Elephantiasis can be prevented - Dr. Biritwum

Accra, Dec. 9, GNA - Dr Nana Kwadwo Biritwum, Programme Manager of the Neglected Tropical Disease Control Programme of the Ghana Health Service (GHS), has asked for the support of all partners including identified endemic communities for the lymphatic filariasis elimination programme and also for other programmes under the Neglected Tropical Diseases Control Programme.

"These include Onchocerciasis Control, Schistosomiasis and Soil Transmitted Helminthiasis Control programmes" he said. Dr Biritwum, who was speaking with the Ghana News Agency (GNA) in an interview in Accra, said the diseases could be controlled or even eliminated with the use of mass drug administration programmes that relied on donated and sometimes procured drugs such as Ivermectin, Albendazole or Mebendazole and praziquantel.

He named morbidity control or alleviation of the suffering from complications of the disease as other aspects of the programme that required further support from everyone including donors, government and endemic communities.

The implementation of morbidity control is being done in collaboration with other Neglected Tropical Diseases such as Buruli Ulcer and Yaws Control programmes whose main strategy is heavily dependent on morbidity control. Dr Biritwum told the GNA that the present focus of the Ghana Health Service was to implement the preventive aspects of the programme. "The disease can be prevented by employing mass treatment of identified endemic communities with Ivermectin and Albendazole in the case of lymphatic filariasis (elephantiasis) and Ivermectin only for onchocerciasis prevention". According to Dr Biritwum, the Ghana Health Service had been implementing annual mass drug administration with Ivermectin and albendazole in Ghana since 2000, starting with a few districts but presently covered all the endemic districts.

He said the regions most affected by lymphatic filariasis (elephantiasis) included Upper West, Upper East, Northern, Western, Central and the Greater Accra regions with a few affected districts in the Eastern and Brong-Ahafo regions. Ashanti and Volta regions have not been identified to be endemic for lymphatic filariasis (elephantiasis) yet. He said "Annually, drugs are distributed freely to endemic communities and eligible people are expected to take the tablets during the distribution exercise. Dr Birtwum said however that the programme faced huge challenges in implementing a successful morbidity control strategy especially for cases of elephantiasis because the condition is not known to be reversible in very advanced stages. He said regular washing of the affected limbs, regular exercising of the affected limbs at the joints, regular elevation of the affected limbs whenever possible and proper management of injury and infection of the affected limbs helped to maintain a healthy limb and prevented further increase in the size of the affected limbs. "Sometimes some reduction in the size of the affected limb becomes an obvious benefit when these measures are strictly adhered to" he added. He said advanced cases of the swelling could however not reduce to the original size and once affected the measures outlined above needed to be applied for the rest of the patient's life. Dr Biritwum said the disease did not only affect the legs but could also affect other parts of the body such as the breast, genitals and arms and sometimes some internal organs such as the kidneys. He lauded the Government of Ghana, the United States Agency for International Development (USAID) and other Non-Governmental Organisations and institutions such as the Liverpool School of Tropical Medicine in general for their efforts in the fight against the disease. Dr Biritwum urged endemic communities to take it upon themselves to help distribute the drugs to everyone and also to make sure all eligible people in the communities take the tablets. An Elephantiasis patient, John Baba, 38, who spoke to the GNA said he acquired the disease in 1991 and wished vulnerable persons, would put in place the necessary measures to avoid being infected. He said his situation might be difficult to control but expressed the hope that a lot could be done for those with slight or minimal attacks of the disease.