Each year on 30 January, World NTD Day marks a day of global awareness to galvanize the global health community and engage the general public in the urgent effort to end neglected tropical diseases. NTDs are a diverse set of 20 diseases and disease groups that affect more than 1.7 billion worldwide. Over 40% of this global burden is concentrated in Africa. The diseases affect one in five people worldwide threatening their physical, economic, and social futures. Ranked among the four most devastating groups of communicable diseases, NTDs cause severe pain, long-term disability and deaths. Among children, infection leads to malnutrition, cognitive impairment, stunted growth and the inability to attend school. The World’s most marginalized communities living in poverty with limited access to water and other necessities are the most affected.
In Rwanda, most common NTDs include:
NTDs related to water-sanitation-hygiene (WASH): 1) intestinal worms, with national prevalence of 45% and 2) schistosomiasis (commonly known as Bilharzia), with prevalence (by immunological test) ranging between 0.6 and 16.7% in mapping units among children aged 8-18 years old surveyed in 2014, and 3) cysticercosis (from tenia of pigs) of which the form neurocysticercosis was found to be the cause of 23% of epilepsy cases in a study conducted in the Southern province;
skin NTDs which also are WASH related issues and include 4) scabies with >110,000 cases diagnosed in patients at health facilities in 2019, 5) podoconiosis (lymphoedema of lower limb) with an estimated 6,000 cases countrywide and 6) tungiasis (also known as jigger disease) with 2,000 cases diagnosed in patients at health facilities in 2019; and diseases transmitted from animals including 7) teniasis from pigs and cattle with an annual average of 2,500 cases diagnosed in patients at health facilities; animal bites such as 8) snake bite envenoming with >1,000 cases reported by health facilities in 2019 and 9) rabies from mainly dog bites with an annual average of 500 dog bites reported each year by health facilities.
Remarkable progresses were made to fight NTDs in Rwanda. Since 2008, over 65 Million treatments against intestinal worms and schistosomiasis were delivered to children aged 1-15 years through bi-annual deworming for intestinal worms and once a year for schistosomiasis. Deworming coupled with the progress made in water-sanitation, hygiene and awareness, intestinal worms prevalence decreased by >20% from 66% in 2008 to 45% in 2014 among surveyed school aged children.
Due to concerted efforts, 7 NTDs that were historically or potentially endemic in Rwanda are no longer public health problems for Rwandan population. Those NTDs are rhodiense Human African Trypanosomiasis, Trachoma and 5 skin NTDs (Yaws-present many decades ago, Leprosy, Lymphatic Filariasis, Mycetoma and Onchocerciasis). The Ministry of Health through Rwanda Biomedical Centre is in the process of gathering data for each NTD as evidence supporting the dossier requesting World Health Organization to officially validate Rwanda as having eliminated those 7 NTDs as public health problems. By 2024, the Ministry of Health targets to have all validations achieved.
Another target related to NTDs by 2024 is elimination of podoconiosis (imidido or ibitimbo) in endemic Districts, defined as <1% prevalence of untreated podoconiosis among individuals aged ≥ 15 years and > 95% of lymphoedema cases treated adequately.
Lastly, by 2024, the Ministry of Health through Rwanda Biomedical Centre targets to reduce:
- to <20% of intestinal worms prevalence;
- by 20% the morbidity of tungiasis (jigger disease);
- by 25% the morbidity of scabies and Cysticercosis/Taeniasis;
- by 50% the morbidity and mortality of Snake Bite Envenoming; and
- by 100% deaths related to rabies.
To achieve above targets by 2024, the national NTD strategic plan 2019-2024 was developed for multi-sectoral interventions across all relevant sectors to tackle collectively those NTDs through a multi-sectoral collaboration approach (One health approach) under NTD sub-Technical Working Group (TWG). The sub-TWG is operational with nominees from different institutions or partners responsible or working in: Water resources, Sanitation and Hygiene, agriculture, animal resources, wildlife, tourism, environment, education, central governance, local governance, disability, medical, academics and research. Additional to multi-sectoral collaboration, for sustainability and lasting impact, NTD control and elimination plans have been decentralized to be under district coordination for an effective engagement of local leadership and community for home-grown solutions “TUJYANEMO”.
For domestic financing of NTDs, the program has recently decentralized activities related to the Mass Drug Administration (mass deworming) against intestinal worms and schistosomiasis to the village level, with integration into existing community platforms (weekly village gatherings, monthly malnutrition screening, drugs’ supply to the community, etc.)
For more equity, with the support of NTD partners, children and adults living in high endemic districts will be dewormed 3 times a year.
For scaling up NTD services: Podoconiosis (non-filarial elephantiasis) treatment centers have been established across the country and will be operational this year. They will also contribute to the surveillance of rare skin NTDs targeted for elimination (Yaws, Leprosy, Lymphatic Filariasis, Mycetoma, Onchocerciasis).
Celebration of World NTD Day 2021 in Rwanda
Following a year of unprecedented awareness of global health, Rwanda joins the Global NTD community in celebrating the World NTD Day on the 30 January 2021. The event will be marked by the lighting up of the Kigali Convention Centre in purple and orange.
Rwanda joins 16 other countries, 32 other global monuments that have agreed to light up on World NTD Day. More than 240 partner organizations representing 50 countries have committed as partners for the 2021 World NTD Day campaign, and more are joining every day. From civil society advocates and community leaders, to global health experts and policymakers working across a diverse set of issues, a growing chorus is unifying behind a common goal to end NTDs.
The 2021 World NTD Day will serve as the launch of both the World Health Organization’s new roadmap to end NTDs, as well as several months of activity leading up to the first-ever summit on malaria and NTDs to be hosted in Kigali in June.
More information on World NTD Day 2021:
More information of RBC’s publications on NTD:
More information of WHO's new NTD roadmap 2021-2030:
The WHO's new road map for neglected tropical diseases 2021-2030 was formally launched on 28 January 2021.
get brochure via www.who.int/publications/i/item/WHO-UCN-NTD-2020.01
By: Dr Eugene Ruberanziza, Alice Rutaremara and Jean Bosco Mbonigaba