Analytical summary - Neglected tropical diseases
The prevalence of neglected tropical diseases has increased over the years in the Gambia, mainly due to lack of Government-coordinated community-based intervention programmes, poverty at household level and related social determinants. Currently, there is no evidence-based information determining the extent of the burden of neglected tropical diseases on families, communities and the state.
Contributing factors may be related to inadequate coordination and management of data and information from the public, nongovernmental organization and private facilities and institutions. According to data from public health facilities, including the Department of Social Welfare, the burden of these diseases far exceeds that of infectious diseases. Efforts are underway to increase awareness and expand data sources through the Integrated Disease Surveillance and Response framework, which will also include private and nongovernment organization data.
Preventive measures are inadequate, mainly due to the inadvertent lack of knowledge and skill of health staff on neglected tropical diseases. The proposed forthcoming assessment of the prevalence and available preventive measures and methods will pave the way forward in strengthening the surveillance system. It is envisaged that evidence-based data and information relevant to the establishment of comprehensive preventive chemotherapeutic services pertinent to prevention and control will be obtained.
Certain neglected tropical diseases are not part of the priority list of diseases under surveillance. These include Buruli ulcer, human African trypanosomiasis, leishmaniasis and onchocerciasis.
Dracunculiasis or guinea worm disease is a targeted disease that has been eliminated since 2002, when the last case was detected. Schistosomiasis is another disease targeted for elimination. No more than 2 cases per 100 000 population are expected from the routine monthly reporting period. Despite the decline in the incidence in two regions (Central River Region, Upper River Region), the disease has progressed to affect two other regions (West Coast Region, North Bank Region) in the past 2 years at the same rate. The reasons for this are related to population dynamics, the rise and timing of rainfall and temperature, and other environmental factors.
Lymphatic filariasis is also a disease targeted for elimination. A study carried out in 2004 indicated the status of the disease and confirmed its decline over the years. There are plans by the Integrated Disease Surveillance and Response framework, in consultation with WHO, for the application of free drugs and supplies for mass treatment over a period of 2 years.
Leprosy is also a targeted disease under the Integrated Disease Surveillance and Response framework.
In the Gambia there is collaboration between health, education and nutrition programmes to control soil-transmitted helminthiasis. Deworming programmes are implemented alongside immunization campaigns and similar activities are conducted in lower basic schools.
The Gambia has made efforts to monitor neglected tropical diseases but there is a need for further studies to measure accurately their burden and contributing factors, as well as identify the most cost-effective intervention methods.