Abstract

Neglected Tropical Diseases (NTDs) affect an estimated 1 billion people in 149 countries. The World Health Organization (WHO) prioritised 17 NTDs for control and elimination by 2020 and defined a Road Map to help countries reach these goals. Improved diagnostics for NTDs are essential for guiding treatment strategies at different thresholds of control, interruption of transmission, elimination and post-elimination surveillance. While substantial progress has been made in the last decade with chemotherapy, the same cannot be said of diagnostics, largely due to the perceived lack of a commercially viable market for NTD diagnostics.New sample in-answer out nucleic acid amplification technologies that can be performed at the point-of-care offer improved performance over current technologies and the potential to test for multiple pathogens using a single specimen. Finding commonalities for different NTDs in terms of geographic overlap, sentinel populations and treatment strategy will allow NTD programs to leverage these innovations to build cost-effective multiplex surveillance platforms. Connectivity solutions linking data from diagnostic laboratories and POC test readers/devices provide opportunities for automated surveillance systems to make health systems more efficient, improving patient outcomes and assessing impact of interventions in real time. New models of public–private product development partnerships are critical in leveraging diagnostic innovation in other priority area for better diagnosis, control and elimination of NTDs.

Highlights

  • Neglected Tropical Diseases (NTDs) affect an estimated 1 billion people in 149 countries in the developing world and give rise to a myriad of adverse impacts, including anemia, blindness, cognitive impairment, and death [1,2]

  • While substantial progress has been made in the last decade with chemotherapy reaching a billion people in 2014 [5], the same cannot be said of diagnostics needed to guide chemotherapy and for surveillance, largely due to the perceived lack of a commercially viable market for NTD diagnostics

  • This article examines recent advances in diagnostic technologies driven by high profile, high burden diseases such as HIV and tuberculosis, emerging global health threats such as antimicrobial resistance and emergencies such as outbreaks of SARS, Ebola virus disease and Zika virus infections, and determines how these innovations can be leveraged to improve the diagnosis and surveillance of NTDs

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Summary

Introduction

Neglected Tropical Diseases (NTDs) affect an estimated 1 billion people in 149 countries in the developing world and give rise to a myriad of adverse impacts, including anemia, blindness, cognitive impairment, and death [1,2]. The World Health Organization (WHO) prioritised 17 NTDs (Buruli ulcer, Chagas disease, cysticercosis, Dengue, drancunculiasis (Guinea worm disease), echinococcosis, endemic treponematoses (Yaws), foodborne trematode infections, human African trypanosomiasis (HAT), visceral leishmaniasis (VL), leprosy, lymphatic filariasis (LF), onchocerciasis, rabies, schistosomiasis, soil-transmitted helminthiases (STH), and trachoma) for control and elimination. These NTDs were selected on the basis that their transmission characteristics or treatment opportunities make them good candidates for control and elimination [3]. This article examines recent advances in diagnostic technologies driven by high profile, high burden diseases such as HIV and tuberculosis, emerging global health threats such as antimicrobial resistance and emergencies such as outbreaks of SARS, Ebola virus disease and Zika virus infections, and determines how these innovations can be leveraged to improve the diagnosis and surveillance of NTDs

Investments in diagnostic innovation
Diagnostics for global health emergencies
Antimicrobial resistance
Innovation in diagnostics for NTDs
Overlapping geographic endemicity and common sentinel populations
Common treatment
Advances in diagnosis of viral infections
The promise of connectivity to strengthen the efficiency of health systems
The challenges of implementing POC diagnostics
Findings
The way forward
Full Text
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