Nigeria, DRC Primed to Become World’s Epicenter of Neglected Tropical Diseases


Report says the two Sub-Saharan African countries are already feeling the bite of poverty-related Neglected Tropical Diseases (NTDs)

Nigeria and the Democratic Republic of Congo (DR Congo) – two sub-Saharan Africa countries entangled in incessant armed conflicts and poverty – are faced with the threat of witnessing the largest epidemic of canine rabies, typhoid fever, cholera, lymphatic filariasis, onchocerciasis, human African trypanosomiasis and other Neglected Tropical Diseases (NTDs), a new report has revealed.

In a PLoS editorial premised on a 2018 report by the Bill & Melinda Gates Foundation and the Institute of Health Metrics that was evaluated at the University of Washington, Hotez P and colleagues disclosed that in the coming decades, urbanisation would drive a new wave of NTDs in Nigeria and DR Congo, with their megacities set to be most affected.

Citing references from recent projections, the article published August 8, stated that by the year 2050, Kinshasha in DR Congo will be the world’s fourth largest city, with an estimated population of 35 million people, while Lagos, with over 32 million people, will be the sixth largest. The consequences of this, Hotez wrote would be dire.

With a combination of risk factors like poverty, food insecurity, climate change, and political instability, the writer noted that there will be new urban foci of hookworm and other soil-transmitted helminth infections; schistosomiasis, and possibly onchocerciasis; arbovirus infections transmitted by Aedes aegypti; canine rabies; and selected bacterial infections such as leptospirosis, cholera, and typhoid fever, to name a few.

The author stated that although extreme poverty could be the dominant factor in the persistence of NTDs in Nigeria and DR Congo, other drivers, including political instability and conflict in the region could act to undermine the countries’ health systems.

“Although the mechanisms underlying these two factors on health require further study, undoubtedly, their ability to collapse health systems is paramount,” Hotez wrote.

“We’re now seeing this play out in North Kivu of Eastern DR Congo, where conflict hinders an international effort to control Ebola virus infection despite the availability of a new vaccine.”

Map showing 10 NTDs hotspots around the globe

Citing the outcome of their analysis, the author stated that conflict may rank second only to poverty as a modern driver of the NTDs, in addition to other factors like malnutrition and food insecurity and climate change, especially for those transmitted by vectors.

In a comparative articulation of the 2013 and 2017 Global Disease Burden Study (GDB), Hotez’s articles revealed that both DR Congo and Nigeria have the highest total numbers of people affected by selected NTDs, especially those endemic to Africa.

“The GBD 2013 found that globally, Nigeria has the largest number of cases of schistosomiasis, the second largest number of cases of onchocerciasis, and the third largest number of cases of lymphatic filariasis. Similarly, in 2013, DR Congo had the largest number of cases of onchocerciasis and human African trypanosomiasis and the third largest number of cases of schistosomiasis. Both nations lead Africa in terms of numbers of cases of human hookworm infection and other NTDs,” Hotez stated.

Citing the result of the repeat analysis using information from the GBD 2017, Hotez disclosed that Nigeria has overtaken both India and Indonesia in terms of the nation with the largest numbers of lymphatic filariasis cases, while Nigeria and DR Congo may now have the world’s highest incident number of cases of malaria.

According to the PLoS article, the consequences of the geographic overlap and co-endemicity of schistosomiasis, human hookworm infection, and malaria have been reported previously to include deep and devastating anemia, usually found among children and women of reproductive age.

One of the striking findings from the 2018 report tagged ‘goalkeepers’ report released in the fall of 2018 was the prediction that by the year 2050, more than 40% of the world’s poorest people will be living in DR Congo and Nigeria. With a projection that Nigeria will be home to about 429 million people, the articles highlighted the finding of the report that not less than 152 million people (35%) will live in extreme poverty by 2050, as will 70 million of DR Congo’s projected population of 171 million (41%).

Other countries in the region with high percentages of their population in extreme poverty could also include Burundi, Central African Republic, Madagascar, Malawi, Somalia, and Zambia.




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