Abstract
Infectious diseases of poverty (IDoP) disproportionately affect the poorest population in the world and contribute to a cycle of poverty as a result of decreased productivity ensuing from long-term illness, disability, and social stigma. In 2010, the global deaths from HIV/AIDS have increased to 1.5 million and malaria mortality rose to 1.17 million. Mortality from neglected tropical diseases rose to 152,000, while tuberculosis killed 1.2 million people that same year. Substantial regional variations exist in the distribution of these diseases as they are primarily concentrated in rural areas of Sub-Saharan Africa, Asia, and Latin America, with geographic overlap and high levels of co-infection. Evidence-based interventions exist to prevent and control these diseases, however, the coverage still remains low with an emerging challenge of antimicrobial resistance. Therefore, community-based delivery platforms are increasingly being advocated to ensure sustainability and combat co-infections.Because of the high morbidity and mortality burden of these diseases, especially in resource-poor settings, it is imperative to conduct a systematic review to identify strategies to prevent and control these diseases. Therefore, we attempted to evaluate the effectiveness of one of these strategies, that is community-based delivery for the prevention and treatment of IDoP. In this paper, we describe the burden, epidemiology, and potential interventions for IDoP. In subsequent papers of this series, we describe the analytical framework and the methodology used to guide the systematic reviews, and report the findings and interpretations of our analyses of the impact of community-based strategies on individual IDoPs.
Highlights
The Global Burden of Disease Study 2010 reports an increase of 111,000 deaths globally attributable to malaria and neglected tropical diseases (NTDs) in the last twoSub-Saharan Africa, Asia, and Latin America, with geographic overlap resulting in high levels of co-infection [7,8,9,10,11]
Global attention and resources have been focused on human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), malaria, and TB as these are outlined in Millennium development goal (MDG) 6, while NTDs have been relegated into the group of “other diseases”, and until 2010, NTDs represented only 0.6% of the total international development assistance for health [13] despite affecting as many poor people as the big three diseases
This paper aims to review the disease burden, distribution, existing interventions, and coverage for the prevention and control of Infectious diseases of poverty (IDoP), and is followed by a series of papers evaluating the effectiveness of community delivered interventions for the prevention and control of each IDoP
Summary
The Global Burden of Disease Study 2010 reports an increase of 111,000 deaths globally attributable to malaria and neglected tropical diseases (NTDs) (including chagas, leishmaniasis, African trypanosomiasis, schistosomiasis, cysticercosis, echinococcosis, dengue, rabies, ascariasis, as well as other NTDs) in the last two. The changing care paradigm A large proportion of infectious diseases in LMICs are entirely avoidable or treatable with existing medicines or interventions which are highly cost effective, their delivery to the affected populations has proven very difficult due to weak health systems and infrastructures [14] Another major issue is access to and utilization of health services, which has been a concern in LMICs, with not enough progress being made on various health parameters. Apart from providing chemotherapy, CHWs can play a major role in imparting health education regarding general hygiene and sanitation and intervene for vector control measures within household and community settings These community delivery strategies are effective but are cost efficient, and by training teachers and other school personnel to administer anthelmintic drugs, costs could be reduced by “piggy-backing” on existing programs in the educational sector [52]. In Ghana and Tanzania, delivery of school-based targeted anthelmintic treatment cost as little as US $0.03 per child, which is as low as one-tenth of the estimated costs for vertical delivery [52]
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