Sashay Away NTDs in Ghana

After a day of nothing working in the lab, getting excited waiting for gels to run (which confirms failure as usual) and the emotional rollercoaster that is my PhD; coming home to settle down with a cup of tea is just the most amazing feeling ever. 

What felt extra amazing was reading an article by Kufuor, the former president of Ghana which addressed NTD’s in Ghana. Politicians actually care about the people!! Did you know that 12 million Ghanaians went untreated for curable NTDs in 2017? That’s crazy right! Ghana has a National Health Insurance Scheme (NHIS) to ensure universal coverage of healthcare, however as of December 2013 only 38% of the population had an active NHIS membership. This low enrolment level is said to be due to the perception that services provided to NHIS holders is at a lower quality compared to those who pay ‘out-of-pocket’. I have to say from personal experience that seems about right. Having spent my childhood hopping between 37 Millitay Hospital and Korle Bu Hospital with my mum; the number of days we waited all day without getting to see a doctor or had doctors tell us it would be better to go to their own clinic which they run at the side was amazing. But if you want ‘free’ healthcare that’s what you have to go through. It did lead to my mum going private and later leaving the country for treatment, so to the 62% of people who don't feel that their NHIS membership give them the quality they deserve- I completely understand. 



But which NTDs affect Ghanaians? 

First lets give a loud applause and big up Ghana a bit shall we. Guinea worm and Trachoma are both eliminated completely now- confirmed by the WHO! And I have to say both are diseases I heard of growing up. Trachoma I thought was another name for Cataract, and Guinea worm another name for Ringworm- silly me. But with diseases having different names and not being told much about a disease UNTIL you have it, no wonder I got confused as a child. Guinea worm absolutely terrfied me. I can remember my environmental science teacher in year 5 talking about the worm that would slowly come out of your skin. How to deal with it!? Well tie a thread around the worm carefully (trying not to kill it) and as it comes out to roll it around a toothpick. Another market for toothpicks?



But Yasmine what NTDs actually affect Ghanaians now? I will be talking about just a few so sorry if your favourite NTD is not mentioned. HAT, River blindness, Elephantiasis, Bilharzia and some lovely worm infections. If you are here for some hardcore science, I am sorry to disappoint but I do have some weird stories for you. Enjoy. 

HAT is basically non-existent however I cannot find anything using the ‘E’ word…’ELIMINATED’. I had never heard of HAT or trypanosomes before going to university and being introduced to the amazing world of parasites. 


Two female elephantiasis patients(https://www.modernghana.com/news/909055/elephantiasis-the-disease-tells-you-why-it-has-that-name.html)

River Blindness (Oncho) and Elephantiasis are both treatable and have both targeted for control and possibly elimination since 1974 and 1990 respectively, so the future is bright for humans affected (not so much for the parasites). I have to say Elephantiasis was the first disease that absolutely blew my mind. A kenkey seller a few streets down from my house had one humongous leg and as a kid I would always whisper to my mum when we were buying kenkey asking her what happened. When my mum said that the lady was ill and had elephantiasis, I honestly thought she was lying to me. Elephant what! I am probably glad she didn’t tell me it was caused by a mosquito bite and worms or there might have been a storm. 7 year old me outraged that she was still treating me like a child lying to me! Gosh did I think I was a grown ass adult. If you don't know what kenkey is you are missing out. It's a sour fermented maize flour dough wrapped in corn husk and steamed. 


Two people enjoying kenkey which is traditionally eaten with a pepper sauce and fried fish 

Bilharzia and Worm infections (Hookworm, Ascariasis and Whipworm) are also some fairly common NTDs. If you are Ghanaian, you will understand when I say I am glad for the Akosombo Dam. Especially when it is acting accordingly; it saved us from the constant Dumsor monster of 12 hours with lights on and 24 hours without light. However, reading that the creation of the Akosombo Dam and therefore the beautiful Lake Volta increased the population affected by Bilharzia jumping from 5% to 40%! I guess electricity was more important to some people. These schistosomes worms can be treated effectively with Praziquantel. Whilst this treatment makes me comfortable to enjoy the resorts around Lake Volta during holidays, I have to admit I still don't take any treatment after assuming I will be fine. As a grown adult living away from home I have escaped my biannual deworming tablet. That’s pretty embarrassing to admit to the whole world that I used to be dewormed like a dog (jokes my one reader who happens to be Ben being forced to read this!). Deworming children being normal means intestinal worms are a problem, one that can be fixed with drugs but still a problem. My nutrients are mine and I do not like to share with cheeky intestinal worms!


I am going to miss Cutaneous Leishmaniasis because that is for another post currently in the works. Like Bilharzia it affects people in my hometown of the Volta region, but as a fairly new finding to the region it requires a LOT more investigation.   

Each one of these diseases have a fascinating parasitic creature with their own story and lifestyle. It’s nice to see the former president address a problem faced by Ghanaians, and holding government accountable towards the elimination of major NTDs rather than relying entirely on outside organisations to tackle the problem. With researchers, politicians and other amazing people addressing these problems we can all say sashay away to these fascinating parasites that are not welcome in our bodies. 




Read more:
https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0002051Predictive vs. Empiric Assessment of Schistosomiasis: Implications for Treatment Projections in Ghana
http://www.tm.mahidol.ac.th/tropmed-parasitology/2011-34-1/34-1-2011-e1-Urinary-Schistosomiasis.pdfUrinary Schistosomiasis among Adults in the Volta Basin of Ghana: Prevalence, Knowledge and Practices 
https://researchonline.lshtm.ac.uk/359/1/pntd.0001200.pdfMapping Helminth Co-Infection and Co-Intensity: Geostatistical Prediction in Ghana 
https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007005Ghana: Accelerating neglected tropical disease control in a setting of economic development
https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-016-0320-1Why are the poor less covered in Ghana’s national health insurance? A critical analysis of policy and practice
https://allafrica.com/stories/201904080772.htmlAfrica: His Excellency John Kufuor - Why I'm saying 'No' to Neglected Tropical Diseases

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