Abuja, 31 January, 2023 - Betty Livingstone, (not her real name), 22 years old native of Benue State, has been living with swollen lower limbs since 2012. 

“I remember waking up one morning and noticing my feet were swollen. The swelling started in my feet and gradually progressed to my legs. Having swollen legs is very embarrassing as people look at me weirdly,” she says.  

After several months of seeking medical help, she has been diagnosed with Elephantiasis, scientifically known as Lymphatic Filariasis (LF), a disfiguring disease that occurs when filarial parasites are transmitted to humans through mosquitoes. 

Due to her health condition, Ms Livingstone battles discrimination and stigmatization which has a psychosocial effect on her life.  She recalled contracting the disease at the age of 13 and almost dropping out of school due to her ailment. 

“I am now in a tertiary institution and have to daily summon the courage to attend school or go to new places.

The condition affects my education and social interaction. When it started, I could not go about my daily activities with ease. On many days, I needed assistance to stand up from bed. No one deserves to go through what I suffer.

I'm taking medication and happy. It has given me hope that my leg will not get swollen than it is now, and that I will not be infecting others.” she says. 

Even though LF has no cure, Ms Livingstone is currently receiving treatment (drugs) to kill the filarial parasite in her blood and to stop the swelling. 

The LF medications are provided by the Nigerian Government with support from World Health Organization (WHO), Merck and GSK and are distributed across, all the 583 endemic Local Government Areas (LGA) in the country. 

Debilitating diseases
Lymphatic filariasis is one of the 20 diverse neglected tropical diseases (NTD) affecting more than 120 million people in 72 countries in Asia, Africa, the Western Pacific, parts of the Caribbean and South America. 

According to the WHO, NTDs thrive mainly in rural areas, conflict zones and hard-to reach-regions where access to clean water and sanitation is scarce and worsened by climate change.  

Nigeria is one of the most endemic countries accounting for 25% of the NTD’ burden in Africa. So far, 15 of these diseases are identified in Nigeria. One of the NTDs,  Guinea worm has since been eliminated.

Meanwhile, in January 2021, the WHO  rolled out a 10-year roadmap for NTDs, with ambitious targets and innovative approaches to tackling the diseases. The move is geared towards the quest to attain Sustainable Development Goals by 2030. In collaboration with the Federal Ministry of health, WHO Nigeria and partners has developed a more robust road map at subnational levels that does not neglect the case management of NTDs, the human resource aspects as well as the programmatic components. 

Taking action 
The National Coordinator of Neglected Tropical Diseases,  Federal Ministry of Health, Mr Nse Akpan says the elimination of all forms of NTDs will reduce poverty and increase productivity in the country.

Mr Akpan says that NTDs affect a nation's productivity as it has a critically adverse effect on the people infected by any of the diseases. 

“The government with support from partners (including WHO) is taking tremendous efforts in combatting the diseases through the distribution of medications, vector control, morbidity and disability management, and community sensitization programmes. 

Elimination of these diseases will reduce malnutrition and increase child enrollment in school.  It will reduce morbidity and disability, and increase food production in the country as well as promote good mental health and well-being of citizens,” he says. 

Additionally, the WHO Country Representative, Dr Walter Kazadi Mulombo, says over the past decade, the WHO has progressively harmonized public health approaches including the distribution of Ivermectin and

Albendazole in endemic communities and for vulnerable and hard-to-reach persons using low-cost, high-impact interventions. 

Meanwhile, NTDs include Buruli ulcer, Chagas disease, dengue and chikungunya, dracunculiasis (Guinea-worm disease), echinococcosis, foodborne trematodiases, human African trypanosomiasis (sleeping sickness), leishmaniasis, leprosy (Hansen’s disease), lymphatic filariasis, mycetoma, chromoblastomycosis, and other deep mycoses, onchocerciasis (river blindness), rabies, scabies and other ectoparasitoses, schistosomiasis, soil-transmitted helminthiases, snakebite envenoming, taeniasis/cysticercosis, trachoma, and yaws and other endemic treponematoses.

Additionally, NTDs tend to affect regions without quality healthcare, leaving poor populations vulnerable to these often debilitating diseases, but they can be effectively controlled, eliminated, or eradicated, through combined public health measures, effective treatment, and community sensitization.  

Technical Contacts:
Dr Anne Jean Baptiste; Email: jeana [at] who.int (jeana[at]who[dot]int)
Dr Aliyu Suleiman; Email: aliyusu [at] who.int (aliyusu[at]who[dot]int)