THE Ministry of Public Health will scale up its use of safe and effective diagnostic tools and interventions to curtail the spread of Neglected Infectious Diseases (NIDs) in Guyana, Dr. Samantha Kennedy said while simultaneously underscoring the importance of having a long term interdisciplinary, multi-sectoral approach in place.
Dr. Kennedy, the Technical Advisor to the Minister within the Ministry of Public Health, was at the time addressing a Stakeholders Meeting on Tuesday at the Regency Suites on Neglected Infectious Diseases (NIDs) in Guyana. According to the Pan American Health Organisation (PAHO), NIDs are a set of infections – many of them parasitic – caused by various micro-organisms affecting communities plagued by poverty and poor access to health services. NIDs include elephantiasis, leprosy and trachoma (blindness caused by trachoma).
The Public Health Ministry has been working closely with its international partners and donors such as Global Fund and PAHO/WHO to further strengthen the primary healthcare system with focus on NIDS.
The ministry, Dr. Kennedy said, will put more effective surveillance and monitoring systems in place to ensure early detection and treatment. “An evaluation system for tracking progress on a regular basis, especially based on performance indicators, will also form part of our strategy to combat NIDs. Ultimately, the data generated will be used for advocacy and for developing more appropriate evidence-based policies and strategies,” the Technical Advisor explained.
The Ministry is currently strengthening all of its national disease control programmes with emphasis on hinterland areas. According to Dr. Kennedy, the intensified initiatives in the hinterland areas will serve as entry points for strengthening primary health care services and providing a catalyst for health-care development.
“This strategy is in direct recognition that health systems appear weak in remote and border areas, where NIDs can remain undiagnosed and untreated. Together, we must work assiduously to narrow the inequities of access to best quality health care services in the hinterland regions,” she explained.
However, she said preventing stigma and discrimination for diseases such as leprosy remain a major challenge. “Training for health staff may be required to increase their awareness of how stigma and discrimination in communities can lead families to discourage their relatives with disfiguring diseases from attending health services, particularly if they are disabled and require assisted travel.”
Despite the challenges, Dr. Kennedy said renewed efforts to eliminate NIDs will bring Guyana closer to achieving the Sustainable Development Goals and strengthen human rights. “NIDs have serious consequences, particularly because those affected experience hunger and poverty and reduced access to education and employment,” she emphasised.
Zooming in on leprosy, PAHO Technical Officer on Malaria and other Infectious Diseases, Dr. Jean Alexandre, said while leprosy was eliminated globally as a public health issue in 2000 with a prevalence of less than one case per 10, 000, it remains a problem.
Citing Guyana as an example, Dr. Alexandre, pointed out that while the country has achieved the elimination goal of less than one per 10, 000, sub-nationally, or regionally, there are increasing cases of leprosy, which is now a cause for concern.
As such, a new target has been set with steps being taken to further reduce its prevalence to less than one per 10, 000 regionally. In reaching this target, the PAHO Technical Officer posited that great attention must be placed on diagnosis, accurate treatment and stigma reduction.
The World Health Organisation (WHO) describes leprosy as a chronic disease caused by a slow multiplying bacillus or a rod-shaped bacterium called Mycobacterium leprae. Due to the nature of the disease, which is also known as the Hansen’s disease, it is transmitted via droplets from the nose and mouth during close and frequent contacts with untreated cases, WHO explained.
However, it takes approximately five to eight years to develop while symptoms can take as long as 20 years to appear. If left untreated, it causes nerve damage in three main areas of the body – the face, hands and the feet. Here in Guyana, the disease is very often misdiagnosed, Acting Director of the National Leprosy Programme, Dr. Nikita McKenzie said, noting that the infectious disease is often mistaken as lota – a skin fungus.
One of the primary symptoms of leprosy is skin lesions, which is often lighter than the normal skin colour and numb, Dr. McKenzie pointed out. Once a diagnosis is made, the patient is placed on a six-month or one-year treatment plan depending on the severity of the disease. The treatment is a Multidrug therapy (MDT), which has been made available by WHO free of charge to all patients worldwide since 1995.
Already for 2017, 26 new cases of leprosy have been recorded with more cases expected. “This is something that has been trending from last year,” she posited, noting that there is a type of leprosy that is not classified by the World Health Organisation (WHO) called Neural Leprosy. According to the Director of the National Leprosy Programme, specialists have been recording patients with Neural Leprosy in addition to Multicacillary and Paucibacillary types of leprosy.
To aid with early detection, the programme through the skin clinic has been scaling up its awareness programme and conducting monthly clinics in Regions Three, Four, Six and 10. Dr. McKenzie and her team are also working to decentralise the programme to have a greater reach. Director of the Vector Control Services, Dr. Horace Cox and Director of Rehabilitation Services, Ariane Mangar, were among the officials present.