Abstract
The neglected tropical diseases (NTDs) represent some of the most common infections of the poorest people living in the Latin American and Caribbean region (LAC). Because they primarily afflict the disenfranchised poor as well as selected indigenous populations and people of African descent, the NTDs in LAC are largely forgotten diseases even though their collective disease burden may exceed better known conditions such as of HIV/AIDS, tuberculosis, or malaria. Based on their prevalence and healthy life years lost from disability, hookworm infection, other soil-transmitted helminth infections, and Chagas disease are the most important NTDs in LAC, followed by dengue, schistosomiasis, leishmaniasis, trachoma, leprosy, and lymphatic filariasis. On the other hand, for some important NTDs, such as leptospirosis and cysticercosis, complete disease burden estimates are not available. The NTDs in LAC geographically concentrate in 11 different sub-regions, each with a distinctive human and environmental ecology. In the coming years, schistosomiasis could be eliminated in the Caribbean and transmission of lymphatic filariasis and onchocerciasis could be eliminated in Latin America. However, the highest disease burden NTDs, such as Chagas disease, soil-transmitted helminth infections, and hookworm and schistosomiasis co-infections, may first require scale-up of existing resources or the development of new control tools in order to achieve control or elimination. Ultimately, the roadmap for the control and elimination of the more widespread NTDs will require an inter-sectoral approach that bridges public health, social services, and environmental interventions.
Highlights
The neglected tropical diseases (NTDs), a group of chronic, debilitating, and poverty-promoting parasitic, bacterial, and some viral and fungal infections, are among the most common causes of illness of the poorest people living in developing countries [1]
It combines with other inequities related to ethnicity, age and gender, and a patchwork of unique ecological niches to establish sometimes highly focal epidemiological NTD ‘‘hot spots.’’ This has important implications for the control of NTDs in Latin American and the Caribbean region (LAC), which may differ from the integrated NTD control currently being advocated for and tested in sub-Saharan Africa and elsewhere [1]
The indigenous people of Bolivia and Peru experience high rates of fascioliasis, cysticercosis, and plague [20,39,67,68]; those in Colombia are at risk for leishmaniasis, Chagas disease, and yellow fever [15]; and in Brazil, there are several well-documented examples of high levels of soil-transmitted helminth (STH) infection and subsequent growth stunting among indigenous people [69,70,71,72], as well as trachoma [55]
Summary
The neglected tropical diseases (NTDs), a group of chronic, debilitating, and poverty-promoting parasitic, bacterial, and some viral and fungal infections, are among the most common causes of illness of the poorest people living in developing countries [1]. In Guatemala and in the neighboring states of southern Mexico, the indigenous populations suffer from some of the highest rates of STH infection in the Americas [19], as well high rates of onchocerciasis [35] and Chagas disease [48].
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