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Data in from Nyadire De-Worming Study

November 1, 2011 - Good news has just come in from Mutoko District of Zimbabwe, where an Upenyu team has finished two weeks of follow-up testing: Schistosomiasis infection rates have dropped from 38% to 1.8%. Soil-transmitted helminth infection rates have dropped from 40% to 0%.

The Upenyu team, consisting of the six Upenyu staff on location and six Zimbabwean lab scientists, returned to the schools that were treated in April, 2011, to determine the effect of the treatment. During the days, samples were collected from 500 children, representing the 5,000 who were treated; during the nights, the samples were analyzed by the skilled and tireless teams.

A huge array of data was collected, including information on nutritional status, anemia levels, and, of course, infection intensities for the following diseases: urinary schistosomiasis, intestinal schistosomiasis, ascariasis, trichuriasis and hookworm. In order to do this, blood samples, urine samples and stool samples had been collected from the 500 children.

These very positive results demonstrate the excellent infrastructure of Zimbabwe. They reflect the fact that Zimbabwe's strong school system and educated citizenship is receptive to public health programs, ensuring high adherence as long as the programs are responsibly enstated.

More importantly, the results highlight the need to expand treatment for these diseases to all of Zimbabwe. The rates are high, and this treatment method has officially been proven effective in the context of Zimbabwe.

In six months, the next round of follow-up testing will occur, to ensure that infection rates do not climb back to high levels twelve months after treatment.

Fellows Depart for Zimbabwe

September 25, 2011 - Upenyu welcomes its three new fellows to Zimbabwe!

Jessica Cheng is a Harvard University graduate, with a degree in molecular biology and health policy. In addition to presiding over several community health initiatives in the Boston area, Jessica has previously served in urban hospitals in Santiago, Chile and Buenos Aires, Argentina.

Katie Frayler graduate of the University of North Carolina, with a degree in health policy. Several years down the road, Katie plans to go to Law School and perhaps become Upenyu's attorney general. In addition to working in North Carolina, she has field experience in Chiang Mai, Thailand.

Cathy Vu is a Princeton University graduate, with a degree in molecular biology. Her research has focused on genetic analysis as it pertains to human disease. This is a burgeoning area of study with regards to schistosomiasis. In addition to working with the Red Cross, Cathy has field experience in La Paz, Bolivia.

Nyadire Hospital Training for Malnutrition Management

December 6, 2010 - Upenyu is supporting a training on Community-based Management of Acute Malnutrition (CMAM). The training will occur at Nyadire Hospital, for nurses and healthcare workers, and will be run by Ministry of Health and Child Welfare workers. CMAM is a national program run by the National Nutrition Unit, but the national program relies in part on NGOs as implementing partners.

CMAM coverage around Zimbabwe is far from complete. In a recent visit to Nyadire Hospital, Ancikaria Chigumira, National Nutrition Unit Director, and Fitsum Assefah, head of the nutrition department at UNICEF, targeted the Mutoko District as high-priority for CMAM programming. Malnutrition rates are especially high in the catchment area of Nyadire Hospital, although reasons for this aberration are unknown. Dr. Kasombo Tshiani, medical superintendent of Nyadire Hospital, intends to study the root of the problem in coming years.

Currently, acute malnutrition is only treated in an inpatient setting in the Mutoko District. The purpose of CMAM is to decentralize treatment. Instead of therapeutically feeding patients admitted to a hospital, CMAM distributes therapeutic food to patients at satellite clinics near to patient homes, and the food is consumed at home. (To read more about CMAM, click here.)

The training will last five days, and involve 35 people associated with both Nyadire Hospital and Mutoko District Hospital. It will help establish the infrastructure of CMAM at Nyadire. Nurses and healthcare workers stationed at clinics are responsible for taking anthropomorphic measurements of patients and distributing therapeutic food (Plumpy'Nut, to be obtained by UNICEF) in the correct quantities. The Zimbabwean CMAM policy was cowritten by the Ministry of Health and Child Welfare and UNICEF, and generally follows globally-accepted protocol.

First Round Closes; Second Round Opens

December 2, 2010 - The first round for the Upenyu Health Fellowship closed yesterday at midnight. Thanks to all who submitted indications of interest. We look forward to getting to know you.

For those who are interested but did not yet submit an indication of interest, don't worry--the second round starts now and ends on December 22nd, 2010.

First Round Deadline Near

Novermber 27, 2010 - Don't forget to apply for the Upenyu Health Fellowship. First round applications are due on December 1st, 2010. We are eager to hear from interested applicants.

The fellowship is a way for Upenyu to recruit more members to develop projects for next year. As our scope continues to expand, we need more creativity and energy for our team. If you are the kind of person who enjoys dedication to a cause, and if you are interested in global health, check it out to see if you may be interested. As a fellow and member you will have the opportunity to see every side of project design, from organization and facilitation in the office to implementation on the ground.

National Schistosomiasis Survey Nears Completion

October 27, 2010 - The national schistosomiasis prevalence survey is coming to an end. The survey is intended to give an up-to-date view on national schistosomiasis prevalence and distribution around Zimbabwe. It is a necessary precursor to a national schistosomiasis control program, because treatment strategies for a given region differ depending on prevalence rates.

The initiative consists of ten survey teams distributed among different parts of the country, traveling from school to school to test for prevalence. Schools were chosen randomly before the beginning of the study, and at each school, a random sample of students are tested. The primary variables of the survey are: infection with Schistosomiasis mansoni (intestinal schistosomiasis), Schistosomiasis haematobium (urinary schistosomiasis), and soil-transmitted helminthiasis. All three are considered neglected tropical diseases, and are suspected to have high rates in Zimbabwe. The prevalence survey focuses on children because control programs focus on children, which in turn is because these diseases primarily afflict children.

The last data on schistosomiasis prevalence in Zimbawbe, while quite outdated, suggested a national prevalence between 35% and 40%. It is unlikely that rates have changed significantly, as there have been no systematic control programs nor changes in water sanitation.

Control of schistosomiasis is a health priority in Zimbabwe. (To read more about Schistosomiasis, click here. Unfortunately, resource limitations prevented this prevalence survey from occuring for over six years. This year the Ministry of Health and Child Welfare was at last able to make it happen, with some support from UNICEF.

Prevalence results will take some time to be released, while data is aggregated and carefully analyzed. Once the process is complete, the Ministry of Health and Child Welfare will begin to formulate policy to call for appropriate response. Due to the same lack of resources that caused the prevalence survey to be delayed by six years, the national control program will rely on NGOs to act as implementing partners. Currently, Upenyu is the sole NGO working on schistosomiasis in Zimbabwe, so its role will be important.

Upenyu Participates in Schistosomiasis Training

Septmeber 12, 2010 - This weekend, six members of Upenyu participated in a two-day training workshop on schistosomiasis. The workshop was run by the National Institute of Health Research (NIHR) to prepare staff for the upcoming national prevalence survey that will occur in October.

The workshop focused on diagnostic techniques for both schistosomiasis and soil-transmitted helminths (STHs). Among these are the Kato-Katz method for counting schistosomiasis egg concentrations, varous urine analysis tools, and a formol ether technique for counting STH.

Practical issues arose as well, such as what to do in the case of adverse reactions. While extremely rare, the possibilities of such reactions necessitate the presence or immediate availability of a health professional such as a nurse. While the prevalence survey will rely on nearby doctors, Upenyu's phase one schistosomiasis control teams will always be accompanied by a nurse from Nyadire Hospital.

An attendee at the workshop suggested that all staff should receive t-shirts to identify them in the field. The idea gained traction until Shungu Munyati, a guest from Biomedical Research and Training Institute, dryly replied, "I thought you were going to say we should get t-shirts for the kids we are treating!"

Upenyu members were guests to the training, invited by Dr. Nicholas Midzi, the organizer of the national prevalence survey. The majority of attendees were people to be involved in the survey, including team leaders, NIHR scientists, lab technicians, and drivers.

Upenyu Presents Projects to Rotary Club in Harare

September 9, 2010 - Today members of Upenyu presented their projects to Rotary CBD (Central Business District - Harare). Upenyu is seeking support for its programs from Rotary International, and for this to go through, Rotary CBD must approve projects.

Members fielded questions from people of all backgrounds and careers. One raised issue was that it may be contentious to import a peanut product into Zimbabwe when the country is one of the world's primary peanut producers. Ready-to-Use Therapeutic Foods such as Plumpy'Nut are peanut-based, but include many other ingredients such as vitamin powder, milk powder and oil. Recently, a delegation from Nutriset in France (the primary producer of Plumpy'Nut) visited Zimbabwe and decided it would be economically infeasible to produce Plumpy'Nut locally. Currently, all Plumpy'Nut used in Zimbabwe is imported from France.

Another point agreed upon by Rotary members was that gaining the trust of schools and schoolchildren is crucial to success of the schistosomiasis program. One Rotary member used memories from primary school as evidence: on days when NGOs came to distribute drugs to children for a disease which he could not remember, he and many of his compatriots skipped class altogether to avoid it. Upenyu has an intensive community sensitization plan to address this problem, which uses official communication channels for local leaders, as well as Nyadire Hospital's influence in its catchment area.

The Rotary club was receptive and optimistic, and the process will move forward until all issues have been addressed.