Strengthening cutaneous leishmaniasis control in Guatemala

The World Health Organization (WHO) is an Agency of the United Nations specialized in health issues. Founded in 1948, and based in Geneva, the WHO is responsible for the worldwide coordination and strategy of the control, follow-up and eradication of disease. In 2015 the WHO was composed of 194 member states. At the same time, the Guatemalan government has considerable experience in working together with cooperative programs, with the European Union, individually with other states, and with other United Nation agencies such as the World Food Program to cite a recent example.


CONTEXT 
Cutaneous leishmaniasis is endemic in Guatemala and is considered to come under the heading of Neglected Diseases for which the WHO has set up special and specific work groups for each illness.
 
It is the most frequent form of leishmaniasis and produces in exposed areas of the body cutaneous lesions, especially ulcerous ones, which leave lifelong scars and are the cause of serious disabilities.   
 
In Guatemala, there are 2,899,000 people in 11 departments who are at risk from contracting the disease. In the areas of greatest incidence, the departments of Peten and Alta Verapaz, the annual rates of prevalence are 69.25 and 35.14 cases/100,000 inhabitants, respectively. Even so, it is acknowledged that the number of cases is underestimated due the isolation of the settlements and the lack of access to healthcare centers in the zone.  
 
The WHO has a control strategy for this disease at regional and worldwide level. In Latin America cutaneous leishmaniasis is endemic in 18 countries and around 60,000 new cases are diagnosed every year. 
 
EXPLANATION OF THE PROJECT
As part of its support to the Guatemalan Health Ministry, the WHO will take part in a national strategic fight against leishmaniasis. The lessons learnt from this project will be of use in reproducing and extending the strategy not only to other areas of Guatemala, but also to countries in Latin America that are suffering from this disease.
 
The project will focus its intervention lines on an active search for cases, creating awareness of the issue at community level, and training healthcare personnel in the diagnosis and treatment of cases. In a parallel manner, it will supply medication to treat at least 500 new cases and set up 10 mobile teams responsible for visiting the communities and training 50 health agents a year. 
 
The fact of working at a community level with follow-up, control and awareness about the disease will provide elements for advocacy with respect to investment in the control and elimination of leishmaniasis.
 
Experience working with health promoters in other countries at a community level has shown that it can be a reference when detecting and referring patients to health units where professionals trained in diagnosis can provide suitable treatment. 
 
BENEFICIARIES
In the department of El Peten: 256,000 people; in Verapaz: 910,000 people.
 
Six different ethnic groups inhabit these two departments. Two thirds of the population lives below the poverty threshold and half of them lack access to healthcare services. 40% of the children aged less than 5 years suffer from malnutrition.