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The World Health Organization (WHO) prioritizes 17 neglected tropical diseases (NTDs) (Figure 1) that affect over a billion of the world’s poorest people and pose a significant economic burden to developing economies (scabies was just added to the list in June of 2014, bringing the count to 18). NTDs are a heterogeneous group of infections caused by parasites, viruses, and bacteria. What makes NTDs different from non-neglected diseases is that these diseases are disablers rather than killers. Indeed, these infections are co-endemic: an individual may be infected with more than one NTD in addition to other well-known diseases such as HIV, tuberculosis, and malaria. For example, the parasite infection schistosomiasis can make women and girls more susceptible to HIV infection, saps micronutrients and iron from developing children to stunt their growth, and renders children less likely to attend school. A chronic helminth parasite infection known as lymphatic filariasis (LF) may reduce vaccine efficacy by broadly modulating the immune system. LF causes severe swelling (lymphedema) in 40 million people rendering them socially stigmatized and largely unable to work. In addition to schistosomiasis and LF, many more NTDs are characterized by chronic disabilities, increased susceptibility to infectious and non-infectious diseases, social stigma, and an economic burden on the individual, the family, and the country.
The World Health Organization (WHO) prioritizes 17 neglected tropical diseases (NTDs) (Figure 1) that affect over a billion of the world’s poorest people and pose a significant economic burden to developing economies (scabies was just added to the list in June of 2014, bringing the count to 18). NTDs are a heterogeneous group of infections caused by parasites, viruses, and bacteria. What makes NTDs different from non-neglected diseases is that these diseases are disablers rather than killers. Indeed, these infections are co-endemic: an individual may be infected with more than one NTD in addition to other well-known diseases such as HIV, tuberculosis, and malaria. For example, the parasite infection schistosomiasis can make women and girls more susceptible to HIV infection, saps micronutrients and iron from developing children to stunt their growth, and renders children less likely to attend school. A chronic helminth parasite infection known as lymphatic filariasis (LF) may reduce vaccine efficacy by broadly modulating the immune system. LF causes severe swelling (lymphedema) in 40 million people rendering them socially stigmatized and largely unable to work. In addition to schistosomiasis and LF, many more NTDs are characterized by chronic disabilities, increased susceptibility to infectious and non-infectious diseases, social stigma, and an economic burden on the individual, the family, and the country.
NTDs don’t just affect low- and middle-income countries, although their victims are often socioeconomically disadvantaged. Cysticercosis, echinococcus, toxocariasis, Dengue virus, West Nile virus, and Chagas disease all have appeared in the United States, disproportionately afflicting the poor. Peter Hotez of the Sabin Vaccine Institute and Baylor College of Medicine has estimated that half of the 20 million people living in poverty in the US are infected with at least one NTD.
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Since the London Declaration, some successes indicate that control and eradication are possible. Colombia recently became the first country in the world to eradicate onchocerciasis. Niger, Nigeria, and the Ivory Coast have also recently eradicated Guinea worm. Twenty-three countries treated at least 75% of children at risk for soil-transmitted helminth infections, and a massive disease mapping program of blinding trachoma using mobile technology has cut the unmapped regions of the world for this disease in half.
However, we still have a long way to go. It has been estimated that of all the drugs approved for distribution, only 65-75% are reaching the people who need them. Implementation and operational research on how to carry out mass drug administrations effectively must be a priority. Even when control programs go well, they can be quickly derailed by political unrest, natural disasters like Superstorm Haiyan, or even epidemics like the ongoing Ebola outbreak that have overwhelmed the existing health systems in Liberia and Sierra Leone. Furthermore, disease boundaries for mosquito-transmitted diseases are especially sensitive to changing temperature and precipitation patterns due to climate change.
Last November in his keynote address to the American Society of Tropical Medicine and Hygiene, Bill Gates highlighted a need for global health innovations, citing the example of the new diagnostic test for human African trypanosomiasis. Gates urged the community to take the digital revolution and apply it to disease surveillance to determine where to concentrate disease-fighting efforts The Bill and Melinda Gates Foundation is a strong proponent that “big data” health care informatics solutions must be apart of efficient disease control programs, and this will represent a burgeoning area of global health research in the near future.
Source:https://blogs.plos.org
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