Mobilizing to Eliminate Trachoma in African Migratory Populations

By Andi Kezh, Task Force Communications Intern

At least three to four times a year, the Ngipian people move across northeastern Uganda leading their families, including young children, and cattle in search of water and pasture.

Hitching on to their migratory journey, undetected dangerous infections like blinding trachoma can follow these groups if they don’t get treatment.

Five districts in Uganda, four of which border Kenya, remain endemic to trachoma, a bacterial infection of the eyes that has impaired over 1.9 million people globally as the leading cause of infectious blindness worldwide. While the disease is entirely preventable with antibiotic treatment, there remain challenges to reaching isolated groups of people, such as migratory populations like the Ngipian community, which was originally from Ethiopia before coming to Uganda.

“These people practice what we call pastoral movement, which we monitor from a public health standpoint,” said Denis Olaka, neglected tropical disease (NTD) focal point for the Nabilatuk District government in Uganda.

Olaka oversees the effort to provide services to the Ngipian migrant people within the Karamoja region of Uganda. Due to the frequent movement that is intrinsic to the cultural traditions of nomadic groups, it is difficult to locate or reach them with essential treatments and care. Often medical teams must walk up to 20 kilometers on foot to reach a migrant group that is inaccessible by vehicle. This leaves these populations especially vulnerable.

“There is a greater risk of infection and spread in these groups. The lack of knowledge is very paramount and they don’t have as clear an understanding or the proper resources for health and sanitation protocols,” said Olaka.

Since migratory populations live in pastoral rural environments, factors such as lack of access to clean water for washing, attraction of flies carrying bacteria, and close proximity to other  families contribute to trachoma infection.

To help protect the Ngipian, Olaka’s team developed comprehensive strategies to fight trachoma within migratory populations with the support of The Task Force’s International Trachoma Initiative (ITI). ITI allocates and distributes the antibiotic Zithromax, donated by Pfizer, to treat active trachoma infections, as well as provides logistical assistance, program monitoring, and research to help local and national governments control the spread of disease.

In addition, Olaka and his local team implement regular mapping and strategy sessions to estimate movements and approximate locations to target migrant groups and organize medical clinics and informational sessions on-the-go. Much of their work also includes cross-border collaboration, such as partnership with their neighboring country to the east, Kenya’s Ministry of Health, to coordinate mass drug administrations (MDAs) of Zithromax.

Community members participate in a trachoma awareness campaign.

We time our respective MDA campaigns specifically so that we don’t duplicate efforts and so the largest number of people across a large landscape of the region can get their treatment at the right time,” said Olaka. Cross-border collaboration between governments and program teams allows for more seamless and efficient distribution of trachoma care for migrant groups. 

In June 2022, Pfizer announced it would extend its donation of antibiotics for the ITI program through 2030, which will guarantee nearly 100% treatment coverage of at-risk communities in 38 out of the 56 countries that were ever endemic for trachoma. As of August 2022, 14 countries have been declared trachoma-free.

Olaka remains hopeful that Uganda will soon be added to this list.

“I owe Pfizer a tremendous applause for the great support in terms of NTD drugs to Uganda in ensuring the elimination of these diseases,” said Olaka. “The support which goes up to 2030 shall be adequate enough in ensuring total elimination of most neglected tropical diseases like trachoma.”

Photos courtesy of Denis Olaka.

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