Guyana eyes elimination status for Lymphatic Filariasis

Apr 05, 2017 News

Guyana, through the efforts of the Vector Control Services Unit of the Ministry of Public Health, is currently on course to realising elimination status for Lymphatic Filariasis.

Dr. Horace Cox, Director (ag), Vector Control Services Unit

According to Director (ag) of the Ministry’s Vector Control Services Unit, Dr. Horace Cox, “we are very optimistic [because] we only have to achieve 65 percent coverage of the country over a period of five years in order to achieve elimination status.”
The approach that the Ministry will embrace this year to fast-track its efforts, according to Dr. Cox, will include venturing into the school system to distribute medications for lymphatic filariasis to school children. Moreover, the Public Health Ministry has been collaborating with the Ministry of Education in order to secure the consent of parents and guardians, so that this initiative could be a success.
“These are minors we will be reaching in the school system and we are going into their setting, so we would want to have their parents’ permission. So we need to map out that activity and ensure that we capture it and secure the authorisation from parents to treat their children and of course, put the necessary systems in place that they could be followed up,” Dr. Cox related.
He however noted that thus far the Ministry has observed that adherence to the use of lymphatic filariasis has been going very well. In fact, he revealed that “we have seen a reduction in the number of cases. We have been looking at the numbers and comparing the data. We would have been comparing, for example, for the past 10 years, data in the different regions…the numbers that we would have had… and we would have seen a reduction. Even in Region Four where we would have had cases diagnosed, based on the number of cases notified, when we compare those, we have seen a reduction,” Dr. Cox said.
The use of medications to tackle lymphatic filariasis, Dr. Cox explained, is preventative chemotherapy, since they are used ahead of the manifestation of the disease.
“This is part of the effort to eliminate it in Guyana…so once we are able to do that Guyana should be free of it. Of course we will still need to maintain a surveillance system so that we will be able to pick up if there are to be any additional cases,” Dr. Cox noted.
He disclosed that currently there are additional persons in training to effectively diagnose and treat the disease. For a number of years the Ministry has been depending on a house to house distribution of medication initiative to combat the disease. However, this measure, he noted, will be modified with the initiative that will target those within the school system and even be extended to places of work.
Given the complex nature of implementing a mass drug initiative, Dr. Cox emphasised the importance of the Public Health Ministry working in close collaboration with stakeholders.
It was for this reason that a stakeholders’ forum was recently held to solicit support to help chart the way forward to tackle neglected diseases.
Lymphatic filariasis is listed among the neglected diseases that are prevalent in Guyana. Other neglected diseases include chagas disease, soil transmitted helminthes, leishmaniasis, and leprosy. According to Dr. Cox, dealing with neglected diseases are priorities of the Vector Control Services Unit and so “we would normally have semi-annual meetings to discuss how we can continue to collaborate.”
Last year the Vector Control Services Unit was engaged in a mass drug administration exercise and, according to Dr. Cox, sometimes these exercises can cost as much as US$250,000 to US$400,000. He moreover noted that “by the financial resources allocated, you can determine the complexity of these programmes. Therefore when it comes to the implementation, what we look to do is collaborate and get different expertise.”
In this regard, Dr. Cox said that “we have recently set up an Advisory Board for Lymphatic Filariasis, where we have representatives from Ministry of Education, Ministry of Communities, the Ministry of Business, persons from school health and other technical areas, so that we can be advised.”
Such collaboration is essential, Dr. Cox noted since “it is not just about distributing medications but we need to ensure that the message gets out there to people for example ‘why you need to take it [medication], and if you don’t take it what happens…”
The Vector Control Director is optimistic that when the messages are disseminated and people are able to internalise them, “we should be able to see a change in their behaviour, whereby they want to comply and work along with us too.”