How Schistosomiasis affects Sub-Saharan Africa


What are Schistosomes and How do they Infect Us?

To start, what are Schistosomes? According to Science Direct, adult schistosomes are grayish-white flatworms that are about 7 to 20 mm long. Eggs called Miracidia are released into the water through feces and urine. They hatch and then go onto penetrate the skin of snails.

At an adolescent age the parasites are released from the snails and and are able to swim freely, they are known as Cercariae. During the penetration of the human skin the Cercariae lose their tails and reach adulthood, they are then known as schistosomula.

Schistosoma male and female pair

The schistosomula then enter the bloodstream and come to rest near the liver, intestines or genitals; each causing a different form of schistosomiasis. The worms pair together and mate for life, laying eggs which are released through urine and feces, beginning the life cycle over again.


What is Schistosomiasis?

Schistosomiasis is a disease caused by the parasitic blood fluke, schistosoma.  Schistosomes in Sub-Saharan Africa cause both intestinal and urogenital schistosomiasis. There are five different species of schistosomes but, the two that terrorize Sub-Saharan Africa are S. Mansoni and S. Haematobium. They cause Intestinal and Urinary/Genital Schistosomiasis.

The World Health Organization 2 states that most people are infected through contact with contaminated water. This would make it very common in underdeveloped countries especially those in Sub-Saharan Africa. WHO estimates “…that at least 91.4% of those requiring treatment for schistosomiasis live in Africa.”

Intestinal schistosomiasis is caused when schistosoma pairs come to rest in blood vessels in or near the intestines. Intestinal schistosomiasis often includes an array of symptoms ranging from minor to dire. This includes blood in feces, diarrhea, abdominal pain, further along the disease can enlargement of the liver.

If left untreated schistosomiasis can lead to a painful death. Those infected with Urogenital schistosomiasis face a similar fate. Telltale signs of urogenital schistosomiasis often include blood in urine, fibrosis of bladder and ureter and kidney damage. Long term infection can also result in bladder cancer, lesions on genitals, infertility and death.

How does this affect children?

Children in Sub-Saharan Africa are at a higher risk for infection of schistosomes and schistosomiasis. This is most likely because children are always playing in water, eating whatever they can, and have no thought or care for cleanliness. They may also be affected during their daily lives, usually through washing clothes, playing and taking baths.

Bio-med central 3 informs that school aged children are the mostly to receive schistosomiasis and die from the disease.

School children’s urine and feces being collected to test for schistosomaisis

This is due to the large quantities of eggs and worms found in the overly exposed children. Infants are also prone to getting the disease during their first year of life. The only available treatment, praziquantel, is often used to treat school aged children.

This often leaves children younger and adults older exposed and in danger. Even with the treatment many school aged children do not receive the medication, allowing for re-contamination. The World Health Organization 2 has found that children infected with schistosomiasis have a different list of symptoms than the adults. Children are often found with anemia and both stunted growth and ability to learn. However, if the treatment is given quickly the effects can be reversed, if not they may be lethal.

What is being done?

In addition to the medication Praziquantel, a preventative chemotherapy drug, there are other ways to help minimize and reduce the spread and infection of schistosomes and schistosomiasis.

The CDC 4 warns travelers that there is no vaccine available at this time and lists way they can minimize their risk of being infected. The largest step is remembering to bring the water used for drinking or bathing to a boil for at least one minute to kill any parasites or contaminants.

It is also recommended to dry with a towel if accidentally exposed to contaminated water. These measures are also taking place in countries that have high infection rates, like those in Sub-Saharan Africa.

In order to help control and reduce the number of people infected, there is being extensive effort to remove the snails the parasites use for their life cycle. This has already worked in other areas like Egypt.

To review, schistosomes are parasitic blood flukes that burrow into the skin of humans, living in blood vessels and producing eggs which are released in urine and feces. These parasites cause schistosomiasis, that produces many different symptoms based on the location of the worms. Left untreated the end result is usually death. Children in Sub-Saharan Africa are at the greatest risk for infection. The only treatment, Praziquantel is usually available for school aged children. There is no vaccine yet available. Matters are being taken to help prevent and control schistosomiasis, such as eliminating the snail population where the schistosomes reside. 

1 Science Direct.2015. “Impact of human schistosomiasis in sub-Saharan Africa” Retrieved March 20

2 World Health Organization. 2018. “Schistosomiasis- Fact Sheet” Retrieved March 19

3 Biomed Central. 2017. “Moving from control to elimination of schistosomiasis in sub-Saharan Africa: time to change and adapt strategies” Retrieved March 20

4 CDC. 2012.  “Parasites-Schistosomiasis, Prevention and Control” Retrieved March 20


HIV/AIDS Epidemic in South Africa and Nigeria

By Caroline Cooney

What is HIV/AIDS and how has it affected Africa?

HIV, which stands for human immunodeficiency virus, is a virus spread through certain body fluids and attacks the immune system. If left untreated, the disease weakens the immune system until the body can no longer fight off infections and disease, leading to acquired immunodeficiency syndrome or AIDS (“What are HIV”, 2017)1. Since the beginning of the HIV/AIDS epidemic, around 78 million people have become infected with the disease and over 35 million have died due to AIDS-related illnesses. According to UNAIDS data in 2016, there were over 36 million people living with HIV worldwide, with an estimated 25 million of those infected living in Sub-Saharan Africa. Two countries hit the hardest by the epidemic are South Africa and Nigeria.

HIV/AIDS funding in the United States

For those who live in the U.S., it may be hard to understand the way other countries suffer from diseases such as HIV/AIDS. Currently, there are around 1 million people living with HIV in the United States whereas countries like South Africa are home to over 7 million people infected with the virus. The United States is able to fight diseases due to the amount of funding and research that is performed every year. We often take for granted the health benefits we are able to receive because we don’t always educate ourselves about why other countries are struggling. According to the Henry J. Kaiser Family Foundation, federal funding for HIV/AIDS rose to more than $32 billion in 2017 (“U.S. Federal Funding”, 2017)2.

New HIV infections and AIDS-related deaths in South Africa from 1990 to 2015

HIV epidemic in South Africa 

With over 7 million people living with HIV, South Africa is home to the largest HIV epidemic in the world (UNAIDS, 2017)3. The man who runs CAPRISA, a major research lab in Durban working to fight HIV/AIDS, known as Salim Abdool Karim, states “one out of every five people living with HIV in the world lives right here in South Africa” (“How South Africa”, 2016)4. Regardless of these numbers, the country has made great efforts to ensure that those infected with the disease are aware of their status and receive antiretroviral treatment (ART). Since HIV is such a major issue, there are three targets countries aim for in an attempt to keep the epidemic under control, known as 90-90-90 targets (“HIV and AIDS”, 2017)5. The goal is for 90% of those infected to be aware that they have the disease, 90% to be receiving treatment, and 90% to be virally suppressed. As of 2016, South Africa has reached 86-65-81. This success is largely due to the amount of funding the country has put towards HIV programs, which has helped them to build the largest ART program in the world and nationwide campaigns which focused on providing education about HIV/AIDS and encouraging more people to get tested for HIV.

Progress made in South Africa

Due to their efforts, South Africa was able to almost reach the first 90-90-90 target, which is for those living with HIV to be aware that they are infected. This is an important step because if they do not get tested, they will not be able to receive treatment. With more people aware of their status, they have been able to get around 56% of adults and 55% of children to be on ART and have lessened the amount of AIDS-related deaths to around 110,000 in 2016.

New HIV infections and AIDS-related deaths in Nigeria from 1990 to 2015

AIDS epidemic in Nigeria

Unlike South Africa, Nigeria has a low prevalence of HIV; however, due to a small number of testing and counseling sites, and low access to antiretroviral treatment for those infected with HIV, a large number of AIDS-related deaths occur in this country. Nigeria has made efforts to increase government spending on HIV/AIDS programs, but has still fallen short as in 2016, there were still around 160,000 AIDS-related deaths (“HIV and AIDS”, 2017)5.

Nigeria’s 90-90-90 targets

A major problem in Nigeria is that many are unaware that they are infected with the disease since there aren’t many testing sites like in South Africa. The 90-90-90 targets in Nigeria are 34-88-81, which is a bit misleading as there really are only 31% of adults and 21% of children infected with HIV receiving treatment. Education is a major need in Nigeria in order to raise the amount of awareness of HIV/AIDS and the number of people getting tested for the disease throughout the country. 

Legal barriers in Nigeria

There are some legal barriers which have affected the number of people who are able to access treatment as in this country. Those who take part in same-sex relations can be sentenced to around 14 years in prison. This has greatly limited access to HIV prevention programming and has caused a great amount of discrimination based on sexual orientation. 

Lack of funding and education in Nigeria

Lack of funding and education may be the largest barrier in Nigeria. While South Africa is able to invest a large amount of money to create strong programs that provide information to educate those who visit about HIV/AIDS, most of the funding of Nigeria’s HIV response comes from international donors. Nigeria’s first 90-90-90 target number of only 34% knowing that they are infected with HIV shows a need for education (UNAIDS, 2017)3. Educating those who are unaware of how HIV is transmitted could have a significant impact on this number as it may persuade more people to get tested for the disease. Also providing ART to all people living with HIV would be beneficial not only to those already living with HIV, but to those at risk of getting the disease as well. Treatment greatly reduces the chances of transmission to others and since in Nigeria there are so many not receiving the treatment they need, it is hard to keep the epidemic under control.

Hope for progress

The HIV/AIDS epidemic has taken a huge toll over the years, infecting 78 million people and taking the lives of over 35 million. While many in the United States have experienced the epidemic, due to a great amount of funding and research, we are able to keep the disease under control. Other countries in Sub-Saharan Africa including South Africa and Nigeria haven’t been as lucky. Although they have been hit the hardest by the epidemic, efforts are being made to control the disease by building testing sites/campaigning to raise awareness and raising funding to allow more access to treatment. While countries like South Africa have made great progress in recent years, many countries like Nigeria have found it difficult to find ways to fund treatment programs; nevertheless, there are hopes to make progress in the near future.






1What are HIV and AIDS? (May 15, 2017). Retrieved from

2U.S. Federal Funding for HIV/AIDS: Trends Over Time. (November 09, 2017). KFF. Retrieved from


3South Africa. (2016). UNAIDS. Retrieved from


4Brangham, W. (Interviewer) & Karim, S. A. (Interviewee). (July 21, 2016). South Africa, the nation hardest-hit by HIV, plans to ‘end AIDS’ PBS News Hour. [Interview Transcript]. Retrieved from


5HIV and AIDS in Nigeria. (March 26, 2018).  AVERT. Retrieved from


Life and Death: Sierra Leone

Mothers waiting outside a clinic in Sierra Leone.

By Cassandra Holden

As human beings, we are drawn to the subject of death as it is an event one day we will all face. However, one circumstance we rarely link with death is childbirth. In the twenty-first century, maternal mortality is at an all-time low and hardly ever occurs in the United States, or so many of us thought. Although the maternal mortality rate in the United States is relatively low at 14 deaths for every 100,000 live births according to the CIA World Factbook 1, there still needs to be a conversation about reducing maternal mortality even further. Especially in countries such as Sierra Leone where the maternal mortality rate is 1,360 deaths per 100,000 live births in 2015. That is by far the highest maternal mortality rate for any country in the world. But why is it so high?

Relief Web states that in 2016 there were 706 reported maternal mortality deaths in Sierra Leone and that it is questionable whether this figure is accurate or if the number is much higher 2. Taking a closer look at Sierra Leone one cause is of this health care crisis is clear; there is a shortage of access to care as well as supplies. UNICEF3 has found that many mothers in rural areas of Sierra Leone have an opportunity to see trained health care professionals due to their scarcity. Some never even seek out help and continue to see traditional birth attends who do not have medical or training. When this women in rural areas do not seek proper care by the time it is realized that the mother is in danger it is already too late.

A family says goodbye after their loved one passed away due to post-partum hemorrhaging.

The birth attendants do not have adequate training and equipment, and the closest doctor could be hours away. In many cases post-partum hemorrhaging that is more than survivable if caught early in the US becomes a death sentence for these women. In addition to seeking health last minute not many women find care throughout their pregnancy which creates a potential risk of missing preexisting conditions and makes it impossible to monitor the mother. With severe outbreaks such as the Ebola virus protecting soon to be moms is impossible.

UNICEF is making many strides to address this healthcare crisis. With capital from the European Union, UNICEF has been supporting five doctors, gynecologists, and obstetricians in Sierra Leone. Plans have been moving forward to distribute care more effectively by creating five emergency birthing units and one comprehensive care center in each of the 14 districts of Sierra Leone. Proposals for a free healthcare initiative have also been in the works which would include the distribution of supplies to mothers of children under the age of 5.

Zainab Turay holds here son after visiting George Brook Community Health Centre throughout her pregnancy.

At this point, you might be asking yourself “what can I do?” One simple thing you can do is to raise awareness about the maternal mortality crisis on Sierra Leone. Women all around the globe deserve to have accessible maternal health care and to bring their children into the world without fear. Just by starting the conversation you can help take the step in the right direction.


1Central Intelligence Agency. (2015). The world factbook. Maternal mortality ratio. Retrieved from

2Relief web. (2016). Maternal Death and Surveillance. Retrieved from

3Mason, H. (2016). UNICEF. Making strides to improve maternal health in Sierra Leone. Retrieved from

Limited Access to Clean Water in Africa Causing Diarrhea

by Lucien Chasse

The Problem

Each year, upwards of 525 000 children die every year because of diarrhea1. In fact, the leading cause of child morbidity worldwide is a diarrhoeal disease. Diarrhea itself is a symptom of infections caused by bacteria and parasitic organisms that are most commonly spread by water contaminated with fecal matter, some of these parasites include: Rotavirus, Escherichia coli, cryptosporidium, and shigella. Unfortunately, there are currently around 319 million people living in Africa without regular access to clean water2

In South Africa, 20% of the children under five deaths are caused by diarrhea3. Tshikuwi is a small rural town in South Africa with a very low employment rate and extremely limited access to clean water. This limited access to clean water sparked an outbreak of diarrhea in 20064. After this outbreak, there was a study to see if the contaminated water and the diarrhea outbreak were truly linked. A questionnaire was made, and forty percent of the households participated. This questionnaire uncovered a few shocking things about Tshikumi: of the forty percent that participated, not one had a flush toilet in their house, they only had pit latrines; their drinking water was collected from abstraction points that were not treated in any way before consumption, and the water that was collected was generally stored in jerry cans for several weeks. Later in the study, a few water samples were taken from the three main water sources. Two of the three water sources had an alarming amount of diarrhea cases.

Young girl drinks dirty water from a plastic bottle.

Water Issue

South Africa is in the midst of a devastating drought that has recently been declared a national disaster. The entire city of Cape Town could be completely out of water by July if the water level in the dams do not rise5. The drought has impacted much more than just Cape Town, it was swept over most of the southern and western regions of the country. This drought has turned a bad situation worse in South Africa because with an even more limited access to clean water impoverished communities will be more susceptible to diarrhea, especially young children6. “…Malnourished children are more susceptible to an infection, and the illness itself causes severe malnutrition once the infection develops into diarrheal disease.”

Member of the United States Air Force tests the quality water of the water using an ultrameter.

The Opportunity 

There is a hope for South Africa, though. Organizations have been making great efforts to design systems and raise money to get clean water to Africa. Organizations like: Safe Water, Living Water International, and Charity: Water. Not only are there hundreds of organizations and governments making an effort to provide clean water to this part of Africa, but there is also an effort being made towards a solution. There are several ideas for this problem, such as graphite coated sand, and bicycle-powered water purifiers; however, one of the simpler solutions just may be one of the best innovations that could be made to provide rural towns in Sub-Saharan Africa with water, the solar still7. The solar still is a device that can be filled with water and left in the sun. As the sun heats the water it begins to evaporate. As the water evaporates the water particles are then trapped in the glass and funneled into a cup or jar for use. While this design has been around for a very long time, scientists today are finding ways to make it large scale and cost-efficient.

While lack of clean water in South Africa is a daunting issue that seems unsolvable, there is always hope. Some of the top minds in the world have come up with feasible solutions that could be made at a large scale to provide clean water to towns like Tshikumi in the very near future; however, with the current state of the country, every contribution counts.




1.Diarrhoeal disease. (May 2, 2017). World Health Organizations. Retrieved from

2.15 Distressing Truths About Africa’s Water Pollution Crisis. (2014). Retrieved from

3.Cholo, L. Michalow, J. Tugendhaft, A. Hofman, K. (April 17, 2015). Reducing diarrhoea deaths in South Africa: costs and effects of scaling up essential interventions to prevent and treat diarrhoea in under-five children. BMC Public Health. Retrieved from

4.Bessong, P. Odiyo, J. Musekene, J. Tessema, A. (October 27, 2009). Spatial Distribution of Diarrhoea and Microbial Quality of Domestic Water during an Outbreak of Diarrhoea in the Tshikuwi Community in Venda, South Africa. Journal of Health, Population & Nutrition,Vol. 27. Retrieved from EPSCOhost.

5.Winning, A. (March 2, 2018). South Africa to investigate water ministry amid severe drought. Reuters. Retrieved from

6.Davies, K. Koizumi, E. Paluch, S. Riviere, S. Summers, M. (April, 2014). Reducing Child Mortality in Sudan by Preventing Diarrheal Disease. The Journal of Global Health. Retrieved from

7.Markham, D. (May 16, 2012). 15 Concepts and Solutions for Providing Clean Drinking Water. Retrieved from

Why Has Nigeria Been Unable to Eradicate Polio?

by Ben Knoer


Here in the United States we take for granted our health benefits and security in everyday life. Americans rarely have to worry about terrorist threats (in comparison to African and European countries) or diseases that have been mostly eradicated. The amount of funding and research that goes into disease prevention yearly in the US is enough to make sure these diseases never come back; over $10.4 billion has been spent in 2017 alone 1.

The African Country of Nigeria does not have the same luxuries as first world countries like the United States. Nigeria is one of only three countries left in the world that has been unable to completely eradicate Polio; along with Afghanistan and Pakistan 2. It has been a long and difficult fight for Nigeria, a country that had gone two entire years (2014-15) without any reported cases of polio. Considering that the World Health Organization created a program called the “Global Polio Eradication Initiative” in 1988 that was very successful, there must be something preventing Nigeria from becoming completely polio free.

What is Polio?

This is an image of an African child receiving a polio vaccine. They are very easy to administer.

Polio is a crippling, dangerous infectious disease that can cause paralysis and can be contracted in several ways, but can only be prevented through vaccination 3. If treated quickly and effectively, polio is relatively harmless. Almost 75% of people won’t even have any symptoms and about 25% of people who do have symptoms will have very minor ones, like stomach aches and headaches. However, if it is left to grow and gather strength without being treated, it can become very deadly and cause paralysis and meningitis as it attacks the spinal cord. The worst part is that it spreads very easily from person to person contact or contact of contaminated food or water. Polio can easily be prevented with vaccines for children, but countries like Nigeria do not have complete access to these vaccines.


The common opinion, especially in America, is that Nigeria can’t eradicate polio because it is a poor African country whose government is non-existent and its citizens are uneducated. Most people can’t even take a second thought about all the possible reasons that Nigeria cannot eradicate polio before making an assumption. With AIDS being a well known issue among sub saharan African countries, it is easy to assume that these countries are just unable to get the healthcare funds together to get rid of the issue. It is also possible to think that a lack of education in Africa has left their people without any knowledge of how to get rid of these diseases.

The Boko Haram

The most difficult obstacle to getting rid of polio is the insurgency of terrorist organizations, like the Boko Haram group 4. How does Boko Haram prevent Nigeria from eradicating polio? It does so by displacing people. Makinde states “that over 2 million people have been displaced since the onset of the insurgency, including 700,000 people being displaced in 2015 alone”. People who live in these now terrorist controlled areas all across the country “have been subjected to severe rationing of meager supplies of food and water whilst in captivity.” Being cut off from the rest of the world and held to rations that barely sustain life, has led these captive people to develop new “wild-type” polio cases. The development of wild-type polio in areas that have no access to healthcare or liberation makes it nearly impossible to fight back against it. The fact that Nigerian health officials don’t even know that some people have polio because they are being held captive is another reason eradication has been impossible.

Map of Boko Haram’s major attacks and impact in Nigeria

The region of Borno, Nigeria is almost completely under control of Boko Haram and around 60% of its people are out of reach of vaccinations 5. It has become far too dangerous for vaccinators to do their job and get vaccines to the children in regions like Borno. Back in 2012, “nine vaccinators were shot dead [by Boko Haram terrorists]” and since then all polio campaign workers have had to do their jobs without announcing that they are in the area. The dangers involved in entering these areas are so great that Nigeria’s border countries, along with itself, declared a public health emergency in these regions. In the case of the Borno region, the polio outbreak was the result of an old strain of polio that had been overlooked. This just highlights how isolated regions like Borno are. The same strain of polio that had infected hundreds of people only six years ago, is still infecting people up until now; even though a vaccine could have stamped it out.

There is hope, however, as a man by the name of Ibrahim Musa has started fighting back in a way that has led many more to follow in his footsteps. “His latest tactics are ‘hit and run’ vaccination campaigns in local bus stations and along roadsides to catch some of the children who’ve been missed as Boko Haram has confounded global efforts to eradicate polio” 6. He has quite a following as well, with hundreds of workers who all spread out across the country and vaccinate children in slums and alleys. They work to do what the Nigerian government cannot, and that creates very dangerous circumstances for Musa and his followers. In 2013 a Boko Haram terrorist attacked his clinic and killed ten people. At that point the polio campaign were suspended. Even so, Musa and others haven’t backed down and have continued to supply vaccinations as best as they can. It is because of groups and people like Musa that there is a hope that polio will become eradicated in Nigeria.


Polio is a crippling and very deadly disease that has no cure and can only be prevented through the use of vaccines and has been eradicated in every other country except for Afghanistan and Pakistan 5. Funding issues and the insurgency of Boko Haram terrorist group displacing people have made it nearly impossible to locate all children who need the polio vaccine. The World Health Organization and people like Ibrahim Musa have attempted to fight back against both the terrorist group and the polio disease itself. To answer the question to my research, there are many reasons that Polio is still around in Nigeria, including funds and education, but the most difficult hurdle to get over is the Boko Haram terrorist group who have done their best to interrupt the vaccination process of polio.  


1. O’Brien, S. (October 30, 2017). Getting the flu can wreak havoc on your finances. CNBC. Retrieved from

2. Progress towards poliomyelitis eradication: Nigeria, January-December 2017. (March 2, 2018). World Health Organization. Retrieved from EBSCO database.

3. What is Polio. (July 25, 2017). Centers for Disease control and prevention. Retrieved from

4. Makinde, J. (October 26, 2016). Eradicating polio amidst insurgency in Nigeria. Scidevnet. Retrieved from

5. Varo, L. (June 1, 2017). A marathon without finish: Nigeria’s fight against polio. New Internationalist. Retrieved from

6. Webster, P. (May 9, 2017). Fighting scourges of polio and terrorism of Boko Haram. National Observer. Retrieved from nationalobserver

Zika Virus: A concern in Sub-Saharan Africa?

By Stacy Ford

Millions of mosquitoes have been released in South Miami to combat Zika. CENTERS FOR DISEASE CONTROL AND PREVENTION

7,557 suspected cases of Zika in Sub-Saharan Africa, specifically in Cabo Verde as of May 8th, 2016 according to the World Health Organization (WHO).1 Zika is now spreading worldwide, but is most prevalent in Sub-Saharan Africa, Asia, the Caribbean, Pacific Islands, Central America and South America.

Where did the Zika Virus come from?
This virus was first discovered in a Rhesus monkey in the Zika forest of Uganda in 1947, making the virus native to Sub-Saharan Africa. The first human case of Zika was reported in 1952 in Nigeria. Between 1952 and 2007 there are only fourteen documented cases of the virus being found in humans. Both Aedes aegypti and Aedes albopictus mosquitos are responsible for the transmission of the virus.

What is Zika?
Zika is a mosquito-born Flavivirus. It is typically transmitted by bites received from the Aedes aegypti and Aedes albopictus mosquitos, but can also be transmitted through sex, blood transfusions and from a pregnant mother to her fetus. Most people who get the virus do not experience symptoms or even know that they have the virus and therefore causing many individuals to be misdiagnosed.

 The Risk of Zika 
The Zika virus is still prevalent in Sub-Saharan Africa. There are numerous reasons for widespread transmission; including mosquitos that transmit the virus are native to Africa. Other reasons the virus is so widespread is due to cross-border mosquito movement between countries and militia groups attacking healthcare workers causing a shortage of medical personal. In addition, there is a lack of education to the people of Africa. There is risk for more outbreaks in Sub-Saharan Africa and other third world countries that do not have access to or receive the government assistance and funding they need.

The good news for the people of Africa and the rest of the world is that once a person gets the virus they build up immunity to it, thus decreasing the chance of reoccurrence. With better education, access to healthcare, funding and security help from countries in Europe and the United States, Sub-Saharan Africa could better be able to control the epidemics and may even find a way to stop the spread of Zika.

1.World Health Organization. (N.D.). WHO confirms Zika virus strain imported from the Americas to Cabo Verde.
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Centers for Disease Control and Prevention. (2017). Zika Virus Overview.
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Baraka, V. & Kweka, E. J. (2016). The Threat of Zika Virus in Sub-Saharan Africa – The Need to Remain Vigilant. Frontiers in Public Health.
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Gyawali, N., Bradbury, R. S. & Taylor-Robinson, A. W. (2016). The global spread of Zika virus: is public and media concern justified in regions currently unaffected? Infectious Diseases of Poverty.
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Whittington, K. T. (2016). How War and Crisis Help Spread Diseases Like Zika. The National Interest.
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Ziegler, A. (2016). Will Africa Suffer Zika’s Bite?. Africa Center for Strategic Studies. Retrieved from


Guinea-Worm: Making Medical Strides in Africa

By Noah Cameron

Imagine going several weeks with a meter-long nematode dangling from a blister on your leg. This was a painful reality for many millions of Africans before the outside efforts intervened. The history of Guinea-Worm, a once crippling parasite, is an excellent example of what cooperation and focus can do to fix African health problems. In the 1980s, over 3 million people were infected with the parasite per year; In 2016 only 26 cases were recorded. 3 In less than 40 years, several groups including the CDC, the Carter Center, The World Bank, and more, were able to bring us closer than ever to eradicating this disease 8. If this amount of progress can be made with guinea-worm, imagine what could be done with other preventable diseases in Africa.

What is guinea-worm? Guinea-worm disease, also known as dracunculiasis, is when people drink unclean water that contains guinea-worm larvae. The larvae incubates in their body for about a year before showing symptoms. After this time, it may cause a painful blister on lower extremities where the meter-long worm emerges over the course of a week or so. This can be accompanied by vomiting and dizziness and it is very rare for this disease to be lethal 5. It may also be hard for the person to walk or do work. Although it might not seem like a big deal, with over 3 million people infected per year in the 1980s, many were out of work and could not provide food for their families, leading to greater problems.

Guinea-worm was mostly in Africa and somewhat in Asia and India 7. According to the Carter Center, in 2002, Sudan alone was responsible for nearly ¾ of all reported cases. Although somewhat easily preventable, there was not enough knowledge and healthcare accessibility to deal with the parasite. As of today, “Guinea worm disease is set to become the second human disease in history, after smallpox, to be eradicated. It will be the first parasitic disease to be eradicated and the first disease to be eradicated without the use of a vaccine or medicine”2.

Many groups took part in the rather hasty eradication of the disease. One of the leaders, the Carter Center, had the strategy of, “ [working] with ministries of health to stop the spread of Guinea worm disease by providing health education and helping to maintain political will” 2*. They called their effort, “The Guinea Worm Eradication Program,” and it primarily wiped out the disease through community-based programs to educate people on the importance of filtering all drinking water and by preventing transmission by keeping the infected away from water sources. Through these types of simple yet effective efforts, the disease has declined to a mere 26 cases in 2016.

Although Guinea-worm is nearly eradicated today, amoebic dysentery is still a problem.  According to Leonila Dans of the National Institute of Health,  “Entamoeba histolytica(The parasite responsible for much of the dysentery in South Africa)… is transmitted in areas where poor sanitation allows contamination of drinking water and food with faeces.” This is astonishingly similar to the issue with the guinea-worm. “ In these areas, up to 40% of people with diarrhoea may have amoebic dysentery”4. Since this disease and the guinea-worm are both water borne parasites, it is likely that it could be eradicated with similar efforts to those used to eradicate guinea-worm.

Obviously guinea-worm and amoebic dysentery aren’t the only water borne diseases in South Africa. If we can eradicate guinea-worm through simple efforts, imagine how many other diseases like guinea-worm can be dealt with in a similar way. It is possible that through humanitarian and political efforts similar to those done by the Carter Center, we can work on wiping out more African diseases and improve health standards everywhere.

           Figure 1: A man pulls a guinea-worm from a blister on his foot.6



Berman, J. (2009, October 29). WHO: Waterborne Disease is World’s Leading Killer. Voice of America News. Retrieved from 2005-03-17-voa34-67381152/274768.html

2 2*Carter Center. (2018). Guinea worm eradication program. Retrieved from

3Carter Center. (n.d.). Distribution by country of 49,886 indigenous cases of dracunculiasis reported during 2002. [Graph]. Retrieved from https://www.cartercenter .org/documents/nondatabase/graph.pdf

4Dans, L. (2007, January 1). Amoebic Dysentery. National Institute of Health. Retrieved from  

5Greenaway, C. (2004, February 17). Dracunculiasis (guinea worm disease). National Institute of Health. Retrieved from

6Hayden, M. (2009, March 30). [Photograph]. Retrieved from   

7Sharma, R. (2000, March 11). India eradicates guinea worm disease. National Institute of Health. Retrieved from

8World Health Organization. (2014). The health of the people: what works: the African regional health report 2014. Retrieved from


Devastating Truth of Malaria and Children of Sub-Saharan Africa

By Kendra Lifer 

The rain is hailing from the dark grey clouds as the drops bounce off the roof of a little home in Sub- Saharan Africa. Adamma, a two-year-old little girl is singing away to the noise while her family is lying in bed. August has come and has brought the rainy season with. Unfortunately, there is a problem with all that rain.  In a matter of days, some children like Adamma won’t be singing anymore. Her mother will be trying to bring down a fever, trying to take away the unexplainable pain, warm her chills and just to provide some comfort to little Adamma. What Adamma’s mother doesn’t know, is those are the first indications of something much worse and all resulted from a single bite a few days ago.  Left untreated and in just twenty-four hours Adamma will be suffering from life-threatening complications of (Plasmodium falciparum) malaria, transmitted by infected female Anopheles mosquitoes.  The clinics and hospitals will see a piercing increase of admissions with children like Adamma suffering from severe anemia, respiratory distress in relation to metabolic acidosis and even cerebral malaria. Sadly, seventy percent of malaria deaths that occur, are in the age group of five and under. 1

Thick and thin blood smears are used to find out whether malaria-causing parasites are in the blood.

Eye-opening Truth

Malaria remains a major killer of children under five, taking the life of a child every two minutes! In 2015 an estimated 303,000 African children died before their fifth birthday due to malaria. 2  Due to their underdeveloped immune system children under five carry the worse prognosis in an endemic area and repeated attacks on can lead to further medical issues such as chronic anemia, malnutrition, possibly stunted growth, and seizures. Survivors of malaria may have sequelae (e.g. hemiparesis, cerebellar ataxia aphasia, spasticity) according to the research in Pediatric Malaria.  According to UNICEF malaria kills 1,200 children daily, about fifty children every hour. 3

The Burden

Malaria is leaving a devasting mark on Africa. World Health Organization is supporting malaria emergency responses in Nigeria, South Sudan, Venezuela (Bolivarian Republic of) and Yemen, where ongoing humanitarian crises pose serious health risks. Among the 41 high-burden countries, overall, funding per person at risk of malaria remains below $2. 4 Africa Indoor Residual Spraying Project known as AIRS has reported the economic burden annually is at an estimated cost of twelve billion in direct cost and has reduced the gross domestic product growth by 1.3%. 5 These endemic areas are suffering due to the lack of tools such as insecticide-treated nets, residual spray, preventive treatments for pregnant women and children. The lack of these tools significantly contributes to death especially in children and young mothers to be. An estimated 10,000 women and up to 200,000 infants under one-year-old annually lose the battle to this infectious yet preventable disease.
President’s Malaria Initiative provides malaria prevention and treatment measures like insecticide-treated mosquito nets.

Insecticide-treated nets or long-lasting insecticide nets hung over the sleeping areas in homes to prevent mosquitoes from biting potential victims. These treated nets range in price and are usually under ten dollars. The use of insecticide-treated nets can reduce the childhood mortality rate by twenty percent according to Presidents Malaria Initiative. 5

AIRS project has made strides to prevent this parasite transmission with indoor residual spraying and enhanced entomological monitoring. In 2015, over 30,000 individuals were trained in indoor residual spraying. According to the Malaria Journal residual spray also known as IRS cost in the range of $2.22-$12.85. 6 However, Sub-Saharan Africa has an estimated 43% of people at risk of malaria in the region that were not protected by either a net or indoor insecticide spraying in 2015. 7

Preventive treatments are also available and these intermittent preventative treatments range in price depending on who is receiving the treatment. UNICEF proves that administering these crucial treatments during the recommended antenatal care visits could reduce neonatal mortality by 31% but with three out of four Sub-Saharan Africa pregnant women not receiving these treatments, especially in endemic areas leaves approximately twenty-eight million unprotected births at risk for contracting malaria during an extremely vulnerable time.


With the overwhelming devastation of malaria in Sub-Saharan Africa, stable along with continuous investment in malaria research and development is critical. World Health Organization Malaria 2017 world report outlines the financial need for the Global Technical Strategy, a 15-year blueprint for all countries working to control and eliminate malaria. The strategy set ambitious targets for 2030, including reducing malaria case incidence and death rates by at least 90%. Eliminating malaria in at least 35 countries and preventing the reintroduction of malaria in all countries that are malaria free. 8 To reach the first milestone, investments need to increase to $6.5 billion annually by 2020.

Striving to Defeat Malaria.

With funding improved in malaria education, prevention, testing, and treatment, lives can be saved. From 2001 to 2013, with improved access to malaria education, prevention, testing and treatment roughly 4.3 million lives were saved, 3.9 million of those lives were children under five in Sub-Saharan Africa. 9 However, malaria deaths reached 445,000 in 2016, a similar number to the 446,000 reported in 2015 according to World Health Organization . 10

“…One day this disease will no longer be a reality of everyday life…” Bovill said during her remarks at World Malaria Day 2010

The devastation on the population in Sub- Saharan Africa leaves all the African countries in a vulnerable state, which is why funding is important. With the End Malaria Now mission and core values: community, commitment, collaboration defeat of malaria, stimulation of economic growth and reduction of poverty in Africa are within reach. “No child should die of malaria. No child and no pregnant woman should be denied access to effective and readily available treatment because of where they live, or how poor they are,” Dr. Chopra added. “Deaths from malaria are preventable and it is up to all of us – governments, the international community, health professionals, or donors – to put measures in place to defeat this devastating disease once and for all.” 11  Malaria is preventable and curable, we can avoid this devastating disease and save the lives of children with the right education, prevention, testing, and treatment.





1Malaria Fact Sheet. (2017, November). World Health Organization. Retrieved from

2WHO. (2017, November). World Malaria Report 2017. World Health Organization. Retrieved from 

3Wallace, Rita Ann. (2015, April 23). Malaria kills 1,200 children a day: UNICEF. UNICEF for every child. Retrieved from

4Key points: World malaria report 2017 (2017, November 29) World Health Organization, Retrieved from

5Malaria Burden in Africa. (n.d). President’s Malaria Initiative Africa Indoor Residual Spraying Project. Retrieved from

6White, Michael T. (2011, November 3). Costs and cost effectiveness of malaria control interventions-a systemic review. Retrieved from

7WHO. (2017, November). World Malaria Report 2017. World Health Organization. Retrieved from

8Chaib and Smith. (2017, April 24). Prevent Malaria- Save lives: WHO push for prevention on World Malaria Day 25th April. World Health Organization, Retrieved from

9Wallace, Rita Ann. (2015, April 23). Malaria kills 1,200 children a day: UNICEF. UNICEF for every child. Retrieved from

10Malaria Fact Sheet. (2017, November). World Health Organization. Retrieved from

11Wallace, Rita Ann. (2015, April 23). Malaria kills 1,200 children a day: UNICEF. UNICEF for every child. Retrieved from




Tsetse Fly

By Megan Grant

In the United States, where proper and affordable healthcare is available to nearly everyone, children don’t have to worry significantly that a mosquito bite during summer vacation will likely kill them in a few months.  To get through the mild irritation that the insect provides, many people turn to Benadryl, baking soda mixes, and even allergy medicine.

In Sub Saharan Africa, many smaller countries are filled with people who can’t access a doctor.  Without any medical attention and unaffordable medication or even basic medical knowledge, many people die from simple illnesses and diseases that could easily be remedied with the right resources.

Instead, people are dropping like flies from insect bites, such as those of the Tsetse fly.  If further research can be contributed to unlocking the secrets to the life cycle of the Tsetse fly, a common preventative practice could be put in place against the diseases they spread, and the genus with its various species could be eradicated.

As the authors of Parasites and Vectors explain, the Tsetse fly is a vector, meaning that it passes diseases onto hosts through its bite 4.  In the case of the Tsetse, the host is utilized to raise its young, and can pass diseases not just from person to person, but to and from other animals.  The editors of the Encyclopedia Britannica explain that the Tsetse fly is “any of about two to three dozen species of bloodsucking flies in the housefly family… that occur only in Africa and transmit sleeping sickness (African trypanosomiasis) in humans and a similar disease called nagana in domestic animals”2.

Furthermore, “Tsetse flies are distinguished in part by a forward-projecting piercing proboscis on the head that is capable of puncturing skin. They readily feed on the blood of humans, domestic animals, and wild game”1. Although identifying the fly isn’t easy unless you get very close to it, recognizing it could be the difference between treatment and death.

Tsetse Life Cycle

Researchers, veterinarians, and Entomologists easily summarized the eight step, the endless cycle of the Tsetse fly 3.  The female flies mate just once, producing a single egg, eventually produce a larva which burrows into the ground where it pupates. After thirty days below ground, an adult fly emerges, matures, and mates, continuing the cycle every 50 days.

The Tsetse fly’s life cycle in full. Courtesy of the CDC.

The findings of researchers Lori Peacock, Simon Cook, Vanessa Ferris, Mick Bailey and Wendy Gibson 4  mix with many others in how the fly passes on African Trypanosomiasis in humans (HAT), which is through the proboscis.  With the disease that these flies pass along to their hosts as they birth and raise their young, there are many symptoms to identify the parasite in individuals.

The World Health Organization outlines the symptoms, ranging from “unspecific symptoms and signs such as headaches, fever, weakness, pain in the joints, lymphadenopathy, and stiffness” to “neurological changes which include the sleep disorder (hence the name “sleeping sickness”), deep sensory disturbances, abnormal tone and mobility, ataxia, psychiatric disorders, seizures, coma and ultimately death” 5.

The more sinister half of these symptoms are caused by “the parasite cross[ing] the blood-brain barrier and migrates to the central nervous system” 5. HAT can be very serious, and conditions worsen quickly, all beginning with a single fly feasting on a human’s blood.

The diagnostic stage is about halfway through the Tsetse fly’s life cycle, and can only be done once symptoms have set in.  Once this stage has set in, it is significantly more difficult to control the early effects of HAT, in both humans and other animals, as they can sometimes pass the disease through zoonosis.

Once the diagnosis has occurred, the WHO clarified that “Sleeping sickness is notoriously difficult to treat considering the toxicity and complex administration of the drugs currently available for treatment. Furthermore, parasite resistance to existing drugs is always a risk” 5. There are only four drugs to help treat HAT, but again, no cure.

A Much Needed Solution
Instead of concentrating on treating victims of HAT, African authorities, medical professionals, and even activists all recommend improving preventative measures.  “Transmission of trypanosomiasis involves four interacting organisms: the human host, the insect vector, the pathogenic parasite and the domestic and wild animal reservoirs” 5, so removing one of these four elements, the others wouldn’t be enough to continue the cycle.  The cycle could be broken by strategic agricultural slaughter, through using pesticides against the Tsetse flies, and implementing educational programs to inform citizens.

In order to overcome and eradicate Trypanosomiasis, the Tsetse fly population needs to be controlled and people need to be taught what to look for and how to avoid the flies. If Tsetse flies are controlled, thousands of lives can be saved. To help, visit here to learn more and donate towards research efforts.


1. CDC Research Team. (2015). Parasites – African Trypanosomiasis (also known as sleeping sickness). Centers for Diseases Control and Prevention. Retrieved from

2. The Editors of the Encyclopedia Britannica. (2017). Tsetse Fly. Encyclopedia Britannica. Retrieved from

3. Ngomtcho, S. C. H., Weber, J. S., Ngo Bum, E., Gbem, T. T., Kelm, S., & Achukwi, M. D. (2017). Molecular screening of tsetse flies and cattle reveal different Trypanosoma species including T. grayi and T. theileri in northern Cameroon. Parasites & Vectors, 10(1). Retrieved from

4. Peacock, L., Cook, S., Ferris, V., Bailey, M., & Gibson, W. (2012). The life cycle of Trypanosoma (Nannomonas) congolense in the tsetse fly. Parasites & Vectors, 5(1), 109. Retrieved from

5. Priogotto, G., Franco, J. (2018). Human African Trypanosomiasis. Retrieved from