Communicable diseases are creating havoc at present. The figures are self revealing. Over 13 million people die each year from infectious and parasitic diseases: one in two deaths in some developing countries. The most vulnerable among them are the poor people, women, children and the aged one. As per one study, communicable diseases account for more than 85% of the diseases seen in the health institutions in Ethiopia.Infectious diseases continue to be the world’s leading killer of young adults and children.

The number and variety of communicable diseases are themselves alarming. The list includes intestinal dracunculiasis, malaria, leprosy, onchocerciasis, tuberculosis, parasitoses, leishmaniasis, schistosomiasis, trachoma and trypanasomiasis etc. The list is endless. Most of these diseases cause lifelong disability and serious social and economical problems but in spite of this usually attract little media and donor attention. However, effective and cheap interventions are available for most of them.

To deal with such neglected diseases, we need strong vector control, surveillance systems, community mobilization. It is also required to have involvement, capacity building and emphasis on communicable diseases in complex emergencies. Strengthening of health systems and better use of existing tools is crucial to prevent, control and ultimately eliminate these diseases as major public health problems.

Some of the above diseases are discussed below:

Dracunculiasis

Guinea worm, which is also known as Dracunculiasis is now endemic in only 12 countries, all of which are found in sub-Saharan Africa. Dracunculiasis is a disease caused by the parasitic worm Dracunculus medinensis or "Guinea worm". This worm is the largest of the tissue parasite-affecting human. The adult female, which carries about 3 million embryos, can measure 600 to 800 mm in length and 2 mm in diameter. The parasite migrates through the victim's subcutaneous tissues causing severe pain especially when it occurs in the joints. The worm eventually emerges (from the feet in 90% of the cases), causing an intensely painful oedema, a blister and an ulcer accompanied by fever, nausea and vomiting. For further development, they need to be ingested by suitable species of voracious predatory crustacean, Cyclops or water fleas.

The problem is compounded by the fact that no medication is available to end or prevent its infection. The common medium of transnission of the disease is water. Safe drinking water is the need of the hour. NGOs and government can get together and provide water suitable for drinking. To combat this disease, this is the only way.

Malaria

1,337 cases of malaria, including 8 deaths, were reported for 2002 in the United States, even though malaria has been eradicated in this country since the early 1950's. Forty-one percent of the world's population live in areas where malaria is transmitted This itself tells the darker side of story.

Plasmodium falciparum and Plasmodium vivax are the most dominant malaria parasites in Ethiopia, distributed all over the country and accounting for 60% and 40% of malaria cases respectively. Plasmodium malariae accounts for less than 1% and Plasmodium ovale is rarely reported. The parasite is principally transmitted by the major mosquito vector known as Anopheles arabiensis. In some areas Anopheles pharoensis, Anopheles funestus and Anopheles nili also transmit the disease.

Almost 45 million of Ethiopia’s 68 million inhabitants are estimated to be at risk of malaria and the problem is compounded by increasing frequency and magnitude of malaria epidemics.

The malaria problem is increasing due to increasing drug and insecticide resistance. Efforts to combat the disease are constrained by shortage of trained manpower, particularly of vector control supervisors at zonal level and technicians at sector and district levels in all regions, weak surveillance systems, shortage of drugs and laboratory supplies, shortage of spray pumps, and shortage of field logistics. Above all, operational finances are inadequate.

Onchocerciasis

Onchocerciasis, "river blindness", is a parasitic disease caused by a filarial worm called Onchocerca volvulus. The disease is transmitted by the blood feeding black fly, of the genus Simulidae. The fly breeds in fast flowing rivers and streams. Hence, transmission is most intense in the river valleys and the disease is most severe in communities located near these rivers. The severity of onchocerciasis is closely related to the prevalence and intensity of infection in the community. Onchocerciasis is endemic in many tropical countries but mainly in the equatorial region of Africa. Out of the estimated 18 million infected people worldwide more than 80% live in Africa.

Efforts are on to control the disease by establishing community-directed treatment with the drug ivermectin (CDTI), supplemented with vector eradication in a few isolated foci. There are two main actions undertaken against onchocerciasis control: spraying of breeding sites in water of the blackflies with larvicides, and the treatment of patients with a drug (ivermectin) that kills the young worms. The disease can also be controlled to a great extent by proper hygiene.

It is obvious that everyone has to join hands in combating these diseases. And, more than that, an affirmative action plan is required.