World NTD Day 2024: Early Career Grant Research into NTDs

In my research on the 'Capacity and readiness of healthcare facilities to diagnose and manage Neglected Tropical Diseases (NTDs) in Eastern Uganda', I am deeply aware of the urgency of the theme 'Unite, Act, Eliminate', especially in the context of climate change. I recognize that climate change is intensifying the spread of NTDs by altering the ecosystems of vectors and hosts. This necessitates a united front where we need a collaborative effort between healthcare professionals, environmental scientists, and policymakers to ensure we eliminate NTDs by 2030. There is need to strengthen capacity at healthcare facilities while also revamping public health strategies to have a successful fight. Most importantly we need to integrate the aspect of climate change in all our efforts. With these in place I am certain we shall be able to eliminate NTDs.

Why have you chosen your area of research?
In my research on the 'Capacity and readiness of healthcare facilities to diagnose and manage Neglected Tropical Diseases (NTDs) in Eastern Uganda', I focused on understanding the readiness of primary healthcare facilities, a crucial baseline for tracking progress towards eliminating NTDs by 2030. Despite the World Health Organization's endorsement, the actual integration of NTDs into Uganda's healthcare systems has been largely unexplored, with significant research gaps in healthcare workers' knowledge and resource availability. My study aimed to assess the readiness and capabilities of healthcare facilities in Eastern Uganda, evaluating health workers' knowledge, diagnostic tools, medications, and reporting systems. The goal was to inform policy and develop more effective measures to combat NTDs, contributing significantly to national and global elimination efforts.

As we look forward to eliminating onchocerciasis before the next decade, it is expedient that we unite our efforts – at the community, national, and international levels – to make meaningful progress. Communities must adhere to mass drug administration with ivermectin so as to kill the parasite in all individuals in at-risk villages. Furthermore, alternative strategies such as the “Slash and Clear” vector control approach against blackflies rely on community ownership for uptake and sustainability. National onchocerciasis programs are called upon to strategize their interventions, by prioritizing areas with the highest burden of disease including the devastating onchocerciasis-associated epilepsy and nodding syndrome. Finally, on the international scene, advocacy should be amplified for stakeholders to move NTDs up on the international agenda which would motivate more attention and funding to eradicate these diseases. 

Why have you chosen your area of research?
In view of the persistent transmission of onchocerciasis despite two decades of ivermectin mass drug administration in Cameroon, it became clear that alternative strategies were needed to achieve elimination. Previous vector control approaches made use of chemical larvicides with serious economic and environmental repercussions. I chose the “Slash and Clear” approach as it is a relatively cheap, community-owned and environmentally friendly strategy to destroy blackfly breeding sites, thereby accelerating onchocerciasis elimination. My research project confirmed that this approach is well accepted by the local community and feasible to the extent of accessibility of the breeding sites in a given onchocerciasis focus. Therefore, it has the potential to be scaled up across Cameroon and other endemic countries.
 

In the face of Neglected Tropical diseases, solidarity is our greatest strength. Together, we can unite to ensure a world free from the burden of Rabies disease. Every step we take towards eliminating Neglected Tropical diseases is an act of defense against the injustices these diseases bring. We must unite and act to create a brighter, more prosperous, and healthier future. It is time to break the chains of Neglected Tropical Diseases. Unite, Act, and Eliminate. Unite in knowledge, Act with compassion, and together, we will eliminate the burden of Neglected Tropical Diseases including Rabies, ensuring a better life for generations to come.

Why have you chosen your area of research? 
Rabies is one of the most lethal infectious diseases with an almost 100% fatality rate. It remains a significant public health problem mostly affecting low- and middle-income countries (LMICs). Ethiopia is one of the most rabies-endemic countries in the world, and it has the 2nd highest human death rate in Africa where 46% of rabies cases are found in the Oromia region. Timely access to human rabies post-exposure prophylaxis (PEP) is a challenge in health facilities particularly at the health center level that poses a threat to the WHO Neglected Tropical Diseases (NTDs) elimination goal. As a Field epidemiologist, I have always been very excited to study the NTDs that pose significant public health problems in our communities including rabies diseases. My interest focuses on barriers to human rabies availability and accessibility for animal bite victim individuals’ I studied the socioeconomic and healthcare facility barriers using facility-based stud. My ultimate goal is to help improve PEP vaccine supply chain management to ensure consistent, planning, forecasting, and distribution of health in facilities, to develop innovative delivery approaches and policies to ensure timely access to PEP for rabies elimination.

My research focuses on studying snake venom properties and advancing antivenom research. The theme of World Neglected Tropical Diseases (NTD) Day aligns closely with my work, emphasizing the importance of a unified goal and decisive action. By uniting our efforts, we aim to significantly reduce and ultimately eliminate the burden of snakebite envenomation, addressing a critical aspect of Neglected Tropical Diseases

Why have you chosen your area of research?
Mass spectrometry enables the thorough identification of proteins found in snake venoms. This is accomplished by examining the mass and peptide sequences of these proteins, allowing for the recognition of a diverse range of venom components. Through the utilization of cutting-edge mass spectrometry technology and proteomic studies, our goal is to create a versatile antivenom capable of offering broad-spectrum protection against various venomous species
 

Unite, Act, Eliminate" serves as a robust rallying cry in the collective effort to combat tropical diseases in Africa and across the globe. Through unity, nations, organizations, and communities can pool resources, knowledge, and expertise to form a formidable front against these health challenges. Taking decisive action is paramount, involving coordinated strategies for prevention, diagnosis, and treatment. From my research, leveraging a united front and implementing proactive measures was done towards eliminating the burden of tropical diseases in Africa and especially Nigeria, paving the way for healthier, more resilient communities. This theme encapsulates the spirit of collaboration and determination needed to overcome the complex health issues facing the local and international communities.

Why have you chosen your area of research?
The research topic, "Mapping the distribution of helminth infections and socio-economic promoters of stunting in infants and preschoolers in Ibadan, Southwest, Nigeria," addresses a critical intersection of health and socio-economic factors. By investigating the prevalence and distribution of helminth infections, the study aims to provide valuable insights into the geographical spread of these parasitic infections. Additionally, the focus on socio-economic promoters of stunting recognizes the multifaceted nature of child health, linking it to broader societal and economic determinants. Hence, choosing this research is poised to contribute significantly to public health initiatives by guiding targeted interventions that not only address the immediate health concerns but also consider the underlying socio-economic factors influencing child development in the specific context of Ibadan, Southwest, Nigeria.
 

As the saying goes “United we stand divided we fall” so is the case with the fight to eliminate NTDs. Governments, Scientists/Researchers and the affected communities must all work together to achieve the set goal.

Female Genital Schistosomiasis (FGS) affects an estimated 56 million girls and women, but shockingly gaps still exist in the epidemiological assessment and burden particularly in Nigeria. Therefore I investigated the disease to see if there is an association with cervical cancer.
 

Neglected Tropical Diseases are a group of diseases that mostly impact the poorest of the poor, especially those living in low-income countries. Following the 2024 theme of World NTDs Day, “Unite, Act, Eliminate,” it is important to demonstrate our humanity through concerted efforts to tackle the diseases that ravage the least advantaged populations of our world.

I am passionate about fighting the so-called ‘diseases of poverty’ having experienced how dreadful it can be. That inspired my interest in researching NTDs. Thanks to the research grant from RSTMH/NIHR I am currently working on a study titled “Assessment of the burden of caregivers and barriers to accessing healthcare for persons with physical disabilities and NTDs.” The study aims to understand the challenges of NTDs not only from the perspective of the persons with lived experience but also to unravel its impact on close relatives and to understand how supporting the caregivers can improve the expected outcomes of combating NTDs.
 

Buruli Ulcer Disease (BUD)has received less attention than it should have in the last couple of years and little research has been carried out on BUD, despite its debilitating and stigmatizing impacts.  There is an urgent need to involve all stakeholders and key actors – employing an intersectoral and interdisciplinary approach towards generating evidence that informs programmes and interventions toward eliminating BUD as well as other NTDs in Nigeria, Africa, and globally!

Why have you chosen your area of research?
Although BUD is the third most prevalent mycobacterial illness in humans, after tuberculosis and leprosy, information is scarce in Nigeria about its epidemiology, management, and outcomes. Some outcomes resulting from the treatment and management of BUD include impacts on the physical and mental health of patients, patients’ belief that they are burdensome to their families and caregivers, and their inability to fully reintegrate into society due to the stigma and discrimination they face. My study seeks to generate evidence on lived experiences and psychosocial implications on BUD patients and convalescents to inform programmes that incorporate psychosocial management and follow-up of BUD patients and convalescents.

The theme 'Unite, Act, Eliminate' encompasses the pressing need for a collaborative effort to overcome the stigma and challenges associated with leprosy and its related disabilities. The theme emphasizes the importance of bringing together all relevant stakeholders, including healthcare professionals, the government, NGOs, and affected communities, to work in harmony towards a common goal of ending leprosy, disabilities, and discrimination. By doing so, we can break down the barriers that prevent access to care and support, and ultimately create a world where people affected by leprosy can lead full and healthy lives.

Why have you chosen your area of research? 
The selection of my research area stems from the pressing need to address the overlooked aspect of oral health among people affected by leprosy. They have the double burden of disability and stigma which hinders them from maintaining their oral hygiene and seeking proper timely oral care. The study findings helped me generate evidence on the oral health needs of people affected by leprosy-related disabilities with the aim of improving healthcare strategies and fostering inclusivity in oral health initiatives.
 

"Hand in hand, we can combine forces to defeat schistosomiasis"
"Together with you the participants, we can make happen the elimination of Schistosomiasis"
"Because we strongly believe that, with your help we can break the chain of transmission of Schistosomiasis".
"Our responsibility is to improve your health, and with a little effort and your commitment, we can do it together".
"By pooling our efforts, we can work together to eliminate Schistosomiasis in our region".
In fact, I chose this theme because previous work has been done in this area to decrease the prevalence of schistosomiasis in Ngoudoufouala. It was important to me to assess the situation again to be able to get updated.
 

Snakebite management requires many sectors working together, only treating the snakebite cases will never be enough to minimize disabilities and deaths. It requires the health sector to unite together with agriculture, education, human resource management, supply chain management, recording and reporting systems to work together. The relevant stakeholders working in close coordination could be the stepping stone to eliminate Snakebite cases. Appropriate financing is vital to act and implement. 

Why have you chosen your area of research?
A news article that reported the death of two siblings due to snakebite triggered my interest in this research area. Survival of the cases completely depends on the appropriate first aid measures followed by treatment with Anti Snake Venom Serum (ASVS) along with supportive care and management of complications. Although dedicated treatment centers have been established, snakebite fatalities and deaths have been increasing. Situation of the treatment centers are not known in terms of how they are functioning and providing their services in Nepal. Hence, I have chosen the area of research ‘Situation analysis and readiness assessment of Snakebite Treatment Centers in Nepal’.
 
 

As we unite to address the challenges posed by NTDs, exploring ways of improving treatment coverage and compliance through operational research provides opportunities to tailor programmes to specific context to accelerate the elimination of trachoma and advance the broader global mission to eliminate PC- NTDs.

I’m working with Muhimbili University of Health and Allied Sciences (MUHAS) a medical university in Tanzania. Tanzania is one of the endemic regions of infectious diseases including Malaria and Schistosomiasis. In line with SDG goal number 3 of promoting health and well-being of all people, MUHAS has a vision of conducting research and consultancy aiming to bring solution to various health-related challenges. I and my group we focus on assessing efficacy and safety of various medications approved for management of infectious diseases in low-middle income countries. In line with our goal, we have built interest in assessing efficacy and safety of praziquantel (PZQ) when used to treat schistosomiasis in pregnant women. However, we have realized that, few pregnant women are given PZQ despite residing in schistosomiasis endemic regions. Most of the schistosomiasis mass drug administration campaign aiming to eliminate schistosomiaasis exclude pregnant women from the program although guideline recommend the population to use PZQ. Therefore, our project aims to assess factors which influence utilization of PZQ in treatment and prevention of maternal schistosomiasis in Lake zone Tanzania.

To have Healthy environment and community, working together on NTD elimination

The main reason that I have been focus Epidemiological survey and knowledge, Attitude and practice of health care professionals at Somali against venomous snake bite in Ethiopia is:
Snakebite is a pressing public health issue in tropical and subtropical regions of Ethiopia. With approximately 22 venomous snake species present throughout the country's varied landscapes, the problem is compounded by the diverse clinical presentations and outcomes associated with these species. Adding to the challenge is the limited accessibility to anti-venom in the country, which significantly impacts treatment outcomes. Furthermore, health facilities often provide inadequate care to individuals suffering from snakebites. Additionally there is no more data/ research finding that thin out the KAPs of health care professionals against treatments snakebite   and snakebite epidemiology. I believe that generating data/evidence that show snakebite significance in the country and inadequate snakebite victim’s treatment gives a clues healthcare sector, policymakers, and communities alike to understand the current state of healthcare practices and provide valuable insights into the prevention and treatment of snake bites. By analyzing the data generated from these surveys, we can identify the gaps in awareness and treatment and develop strategies to improve the healthcare response to snake bites in the region and to come up with the direction of prioritizing the availability of anti-venom and improving healthcare delivery.
 

Neglected tropical diseases (NTDs) such as dog-mediated rabies remain a burden to most economically disadvantaged countries in sub-Saharan Africa (SSA), including Malawi. Despite being completely preventable in the humans, research cites failure to implement well-defined control measures (e.g., intensive public awareness, well-coordinated disease surveillance and diagnostics systems, dog vaccinations and PEP) for humans in endemic areas ignites the deadly disease to continue to disproportionately affect rural communities, particularly children. 

Why have you chosen your area of research?
Although improved rabies surveillance or diagnostic systems and educating campaigns are widely advocated for to curb rabies globally, lack of secondary interventions such as homeopathic or pre-or PEP remedies in SSA to reduce chances of infection after human exposure leaves mass dog vaccination as the only option for African states. However, research suggests that efficacy of mass dog vaccination, combined with secondary interventions needs to be characterized further so as to provide relevant information for understanding disease dynamics and the development of policy measures. Thus, in line with the #WorldNTDDay theme, I chose to ‘Unite’ with fellow scientific researchers to ‘Eliminate’ dog-mediated rabies by conducting a mechanistic study ‘Act’ that has employed a mathematical model to evaluate the efficacy of multiple interventions in controlling the spread of dog-mediated human rabies in Malawi.   
 

Thin skin and a body of pain or thick skin and a body of hope?  “The children are crying”, it itches most in the night when we are alone, from the head to our toes. Imagine healing scabies and layering our body together, a thick skin and nothing less but hope. ‘Unite, Act, Eliminate.’

Why you have chosen your area of research?
Scabies is a major public health problem in many low-and middle-income countries and a significant cause of morbidity. In Hoima district, there is a high rate of scabies infections as about 1500 people were infected of which more children aged below 5 years (31.7%) and between 5 to 14 (28.7%) years were most affected according to the surveillance exercise conducted in 2022 and yet historically there is limited scabies research in Uganda. This is because for a long time skin diseases have been neglected therefore, the study aims at providing more information to trigger evidence based interventions and decision making.
 
 

“Unite, Act, Eliminate" gains urgency in addressing the burden of schistosomiasis and soil helminths among school children, as these neglected tropical diseases contribute significantly to the prevalence of anemia. Collaborative initiatives and proactive measures are essential to break the cycle of infection, enhance access to treatment, and ultimately eliminate the adverse impact of these diseases on the health and educational prospects of vulnerable children worldwide.

Why have you chosen your area of research?
Conducting this study was crucial as it guides the implementation of successful intervention programs by assessing the prevalence of schistosomiasis and soil-transmitted helminth infections in the Kpone Katamanso Municipality. The focus stems from the pressing need to address neglected tropical diseases in vulnerable populations. Additionally, the research aimed to determine the impact of these Neglected Tropical Diseases as well infections on anemia, filling the knowledge gap in this area. The study's outcomes did not only inform stakeholders and policy makers but also contribute valuable insights into the association between schistosomiasis, soil-transmitted helminth infection, and school absenteeism among children in the Kpone Katamanso Municipality in Ghana. This specific area of research was chosen to contribute insights that can inform targeted interventions, alleviate the health disparities in the region, and empower communities through a nuanced understanding of the interplay between parasitic infections and anemia among school-going children.
 
 

A multi-sectoral approach is imperative to address the challenges posed by scabies. Key stakeholders from the community, grass root level health workforce and trained medical professionals, should work in unison to raise awareness regarding the clinical manifestation of scabies and the potential adverse consequences if untreated. Disease elimination becomes feasible when community members act promptly to seek healthcare services and medical personnel effectively manage the condition. The integration of routine surveillance into the existing healthcare system is crucial for the successful elimination of this neglected tropical disease.

Why have you chosen your area of research?
Research on scabies in children under five years of age is scanty. Undertaking projects specifically targeting this age group would aid in estimating the disease prevalence, devising strategies for early control, preventing adverse outcomes, and ultimately working towards its elimination. Given the presence of a pre-existing health workforce at the grassroot level of healthcare delivery system in India, my project focused on efficiently mobilizing and repurposing their routine visits to actively identify scabies cases within the community
 

To 'Unite, Act, Eliminate' snakebite morbidity and mortality, we must understand the complex socio-cultural factors influencing disease prevention and treatment. My research explored knowledge gaps, perceptions, and healthcare seeking behaviors for snakebites in rural Kamuli. Bridging the disconnect between communities and health systems is key to eliminating this neglected tropical disease.

Using participatory research appraisals, I chose to study community knowledge and behaviors for snakebite management in rural Uganda because treatment delays contribute to deaths and disability. By uncovering perceptions influencing healthcare choices after snakebite, my research provides insights to guide culturally-appropriate education and interventions. Together we can act to save lives from this neglected health threat."