Thursday, December 16, 2010

GHS undertakes deworming exercise -To fight elephantiasis

Story: Lucy Adoma Yeboah
THE Ghana Health Service (GHS) and its development partners have over the years implemented a number of interventions which have proven to be globally effective in the control of a worrisome disease called lymphatic filariasis.
In that direction, the Greater Accra Regional Health Directorate has devoted the period between December 13 to 17, 2010 to embark on mass administration of dewormer (Albendazole and Ivermectin) to prevent the infection which could bring about elephantiasis.
A statement from the directorate and signed by Ms Honesty Numetu, the Head of Health Promotion Unit (HPU) indicated that the lymphatic filariasis could render an individual inactive, less productive and prevent him/her from socialising.
For families, infection could force them into poverty, malnutrition and with communities they could experience famine, less communal labour and outbreak of other diseases due to filthy environment.
Filariasis is a parasitic disease and is considered an infectious tropical disease, that is caused by thread-like filarial nematodes (roundworms).
Filariasis is "considered" endemic in tropical and sub-tropical regions of Asia, Africa, Central, South America and Pacific Island nations, with more than 120 million people infected and one billion people at risk of infection.
In communities where lymphatic filariasis is endemic, as many as 10 per cent of women can be afflicted with swollen limbs, and 50 per cent of men can suffer from mutilating genital symptoms.
There are eight known filarial nematodes which use humans as host. In all cases, the transmitting vectors are either blood sucking insects such as flies or mosquitoes over a long period of time.
Human filarial nematode worms have a complicated life cycle, which primarily consist of five stages. After the male and female worms mate, the female gives birth to live micro-filariae by the thousands. The micro-filariae are taken up by the vector insect (intermediate host) during a blood meal. In the intermediate host, the micro-filariae moult develop into third stage larvae. Upon taking another blood meal, the vector insect injects the infectious larvae into the dermis layer of the skin. After about one year, the larvae moult through two more stages, mature into the adult worms.
The disease is spread from person to person by mosquito bites. When mosquito bites a person who has lymphatic filariasis, microscopic worms circulating in the person’s blood enter and infect the mosquito. Human beings get lymphatic filariasis from the bite of an infected mosquito. The microscopic worms pass from the mosquito through the skin and travel to the lymph vessels. In the lymph vessel, they grow into adults. An adult worm lives for about five to seven years.
The adult worms mate and release millions of microscopic worms, called micro-filarae, into the blood. People with the worm in their blood can give the infection to others through mosquito bites.
Repeated mosquito bites over several months to years as well as people who live in endemic areas are at risk.
Signs and symptoms
The most spectacular symptom of lymphatic filariasis is elephantiasis—oedema with thickening of the skin and underlying tissues —which was the first disease discovered to be transmitted by mosquito bites. Elephantiasis results when the parasites lodge in the lymphatic system.
Elephantiasis affects mainly the lower extremities, while the ears, mucus membrane and amputation stumps are affected less frequently. However, different species of filarial worms tend to affect different parts of the body such as the legs, arms, vulva, breasts and scrotum.
Most people develop these clinical manifestation years after being infected. It is caused by the inability of the body to fight infections due to swelling and decrease function of the lymph system. This results in the hardening and thickening of the skin, which is known as elephantiasis.
Prevention
In 1993, the International Task Force for Disease Eradication declared lymphatic filariasis to be one of six potentially eradicable diseases.
Studies have shown that transmission of the infection can be broken when a single dose of combined oral medicines is consistently maintained annually for approximately seven years.
With consistent treatment, and since the disease needs a human host, the reduction of micro-filariae will not be transmitted, the adult worms will die out and the cycle will be broken.
In Ghana, there are free pills called Albendazole and Ivermectin which could be taken to prevent it. The pill is taken once a year.
The drug is for everybody aged five years and above with height ranging from 90 centimetres and above, however, children under five years, pregnant and lactating mothers and seriously ill patients would not be given the drug.
The strategy for eliminating transmission of lymphatic filariasis is mass distribution of medicines that kill the micro-filariae and stops transmission of the parasite by mosquitoes in endemic communities.
It can also be prevented if people avoid mosquito bites between the hours of dusk and dawn, sleep under treated mosquito nets, wear long sleeves and trousers and use mosquito repellent on exposed skin between dusk and dawn.
The deworming exercise is starting from Monday, December 13, to
Friday, December17, 2010 and people have therefore been advised to avail themselves of the drug. Volunteers would move from house to house to administer the drug in the endemic districts of Ledzokuku Krowor, Ga West, Ga East, Ga South, Ayawaso, La, Ablekuma and Ashiedu Keteke within the Greater Accra Region.
The GHS advise that people with swollen legs, scrotum and any other parts should seek healthcare from the nearest health facility.

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