Abstract
The ten member states of the Association of Southeast Asian Nations (ASEAN) constitute an economic powerhouse, yet these countries also harbor a mostly hidden burden of poverty and neglected tropical diseases (NTDs). Almost 200 million people live in extreme poverty in ASEAN countries, mostly in the low or lower middle-income countries of Indonesia, the Philippines, Myanmar, Viet Nam, and Cambodia, and many of them are affected by at least one NTD. However, NTDs are prevalent even among upper middle-income ASEAN countries such as Malaysia and Thailand, especially among the indigenous populations. The three major intestinal helminth infections are the most common NTDs; each helminthiasis is associated with approximately 100 million infections in the region. In addition, more than 10 million people suffer from either liver or intestinal fluke infections, as well as schistosomiasis and lymphatic filariasis (LF). Intestinal protozoan infections are widespread, while leishmaniasis has emerged in Thailand, and zoonotic malaria (Plasmodium knowlesi infection) causes severe morbidity in Malaysia. Melioidosis has emerged as an important bacterial NTD, as have selected rickettsial infections, and leptospirosis. Leprosy, yaws, and trachoma are still endemic in focal areas. Almost 70 million cases of dengue fever occur annually in ASEAN countries, such that this arboviral infection is now one of the most common and economically important NTDs in the region. A number of other arboviral and zoonotic viral infections have also emerged, including Japanese encephalitis; tick-borne viral infections; Nipah virus, a zoonosis present in fruit bats; and enterovirus 71 infection. There are urgent needs to expand surveillance activities in ASEAN countries, as well as to ensure mass drug administration is provided to populations at risk for intestinal helminth and fluke infections, LF, trachoma, and yaws. An ASEAN Network for Drugs, Diagnostics, Vaccines, and Traditional Medicines Innovation provides a policy framework for the development of new control and elimination tools. Together with prominent research institutions and universities, the World Health Organization (WHO), and its regional offices, these organizations could implement important public health improvements through NTD control and elimination in the coming decade.
Highlights
Association of Southeast Asian Nations (ASEAN) was founded in 1967 in order to promote economic and cultural development; to promote trade, agricultural, industrial, and scientific collaboration; and to promote peace and stability in the region [1]
While the neglected tropical diseases (NTDs) of Southeast Asia were reviewed in 2010 [10,11], here we summarize some of the revised estimates published over the last four years for the 14 of 17 NTDs endemic among the countries of ASEAN (Box 1)
New studies by Pullan et al [12] on soil-transmitted helminth infections determined that 126.7 million people in Southeast Asia are infected with Ascaris roundworms, while 115.3 million are infected with Trichuris whipworms, and 77.0 million have hookworm infections, including a high proportion of cases with Ancylostoma ceylanicum infections, a unique zoonotic hookworm infection found in ASEAN countries, especially Malaysia, Thailand, Cambodia, and Lao People’s Democratic Republic (PDR) [13,14]
Summary
The ten member states of the Association of Southeast Asian Nations (ASEAN) constitute an economic powerhouse, yet these countries harbor a mostly hidden burden of poverty and neglected tropical diseases (NTDs). NTDs are prevalent even among upper middle-income ASEAN countries such as Malaysia and Thailand, especially among the indigenous populations. The three major intestinal helminth infections are the most common NTDs; each helminthiasis is associated with approximately 100 million infections in the region. Almost 70 million cases of dengue fever occur annually in ASEAN countries, such that this arboviral infection is one of the most common and economically important NTDs in the region. There are urgent needs to expand surveillance activities in ASEAN countries, as well as to ensure mass drug administration is provided to populations at risk for intestinal helminth and fluke infections, LF, trachoma, and yaws.
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