Abstract
The neglected tropical diseases (NTDs) are the most common conditions affecting the poorest 500 million people living in sub-Saharan Africa (SSA), and together produce a burden of disease that may be equivalent to up to one-half of SSA's malaria disease burden and more than double that caused by tuberculosis. Approximately 85% of the NTD disease burden results from helminth infections. Hookworm infection occurs in almost half of SSA's poorest people, including 40–50 million school-aged children and 7 million pregnant women in whom it is a leading cause of anemia. Schistosomiasis is the second most prevalent NTD after hookworm (192 million cases), accounting for 93% of the world's number of cases and possibly associated with increased horizontal transmission of HIV/AIDS. Lymphatic filariasis (46–51 million cases) and onchocerciasis (37 million cases) are also widespread in SSA, each disease representing a significant cause of disability and reduction in the region's agricultural productivity. There is a dearth of information on Africa's non-helminth NTDs. The protozoan infections, human African trypanosomiasis and visceral leishmaniasis, affect almost 100,000 people, primarily in areas of conflict in SSA where they cause high mortality, and where trachoma is the most prevalent bacterial NTD (30 million cases). However, there are little or no data on some very important protozoan infections, e.g., amebiasis and toxoplasmosis; bacterial infections, e.g., typhoid fever and non-typhoidal salmonellosis, the tick-borne bacterial zoonoses, and non-tuberculosis mycobaterial infections; and arboviral infections. Thus, the overall burden of Africa's NTDs may be severely underestimated. A full assessment is an important step for disease control priorities, particularly in Nigeria and the Democratic Republic of Congo, where the greatest number of NTDs may occur.
Highlights
The neglected tropical diseases (NTDs) are a group of chronic, disabling, and disfiguring conditions that occur most commonly in the setting of extreme poverty, especially among the rural poor and some disadvantaged urban populations [1]
From the analysis reported here, two nations stand out has having the largest number of NTD cases and possibly disease burden
Nigeria is estimated to have the highest prevalence of helminth infections such as hookworm, schistosomiasis, ascariasis, trichuriasis, and lymphatic filariasis (LF) in sub-Saharan Africa (SSA), as well as the second highest registered prevalence of leprosy (Table 3)
Summary
The neglected tropical diseases (NTDs) are a group of chronic, disabling, and disfiguring conditions that occur most commonly in the setting of extreme poverty, especially among the rural poor and some disadvantaged urban populations [1]. Previous studies indicate that the NTDs are widespread among the poor in SSA [3,4,5,6], with the most common NTDs, such as the soil-transmitted helminth (STH) infections, schistosomiasis, lymphatic filariasis (LF), trachoma, and onchocerciasis together affecting more than 500 million people [3,6,7,8] Because of their adverse effects on child development, pregnancy outcome, and agricultural worker productivity [1,3,6,7,9,10,11,12,13,14,15,16,17], the NTDs represent a major reason why the ‘‘bottom 500 million’’ people in SSA cannot escape poverty. Total SSA population living on less than $2 per day Percentage of world’s population living on less than US$2 per day in SSA
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