A Country Free of Guinea Worm Menace

For more than three decades, Nigeria had been grappling with the guinea worm menace earning the dubious title of the most endemic country at a time. Paul Obi writes on Nigeria’s freedom from the disease Guinea worm, a disease, which is medically known as drucunculaisis is said to be caused by contaminated water that emanates from drucunlus larva parasite. It is more rampant in Asia and Africa, specifically, the western coast of the continent. Nigeria used to top the list of countries with the epidemic.
Worst still, Nigeria was far lagging behind compared with countries like Niger, Mali, Burkina Faso, Ethiopia and a host of others. At a time, Niger had to be certified earlier than Nigeria, that was way back in 2008. Basically, Nigeria was left to grapple with guinea worm epidemics even when other countries less endowed than her have eradicated the disease. As Nigeria continued to be in the radar of countries with more guinea worm infections, the federal government, the Carter Centre and the Yakubu Gowon Centre were in the forefront of combating the disease. Former Nigerian Head of State, Gen. Yakubu Gowon was one of those ambassadors that showed commitment to the fight against Guinea Worm.
The drive to eradicate guinea worm according to statistics remain the most financially challenging in most cases. In 2008, the Gates Foundation, DFID, the Carter Centre and WHO injected about $55 million to fight the disease. Sources from the Carter Centre estimated that nearly $255 million have been expanded in Africa to fight the scourge. These donations have also helped to push the frontiers in combating the disease. Nigeria appeared to have tapped into these opportunities to accelerate the process of stemming the tide of the disease.
Late last year, Nigeria won her most sought after price in the health sector as the World Health Organisation (WHO) certified the country guinea worm free. A jubilant Minister of Health, Prof. Onyebuchi Chukwu said the achievement has been one great feat the government is elated about. At the presentation of the certificate to President Goodluck Jonathan, Chukwu went memory lane to explain how tedious the journey to eradicate guinea worm had been. According to him, the resolve to rescue Nigeria from the disease started in the 1980s. Chukwu said this was "with a view to combating water and sanitation-related diseases particularly in developing countries." The minister further stated that "in line with this, WHO adopted the World Health Assembly Resolution in 1986 to eradicate guinea worm disease globally," Chukwu observed. He added: "accordingly, Nigeria established the Nigeria Guinea Worm Eradication Programme (NIGEP) in 1988. At that time Nigeria being the most endemic country globally, with 650,000 guinea worm disease (GWD) cases reported in 5,879 villages, represented about 50% of the world’s reported GWD cases."
Speaking about the challenges that the country encountered in the fight to end the disease, the minister told the gathering that collaboration with other agencies was an impetus that helped sealed the deal in attaining the set target. "The task seemed daunting at the time but the government of Nigeria through the Federal Ministry of Health took on the arduous task, with NIGEP collaborating with the three tiers of government, affected communities, WHO, UNICEF, UNDP, the Carter Centre, JICA, and the Yakubu Gowon Centre to carry out the interventions. This partnership also received technical support from the NIGEP Steering Committee, NIGEP Task Force and the National Certification Committee on Guinea worm Disease Eradication (NCC-GWDE). He further maintained that "the collective effort paid off as Nigeria recorded the last case of GWD on November 11, 2008 at Ezza Nkwubor, Enugu East Local Government Area of Enugu State."
Going further, Chukwu explained that "having interrupted the transmission of GWD in Nigeria, it was now left to the Yar’Adua administration and subsequently, the Jonathan administration to ensure that Nigeria maintained a clean slate in order for her to achieve the status of a guinea worm disease-free country. To earn certification for eradication of GWD, a country must not have a single case of GWD for at least three years. Although from 2008 till date, over 900 GWD rumour reports have been received and investigated nationwide, none was found to be GWD."
In 2011, the Carter Foundation gave an award to Nigeria for interrupting GWD transmission for two years and maintaining the zero case status in defence of its pre-certification status. The certification itself by WHO came on the heels of several mission by the Geneva based organisation to ascertain how free Nigeria was and is from the disease. But between 24th June and 12th July, 2013 the International Certification Team (ICT) for GWD Eradication led by Prof. David Molyneux moved around the country, touring historical locations where the pandemic had had its highest presence in time past. It was this tour by WHO ICT that culminated to Nigeria being issued the certification. The team judgment on the spot assessment and it's subsequent recommendations to the International Certification Commission on Dracunculiasis Eradication (ICCDE) of the WHO was also instrumental in facilitating the process. In the words of Chukwu, "it was on the recommendation of the ICT to the ICCDE that Nigeria was certified GWD free." Presenting the certificate to President Jonathan, the minister said "we are happy that the eradication of GWD in Nigeria and Nigeria’s certification by WHO took place under your administration, and I now have the honour to present to you, the formal notification for Nigeria’s international certification as a GWD free country, signed by the WHO Director General."
Beyond this achievement, observers believed it is important government replicate such efforts in eradicating other diseases with similar challenges like guinea worm. Of a truth, this is one great feat that Nigeria has shown clear leadership. But government should not be quick to ignore or downplay the enormous contributions of NGOs like the Yakubu Gowon Centre. The dogged efforts by the centre to end guinea worm need to be applauded. The certification of Nigeria as a guinea worm-free country lends credence to the fact that NGOs are also reliable partners in the health
(Excerpts from This Day Live )

High Blood Pressure and Miscarriage

The loss of an unborn child can be an outrageous experience for soon-to-be parents. Although, many factors have been associated with child mortality, experts have suggested that maintaining a good blood pressure before, during and after pregnancy could be of immense benefit to the mother and also the unborn child in the latter stages of life as it prevents pregnancy loss and enables proper growth and development. However, pregnancy loss is often linked with stress, sex, spiritual attacks and increased home chores. In a recent study conducted by researchers on the cause of miscarriage, evidence has shown that blood pressure level of women before pregnancy may be responsible for the nearly 2% risk of losing a baby during pregnancy. Needless to say that besides the blood pressure of women which should be checked before and during the stages of pregnancy, preconception care which prepares a woman for pregnancy should be taken seriously.
Researchers have discovered that in spite of a healthy status for a woman’s blood pressure before pregnancy, an increase in the systolic blood pressure by 10mmHg was linked to an 8% risk of having a miscarriage. It was also reported that women with diastolic blood pressure readings above the normal score of 80mmHg have a higher chance of losing their pregnancy. There is increasing concern as elevated blood pressure puts unborn babies at risk. Doctors stated that more attention should be paid to the elevated blood pressure of women at each stage of pregnancy because the higher the blood pressure, the higher the chance of suffering a miscarriage. On the other hand, women who are trying to conceive have been warned to have a regular check of their blood pressure level, exercise regularly, eat nutritious diet,and maintain healthy lifestyle behaviour to ensure a successful outcome.
Although, several reasons have been identified for miscarriage suffered by pregnant women, the exact reason still remains unknown. Diseases such as diabetes, hypertension, women with compromised wombs and those with a history of miscarriage have been suggested to be responsible for miscarriages. Despite the introduction of drugs to reduce the risk of miscarriage during pregnancy, it has been reported that an elevated blood pressure level before can lead to miscarriage towards the end of pregnancy rather than early pregnancy if early intervention is not considered. Given the devastating circumstances encountered during miscarriage, it is quite important measures and precautions are taken to ensure every unborn child does not suffer similar fate during pregnancy.
Medical personnel have reported that the negative effects of elevated blood pressure before and during pregnancy can lead to a less desirable outcome. In most cases, it results in the death of the child in the mother’s womb at a rather advanced age. Moreover, a woman who has a pre-existing hypertension is very likely to have preeclampsia during pregnancy. These pre-existing conditions including diabetes present in the mother also pose great harm to the unborn child if not quickly addressed, hence awareness should be raised to ensure women understand the importance of preconception care before pregnancy with a blood test being able to accurately determine if a pregnancy would suffer a miscarriage.
(Excerpts from Tribune Online )

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