Akindele Rukayat’s ordeal began one day in 2012 while she was in her office. She said she felt hotness in her right leg and after some time, the leg turned reddish. She suffers from a disease called lymphatic filariasis also known as elephantiasis, one of the Neglected Tropical Diseases (NTDs).
The mother of three who used to be a videographer and photographer at a communication centre said she sought permission and left the office but slumped before she got to the doorsteps of her house.
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“I was rushed to University College Hospital, Ibadan, and was told it was ulcer of the leg. I was treated with antibiotics and got better,” she said. However, the ailment returned in 2014 with lumps and rashes that got swollen and began to secret a lot of water.
She told Daily Trust that she kept going to the hospital but the leg began to bring out mupus to a stage that two particular spots busted into open wounds. She couldn’t walk after that except with the aid of crutches.
“I kept going to the hospital until 2018 when I got tired because the antibiotics were making me fatigued and weak. Now I can’t do my job anymore. I can’t do anything myself. I rely on my mother, siblings and children. Recently, someone told me to go to the ministry of health for some drugs, so I went. I was given a drug and told I have to take it twice a year. I have taken the first dose. I will take the second in February next year. But most times the leg will become very hot with rashes and very swollen and I will become very weak and in pains,” she told Daily Trust in tears.
Lymphatic filariasis is caused by Wuchereria bancrofti and transmitted by an infected female mosquito during human blood meals in Nigeria. The life span of the adult lymphatic filariasis parasite is between four to six years.
Sunday Solomon, 50, a labourer, has lived with onchocerciasis, another type of NTDs, also called river blindness, for seven years. Onchocerciasis is a parasitic disease caused by small worms living in the body, transmitted by the bite of a black fly which is the vector for River blindness. Manifestations of the disease include severe itching, hanging groin, thick and rough skin and blindness.
Speaking to this reporter in Onipaland in Oyo state , he said he started taking the drug for the disease six years ago, a year after he started feeling the symptoms. And when the illness began, he used to feel dizzy, as if there were cobwebs in his eyes, his hands always shaking, and sometimes fell down while walking.
He said since he started taking the drugs he felt better. He however added that he has not accessed the drug for some time now.
Wife of the Baale of Onipaland in Ibadan, Mrs Florence Foluke Opaleye, said the village was ravaged by river blindness from the river in the community. Drugs were available from state and health authorities but that distribution to the people who needed them in the surrounding villages was a problem because the workers complained of poor incentives and stopped working.
NTDs are a diverse group of communicable diseases that prevail in tropical and subtropical conditions in Nigeria and 148 other countries, according to the World Health Organsation (WHO). They affect more than one billion people and cost developing economies billions of dollars every year.
Experts say they are responsible for thousands of preventable deaths every year and cause disabilities that perpetuate the cycle of poverty by keeping millions of adults out of work and children out of school.
Despite their prevalence, they have not always been at the top of public health priorities. Experts said there are serious funding gaps for the response to the diseases in Nigeria.
According to Dr. Chukwuma Anyaike, National Coordinator,Neglected Tropical Diseases Elimination Programme of the Federal Ministry of Health, NTDs are a group of 20 disease conditions that are common in tropical or subtropical regions, and are closely associated with poverty, poor sanitation, lack of safe water sources, substandard housing conditions and deficient healthcare access.
He said the diseases are called ‘neglected’ because they tend to affect the world’s poorest, and received less attention than other diseases.
He said about 122 million Nigerians are at risk of NTDs. Of this number, 20% are pre-school children while 52 percent are adults.
During the media dialogue on Neglected Tropical Diseases Control in Nigeria organised by UNICEF in Ibadan, he said all states are endemic for one or more of these NTDs. “Some states have even four of the NTDs,” he said.
”They disfigure, disable, keep children out of school and parents out of work – limiting their potential, and leave communities stuck in poverty. They may not kill as fast as other diseases but come with disabilities. Sometimes their legs are amputated because they couldn’t manage the wound, some no longer wear trousers or shoes. Someone that sees before cannot see anymore, someone that works before cannot work, NTDs are the worst of all the diseases that cause disabilities.
“The diseases are called neglected because they tend to affect the world’s poorest and receive less attention than other diseases. You get them at rural and hard to reach areas, even in the urban areas , you see them around slums, most of those affected by the diseases are voiceless. The government, policymakers , philanthropists need to know that they are in the villages, no one speaks for them, ” he said.
Head, Child Rights Information Bureau, Federal Ministry of Information, Ms Mercy Megwa, said, “They are associated with poverty and commonly found in rural communities, with substandard health conditions, inadequate and unsafe water sources, and poor hygiene. The government of Nigeria is highly concerned about this trend because the burden of the disease is heavy. These NTDs come with some disabilities in humans; damage child intellectual development and growth and limit national productivity.”
The 12 Neglected Tropical Diseases targeted for control and elimination in Nigeria are: Onchocerciasis, lymphatic filariasis, schistosomiasis, soil-transmitted helminthiasis, Trachoma onchocerciasis , trachoma, soil transmitted helminthes, Lymphatic filariasis, and schistosomiasis , snakebite envenoming, rabies, buruli ulcer, leprosy, yaws, leishmaniasis, Human African Trypanosomiasis (HAT), Guinea-worm Disease (eliminated).
Emmanuel Davies, an NTDs Desk officer from the federal Ministry of Health said 583 local governments in the country are endemic for the disease. Major chronic stages of the disease are lymphodema, elephantiasis, and hydrocele. “It takes 10 years or more for the clinical manifestation of Lymphatic filariasis disease in infected persons,” he said.
He also said the national programme is confronted with challenges such as inadequate funding for treatment, supervision, and assessment.
Dr Nicholas Olobio, Programme Manager, National Trachoma Elimination Programme, said trachoma is the leading infectious cause of blindness worldwide.
“The disease is highly prevalent in the northern part of Nigeria which falls within the trachoma belt. It is found in the most vulnerable communities disproportionately affecting children and women,” he said.
Dr Anyaike , the National Coordinator, Neglected Tropical Diseases Elimination Programme, said the first five of the listed NTDs targeted for elimination in Nigeria could be managed through Preventive Chemotherapy (PC) while the remaining seven is through case management. Preventive chemotherapy involves administering drugs to community to protect the person infected and others around while the second set of disease-affected individuals go to hospital for management.
The Coordinator said, “If we want to remove 10 million people out of poverty in Nigeria, NTDs should be considered because it will pull them out poverty and they will be able to take care of themselves.
“We wouldn’t be able to achieve anything on poverty reduction initiatives If we neglect NTDs. Sustain economic development can’t occur without addressing NTDs.”
He said poor funding support by all tiers of government for NTDs interventions is affecting efforts against them.
He said there was still a lot of misconceptions about NTDs with some attributing the illnesses to adultery and other sins, witchcraft, and affliction from enemies among others.
He said some interventions against the diseases include:
-Mass Administration of Medicines (MAM)
- Innovative/Intensified Disease Management (IDM)
- Integrated Vector Management (IVM)
- Water, Sanitation and Hygiene (WASH)
- Morbidity Management and Disability Prevention
Bioye Ogunjobi of UNICEF said the organization has been supporting elimination of NTDs since 1991 and supports onchocerciasis and lymphatic filariasis control interventions in 12 states.