Abstract
With the rise of global migration, international trade, and global environmental challenges such as climate change, it is not surprising that the interactions between humans and other animals are shifting. Salient infectious diseases, such as malaria and HIV (which have high burdens of disease), attract sophisticated public health frameworks and funding from global/regional organisations, such as the WHO. This unfortunately detracts attention from the many emerging zoonoses that fall under the radar as neglected tropical diseases (NTDs). This review considers the available literature and the attribution of burden of disease to the most insidious NTDs and recommends which five are deserving of policy prioritisation. In line with WHO analyses of NTDs, intestinal nematode infections, leishmaniasis, schistosomiasis, and lymphatic filariasis should be prioritised, as well as the burden of disease of cryptosporidiosis, which is largely underestimated. Both monitoring and treatment/prevention control methods for cryptosporidiosis are suggested and explored.
Highlights
When considering global burden of disease (BOD) of infectious origin, it is usually certain ‘poster-child’ diseases that come to mind, such as tuberculosis, malaria, avian influenza, and HIV
This is reflected in global prevention strategies and allocation of resources [1]; it means that there is a large body of infectious diseases called neglected tropical diseases (NTDs) that may fall below the global public health radar and either continue untreated or pose possible pandemic risk [2]
Upon outlining the relevant literature and presenting the top five zoonotic parasitic diseases in terms of global BOD, an integrated control program will be suggested for cryptosporidiosis, which is largely neglected in salient public health literature and public health policy
Summary
The largest critique of the WHO’s analysis of NTDs is the choice to not include cryptosporidiosis in the NTD category despite it contributing significantly to the global BOD, with an estimate of 8.37 million DALYs according to 2010 data, which may be an underestimation in itself [7]. According to the Centers for Disease Control and Prevention (CDC), transmission of C. parvum and C. hominis (the two primary species affecting humans) occurs mainly through drinking or eating contaminated water/food where thick-walled oocysts are ingested, allowing further parasite maturation in the intestines and reproduction into auto-infective thin-walled oocysts and thick-walled oocysts that pass through faeces into the environment [13]. This life cycle is not unique to humans with other Cryptosporidium spp. infecting essentially all mammals, including those in close domestic proximity to humans [13]. Eggs can survive from months to years in the environment, and with the addition of mammalian hosts the spread of a wider variety of zoonoses is made possible, with humans being incidental hosts of nematodes such as in the life cycle of Trichinella spp. [17]
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