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Jun 06, 2019 News
There is no denying that Guyana has the capacity to eradicate, in the near future, a disease that has caused many to be stigmatised and discriminated against. No, it isn’t the Human Immunodeficiency Virus [HIV]. Rather it is called Lymphatic Filariasis or simply filaria in these parts.
Guyana through its Ministry of Public Health has over the years been implementing strategic measures to combat the disease that has impacted the lives of many people over the years. In order to achieve its proposed goal to eradicate the disease, this country has been working in close collaboration with its technical partners: the Pan American Health Organisation/World Health Organisation [PAHO/WHO], the United States Agency for International Development [USAID] and the Centres for Disease Control and Prevention [CDC].
Speaking on the multi-agency collaboration, PAHO’s Regional Adviser on Neglected Infectious Diseases, Dr. Santiago Nicholls, made it clear, “We are very committed to support Guyana, and also our colleagues at the WHO are very committed to support Guyana to achieve the goal of eliminating lymphatic filariasis as a public health problem here.”
A move in this direction, he said, is especially important in the region of the Americas. Among the countries in the Americas that have been endemic for the disease in addition to Guyana, are Brazil, Dominican Republic and Haiti.
“We want to eliminate this from the Americas, so eliminating it in Guyana would be a big milestone,” said Dr. Nicholls. This achievement will help to prevent people from having the chronic outcomes of the disease such as elephantiasis, lymphedema and hydrocele.
“Not only does it impact people’s ability to live and have a good quality of life, but also to work and in some cases causes stigma and discrimination of the people who suffer from this condition, unfortunately,” said the Regional PAHO Adviser as he added, “The stigma and discrimination are totally unjustified.”
Even as he recognised the efforts being made to tackle the scourge of the disease, Dr. Nicholls noted, “Not that it is easy to eliminate this disease but we have the tools to do so. It is a challenge but we are confident in the capacity of the country to get the work done and we in PAHO, as well as our partners from USAID, CDC, and other colleagues in academic institutions are very willing to support the country to achieve this very important goal.”
Mass Drug Distribution campaigns executed in 2017 and 2018 saw the Ministry realising 85 and 86 percent coverage respectively.
“This was in part due to micro planning and macro planning, a lot of community involvement and multi-sectoral involvement,” said Deputy Chief Medical Officer [DCMO], Dr. Karen Gordon-Campbell.
She said that in order for Guyana to reach the WHO recommended 2020 target for elimination of the disease, it would require three more years of MDA using two drug types – 100 mg Diethylcarbamazine [DEC] and 400 mg Albendazole.
But according to Dr. Gordon-Campbell, “We don’t have those three years. So if we are to reach eligibility for 2020, we have to slightly adjust our strategy. The strategy that we have available to us is to implement a triple drug therapy.”
The triple drug therapy referenced by Dr. Gordon-Campbell includes 200 kg Ivermectin which will allow the Ministry to reach its target within the WHO stipulated time.
“We have this year and we have 2020 [next year], and if we manage to reach over 80 percent coverage we could be eligible for elimination,” said the DCMO as she named Costa Rica, Suriname and Trinidad as countries in this part of the Region that were formerly endemic for filaria but have since achieved elimination.
“We want to join them, we want to be part of those countries that can say we no longer have this as a problem and that is going to require consorted efforts on our part. It’s going to require multi-sector involvement, private sector involvement,” said Dr. Gordon-Campbell.
According to her, thus far the Ministry has seen its greatest successes in Regions Three, Four, Five and Ten, which are predominantly urban.
But according to her, the Ministry is now tasked with reaching out to hinterland locations which, she noted, have multiple challenges including: culture, language, cost and geography. “We can’t immediately say that because we were successful for the past two years that we will be successful with these [other locations], not at least with this same strategy, so we are going to have to go back to the drawing board.
We are going to have to sit with the same communities that we are trying to target now and work out what will work best,” the DCMO disclosed.
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