Public Health Crisis in Madagascar -- Ascaris

By Kevin Yuan

Ascaris lives in the intestine, and Ascaris eggs are passed in the feces of infected individuals. Ascaris lumbrocoids or Ascariasis infections are usually treated using benzamidazoles, such as Mebendazole or Albendazole. Although these anti-parasitics are chemically similar and both are extremely effective, the recommended dosage may vary. In the current state of our economy, expenses allocated regarding health issues are severely limited, especially when those allocations are towards topics affecting other countries. Given the limitations, countries that are determined to help Madagascar with its current Ascariasis crisis should allocate their  available funds should be used to hire teachers and build latrines, than to purchase anti-parasitics for those at risk in Madagascar.

The money in place should be used to fund teachers and latrines, because Ascariasis is a perpetual problem for Madagascans. The vulnerability of the 20 million people in Madagascar to Ascaris demands that long-term measures must be taken in order to provide the greatest benefits for reducing Ascaris infections in the future. Although the anti-parisistics used to treat Ascariasis are effective, the money available would not be able to treat all the children in Madagascar; in addition, Ascaris is an infection that can be acquired repeatedly, even after one gets treatment. The source of transmission is from ingestion of eggs from soil contaminated with human feces and is prevalent in areas with poor hygiene. With over 85% (as indicated by GEXSI) of the country’s inhabitants living in rural areas, the lack of hygiene, nutrition, and access to drinking water enables great susceptibility to Ascariasis. 

A significant portion of revenue available should be distributed to establishing latrines to reduce open defecation. With communal latrines costing from 250, low-cost communal latrines can be established. The money should be distributed to schools in rural villages where not only students will have access to the latrines, but also inhabitants of homes located near the schools. As Kightlinger et al mentions, “children were allowed to defecate in the village with 13% habitually defecating within 10m of their house.” The lack of sanitary measures illustrates the susceptibility of people, especially children, to Ascariasis. Ultimately, with the establishment of latrines, the benefits will drastically improve sanitary conditions.  

Part of the funds available should be used for hiring teachers who are well-informed about sanitation, especially regarding Ascaris infection. With money distributed towards education, health teachers can be hired to educate schoolteachers about hygiene, and that information can be passed to students. Hygiene education should build children’s knowledge to transmit information on appropriate health practices to families and communities. This education will also incline children that live near the school to utilize the latrines. Harnessing the health skills will provide long-term benefits. The half million should also be spent on “materials to support health promotion activities and habits, including posters, exercise books, and stickers posted on latrine and classroom doors” as suggested by UNICEF. Bringing teachers to educate about the importance of sanitation will show significant benefits in the long-run. 

In conclusion, we can clearly see that in order to generate the greatest benefit from the money, the funds should be utilized in a way to educe a long-term solution contrary to a short-lived solution by using the money for antiparistics.