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Schistosomiasis Control in Kwabeng

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Schistosomiasis Control in Kwabeng Social, Environmental, and Engineering Challenges to Reducing Schistosomiasis Incidence in a Rural Town in Eastern Ghana – PowerPoint PPT presentation

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Date added: 7 February 2020
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Title: Schistosomiasis Control in Kwabeng


1
Schistosomiasis Control in Kwabeng
  • Social, Environmental, and Engineering Challenges
  • to Reducing Schistosomiasis Incidence
  • in a Rural Town in Eastern Ghana

Tufts University Department of Civil and
Environmental Engineering
2
Project Team
  • Student Members
  • Casey Caldwell, Robert Curry, Charline Han, Daron
    Kurkjian, Kelly Sanborn, and Katie Shuman
  • Faculty Advisors
  • John Durant and David Gute

3
The Problem
  • Schistosomiasis is water-borne parasitic disease
    that is contracted by coming into contact with
    contaminated water
  • We hypothesized that hydraulic alterations to the
    river in Kwabeng have increased the incidence of
    schistosomiasis

Source Rob Curry
4
Life Cycle of Schistosomiasis
Source http//www.payer.de/entwicklung/entw2039.g
if
5
Long Term Project Objective
  • Decrease, if not eliminate, the incidence of
    schistosomiasis in Kwabeng, Ghana
  • Promote better management of water resources in
    Kwabeng
  • Assess the transportability of our approach to
    other affected communities

6
First Year Project Objectives
  • Research the nature and complexity of the problem
  • Establish baseline data for Kwabeng
  • Create relationships with community members
  • Design a matrix to determine the best possible
    solutions

7
Research Methods in Kwabeng
  • Gathered water data
  • Velocity, Temperature, pH, Dissolved Oxygen,
    Specific Conductivity

Source Rob Curry
8
Research Methods in Kwabeng
  • Identified presence of schistosomiasis in water
    and in children
  • Collected snails
  • Identified schistosomes in snails
  • Conducted school surveys to determine incidence
    of infection in children, along with river use
    habits

9
Snail and Velocity Correlation
10
Research Methods in Kwabeng
  • Met with community members and leaders
  • Gathered community acceptance and historical data
    for the town
  • Helped establish a committee to continue project
    efforts in Kwabeng

Source Katie Shuman
11
Research Methods in Kwabeng
  • Made maps of the before and after mining company
    changes
  • Used a GPS unit, measuring tape, and compass
  • Digitized the maps for use in GIS

12
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13
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14
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15
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16
Identifying Interventions
  • Identified three types of interventions
  • Reduce number of snails in the river
  • Prevent people from exposure to parasites
  • Reduce the population of parasites in snails

17
Selection Criteria
  • Cost
  • Relative cost taking into account capital cost
    and O M
  • Feasibility
  • How possible the intervention technology is in
    Kwabeng
  • Access to equipment
  • Human health and safety concerns
  • Community Acceptance
  • How well the proposed solution resonates with the
    community
  • Cultural, political and economic implications

18
Selection Criteria Continued
  • Efficacy
  • Success rate in decreasing the incidence of
    schistosomiasis
  • Can the intervention stand alone
  • Has it been successful in other areas
  • Sustainability
  • Longevity of the intervention

19
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20
Numbering System
  • Cost
  • 1 most expensive 5 least expensive
  • Feasibility
  • 1 least feasible 5 most feasible
  • Community Acceptance
  • 1 not supported 5 very supported
  • Efficacy
  • 1 not effective 5 very effective
  • at decreasing infection
  • Sustainability
  • 1 not sustainable 5 indefinitely sustainable

21
All Possible Rated Interventions
22
Snail Control Reducing the amount of snails in
the river
23
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24
Biological Controls
  • Adding Terrestrial Plants for Shade
  • Shade reduces aquatic plant life in river,
    habitat of the snails
  • Competing land requirements from farmers near
    banks of river
  • Correlation between high shade and low/no snail
    population
  • Harvesting Aquatic Plants
  • High labor demand
  • Competing growth surfaces reduce efficacy
  • Continual removal of aquatic plants will lower
    biological productivity of river
  • Kwabeng community view option as drastic

Source http//www.kauai-vacation-rentals.com/sha
desofgreen/100shades.htm
25
Biological Controls
  • Increase Snail Predator Population
  • Fishing of beneficial predators would limit snail
    reduction gains
  • Ecological equilibrium would require constant
    addition of fish to effectively reduce snail
    populations
  • Risk of unintended consequences of species
    introduction
  • Population monitoring costs high
  • Increase Direct Snail Competitors
  • Competitive species could be local foods (certain
    snail species)
  • Ecological equilibrium between species will
    require excessive competitor population

26
Chemical Controls
  • Herbicide
  • Ineffective long term solution
  • Risk to farmers who irrigate from river water
  • Town water supply impacted
  • Molluscicide
  • Requires 8 hour contact time with river
  • Temporary solution
  • If implemented incorrectly could increase
    chemical resistance of snails
  • Towns water supply impacted

27
Increasing the River Velocity
  • Increase slope channel
  • Effective, but impractical
  • Major earth moving needed
  • Water supply weir would need to be removed
  • Changes to the water supply system drastic
  • Reduce Cross-Sectional Area
  • Entire river would need width contraction high
    expense
  • Maintenance against erosion could be high, with
    seasonal storm and flood events
  • Community skeptical of option

28
Increasing the River Velocity
  • Increase Input Through River Restoration
  • Rejoin the Awusu and the Abodusu Rivers
  • Partnership with Mining Co. necessary
  • Earth moving equipment in hands of Mining Co.
  • Experience in river alterations
  • Highly effective
  • Desired by many in community

Source Charline Han
29
Alternatives to Using the River
30
Public Showers
  • Construction, operation, and maintenance costs
  • Adults would be willing to pay a small fee, but
    children would have to be free.
  • Attendant needed for maintenance and up keep.
  • Need cooperation with Ghana Water Ltd.
  • Does not prevent river use
  • Must be coupled with other interventions

31
Public Wells
  • Construction, operation, and maintenance costs
  • Dont know depth to water table
  • Small fee for usage (1-2)
  • Community is resistant to using wells because
    they are usually hand dug and the water does not
    come from the river
  • Does not prevent river use
  • Must be coupled with other interventions

Source Charline Han
32
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33
Public Taps
  • Construction, operation, and maintenance costs
  • Many taps already in town
  • Small fee for usage (1-2)
  • Does not prevent river use
  • Must be coupled with other interventions

34
Recreation Area
  • Construction cost and constructability.
  • Are supplies available in Ghana?
  • Will Children use it?
  • Does not prevent river use
  • Must be coupled with other interventions

35
Expand Household Distribution System
  • Implementation costs high as are recurring costs
  • Not everyone has a house
  • Requires cooperation of Ghana Water Ltd.
  • Does not prevent river use
  • Must be coupled with other interventions

36
Schistosome Control Reducing parasite population
in snails
37
Medical Treatment-Increase Staff for Existing
School Visit Treatment System
  • Currently one nurse conducts school visits to
    evaluate childrens health
  • Students are required to self-assess illnesses
  • Town clinic run by Ghana Health Services,
    therefore requires cooperation
  • Community questions current systems
    accountability and supports increased assistance
  • Long term monitoring needed

38
Medical Treatment-Monthly Free Schistosomiasis
Screening and Drug Distribution Days
  • Salary of nurse, MDs, and lab techs
  • Cost of Praziquantel (most common drug used for
    treatment)
  • Reinfection rate a concern
  • Medication does not confer immunity
  • Reduces egg return to the river, thus breaking
    life cycle

39
Latrines - Reducing Egg Return to River from
Humans
  • Construction, operation, and maintenance costs
  • Small income generated because adults would pay
    to use latrines
  • Latrines already exist in town and are not widely
    used because of their cost to the users
  • Finite life span, therefore lacks sustainability
  • Reduces egg return to the river, thus breaking
    life cycle

40
Town-wide Education Campaign
  • Two target populations children and adults
  • Cost of educated health personnel
  • Behavioral changes are often difficult to
    implement and sustain
  • Constant reeducation necessary
  • Preventing schistosomiasis is not presently a
    priority in Kwabeng

Source Charline Han
41
No Action Alternative
  • Side effect of schistosomiasis is anemia, which
    makes people feel weak and decreases worker
    productivity
  • Community is invested in working with us to find
    a solution
  • Hypothesis that incidence rates on the rise

42
Conclusions and Recommendations
  • Top three interventions
  • Increase river velocity by river restoration
  • Town-wide education campaign
  • Monthly schistosomiasis screening and treatment
    days
  • Interventions can be used in conjunction with
    each other
  • Lower scoring interventions can be used to
    supplement main intervention

43
Future Work
  • Ongoing
  • Locate sources of funding
  • Identify international partners
  • Year 2 In depth data collection on the
    recommended interventions and selection of the
    best intervention
  • Year 3 Design of selected intervention
  • Year 4 Implementation
  • Year 5 Monitoring and evaluation

44
Acknowledgements
  • Professors John Durant and David Gute
  • Kwabena Kyei-Aboagye
  • Dr. Kwame Boadu
  • Kwabeng District Superintendent of Schools
  • Professor Manu, University of Ghana
  • Provost Bharucha
  • Tufts University Center for Children
  • Department of Civil and Environmental Engineering
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