders are the key to driving behaviour change and ensuring that communities remain engaged throughout the process. By creating solutions that are both community-driven and supported by technical expertise, Rwanda can strengthen its efforts to eliminate NTDs and improve overall public health,” he added. The government is actively working on several initiatives, including rehabilitating non-functional water supply systems and constructing new ones in areas of greatest need. The Ministry of Infrastructure is particularly focusing on the development of faecal sludge treatment plants, part of a broader strategy to improve living conditions and reduce waterborne diseases.
