Common Neglected Tropical Diseases Research Articles

Low-Cost Microfluidic Systems for Detection of Neglected Tropical Diseases

Neglected tropical diseases (NTDs) affect tropical and subtropical countries and are caused by viruses, bacteria, protozoa, and helminths. These kinds of diseases spread quickly due to the tropical climate and limited access to clean water, sanitation, and health care, which make exposed people more vulnerable. NTDs are reported to be difficult and inefficient to diagnose. As mentioned, most NTDs occur in countries that are socially vulnerable, and the lack of resources and access to modern laboratories and equipment intensify the difficulty of diagnosis and treatment, leading to an increase in the mortality rate. Portable and low-cost microfluidic systems have been widely applied for clinical diagnosis, offering a promising alternative that can meet the needs for fast, affordable, and reliable diagnostic tests in developing countries. This review provides a critical overview of microfluidic devices that have been reported in the literature for the detection of the most common NTDs over the past 5years. Expected final online publication date for the Annual Review of Analytical Chemistry, Volume 16 is June 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

La interrupción de la transmisión materno-infantil y la detección y tratamiento de los hijos de mujeres infectadas como una contribución para la eliminación de la enfermedad de Chagas en Europa

Chagas disease is grouped among the Neglected Tropical Diseases (NTD), according to the classification of WHO and among the Neglected Infectious Diseases susceptible to be eliminated according to PAHO (EID). Chagas disease is the most common NTD (or EID) in wide areas of South and Central America where the vector – an insect, which transmits the parasite Trypanosoma cruzi via its bite – and the great majority of patients live. However, due to population movements, this disease has now become a global problem, especially in the USA and Spain. The control of transmission by the vector or by blood transfusions has progressed considerably. However, transmission by other routes, namely oral and mother-to-child are still a challenge in regards of control and access to health care. In the countries where transmission by the vector doesn’t take place, vertical transmission is the main route of transmission. Taking into account that there is a huge gap in diagnosing and treating patients suffering from Chagas disease, early diagnosis and treatment of infected women in childbearing age, pregnant women and children, as well as asymptomatic infected people, is an important contribution towards the control of this disease which is potentially fatal if left untreated. Aiming for this objective, all available tools should be optimized and implemented. There are several countries and regions already implementing this strategy in this particular group of women and children. The advances achieved are a good example of the collaboration between organizations and institutions in the public and private sectors, although a greater political commitment is needed in order to achieve Chagas elimination as a public health problem by 2030 as promoted by the ETMI-Plus strategy established by PAHO, the new WHO-NTD road map, the UN sustainable development goals (SDG) and the program “No baby with Chagas” launched by the SEGIB.

Schistosomiasis, strongyloidiasis and Chagas disease: the leading imported neglected tropical diseases in Italy.

In recent years, an increasing number of individuals affected by neglected tropical diseases (NTDs) have been observed in Italy, due to migration, international travels and climate changes. Reliable data on the current NTD epidemiology in Italy and the health system preparedness on this issue are not available. We report the results of a survey on selected NTDs (schistosomiasis, strongyloidiasis, echinococcosis, Chagas disease, leishmaniasis, cysticercosis, filariasis and scabies) in nine Italian sentinel centres, in order to investigate their occurrence throughout the country and identify which ones are a priority for public health interventions, development of protocols for case management, and training activities. To explore the preparedness of the centres, we investigate the availability of specific diagnostic tools and drugs, needed for the management of the most common NTDs. We also reviewed and summarized the available national policies, recommendations and guidelines on NTDs in Italy. Overall, 4123 NTDs cases were diagnosed in nine Italian centres within a 7-year period (2011-2017). Schistosomiasis and strongyloidiasis were the most common NTDs, accounting for about one-third each of all the diagnosed cases, followed by Chagas disease. The number of cases showed a significant trend to increase over time, mainly due to foreign-born subjects. Serology for Schistosoma spp. and Strongyloides stercoralis was available in seven and five centres, respectively. Agar plate stool culture for S. stercoralis was available in three sites. Ivermectin and praziquantel were always available in six centres. Six national policies, recommendations and guidelines documents were available, but for the most part, they are not fully implemented yet. This survey showed how some NTDs, such as schistosomiasis and strongyloidiasis, are becoming more common in Italy, due to multiple components. A list of seven key actions was proposed, in order to improve diagnosis, management and control of NTDs in Italy.

Neglected tropical diseases (NTD) morbidity and disability toolkit validation: A cross-sectional validation study of the EMIC-AP stigma scale for affected persons and the WHOQOL-DIS scale in Papua, Indonesia

Background: There is a lack of information about the burden of neglected tropical diseases (NTDs) in terms of morbidity and disability. Therefore, there is a need for agreed instruments that can provide this information. This study is a first phase validation study of the EMIC-AP and the WHOQOL-DIS instruments conducted in Papua, Indonesia. Leprosy and Lymphatic filariasis are common NTDs in Papua. The research question was: “How valid are the EMIC-AP and the WHOQOL-DIS of the NMD toolkit among people affected by the NTDs leprosy or lymphatic filariasis living in Papua, Indonesia?” Methodology/Principal Findings: Data were gathered using translated interviewadministrated versions of the questionnaires. The sample included participants with leprosy (n = 16) and lymphatic filariasis (n = 18) experiencing disabling consequences from their NTD. The study focused on item equivalence (relevance and acceptability), semantic equivalence (understanding and meaning) and operational equivalence (format of administration and questions, and suitability of response scales). Testing of the item equivalence showed that 94% thought the questions of WHOQOL-DIS were relevant and 90% felt comfortable with the topics. Concerning the EMIC-AP, 93% thought the questions relevant, and 90% felt comfortable. Semantic equivalence was more problematic with 51% and 23% having difficulties in understanding the WHOQOL-DIS and the EMIC-AP, respectively. Seventy-three percent was positive about the format of the EMIC-AP, while only 58% was positive about the WHOQOL-DIS format. Conclusion: The item equivalence was good for both the WHOQOL-DIS and EMIC-AP, and the operational equivalence showed room for improvement for the WHOQOL-DIS. The semantic equivalence was relatively poor. This was especially true for the WHOQOL-DIS. The main reason for this is that there are over a 250 different languages in the province of Papua. With minor adjustments, it is likely that the EMIC-AP can be used under the condition that the participants speak sufficient Bahasa. The WHOQOL-DIS does not appear suitable for use with this population. Author Summary This study tested two instruments that measure stigma (EMICAP) and quality of life (WHOQOL-DIS) among people affected by leprosy or lymphatic filariasis in Papua, Indonesia. The interviews comprised questions of both instruments and additional questions to get the participants opinion about the instruments. The focus of this study was on whether the participants understood the questions, whether they were relevant and acceptable and if the design of the questionnaires were clear. Using the answers to the additional questions, we could check whether the translations of the instruments were applicable for persons affected by NTDs in Papua. Results showed that the WHOQOL-DIS was not considered suitable for use with NTD-affected people in Papua. In contrast, the EMIC-AP can be used in Papua after some minor adjustments and if participants are fluent in Bahasa Indonesia.

Neglected tropical diseases—Challenges and opportunities in India

Abstract Neglected Tropical Diseases (NTDs) are a major public health problem globally as well as in India. The World Health Organization recognizes seventeen (17) major parasitic and related infections as the neglected tropical diseases (NTDs) out of which the common ones in India are Lymphatic filariasis (LF), Visceral Leishmaniasis (VL) , Leptospirosis ,Rabies, Soil-Transmitted Helminthic Infections (STH) and Dengue. Most of the NTDs are highly disabling and many are chronic in nature. India is home to millions of people who are poor and live in impoverished environments, and hence, are at risk of these diseases. As per WHO‘s 2020 roadmap to eliminate at least 10 of NTDs ,India is committed to provide the necessary resources to remove the primary risk factors for NTDs –poverty and exposure by ensuring access to clean water and basic sanitation ,integrated vector control, health education and improved living conditions. The present article reviews the common NTDs in India, their magnitude, current status of interventions for control, and challenges and opportunities for the elimination of NTDs.

Management and Treatment of Dengue and Chikungunya - Natural Products to the Rescue.

Neglected tropical diseases (NTDs) flourish mostly in impoverished developing nations of the world. It is estimated that NTDs plague up to 1 billion people every year thereby inducing a massive economic and health burden worldwide. Following explosive outbreaks mostly in Asia, Latin America, Europe and the Indian Ocean, two common NTDs namely, Chikungunya and Dengue both transmitted by an infected mosquito vector principally Aedes aegypti have emerged as a major public health threat. Given the limitations of conventional medicine in specifically targeting the Chikungunya and Dengue virus (CHIKV and DENV), natural products present an interesting avenue to explore in the quest of developing novel anti; mosquito, CHIKV and DENV agents. In this endeavor, a number of plant extracts, isolated phytochemicals, essential oils and seaweeds have shown promising larvicidal and insecticidal activity against some mosquito vectors as well as anti CHIKV and DENV activity invitro. Other natural products that have depicted good potential against these diseases include; the symbiotic bacterial genus Wolbachia which can largely reduce the life span and infectivity of mosquito vectors and the marine Cyanobacterium Trichodesmium erythraeum which has shown anti- CHIKV activity at minimal cytotoxic level. The impetus of modern drug discovery approaches such as high throughput screening, drug repositioning, synthesis and computer-aided drug design will undeniably enhance the process of developing more stable lead molecules from natural products which have shown promising antiviral activity in-vitro.

Neglected tropical diseases among the Association of Southeast Asian Nations (ASEAN): overview and update.

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.

Development assistance for neglected tropical diseases: progress since 2009.

Neglected tropical diseases (NTDs) is an umbrella term for a diverse group of debilitating infections that represent the most common afflictions for 2.7 billion people living on less than US$2 per day. Major efforts have recently re-focused attention on NTDs, including structured advocacy by the Bill and Melinda Gates Foundation, technical and political support by WHO and large-scale drug donation programs by pharmaceutical companies. An analysis of the Official Development Assistance (ODA) for NTDs in 2009 showed that Development Assistance Committee members and multilateral donors had largely ignored funding NTD control projects. This study reviews the changes since 2009 and finds an increased engagement by pharmaceutical manufacturers through drug donation programs substantially increased by the 'London Declaration' in 2012, a focused effort of 77 public and private partners on control or elimination of the 10 most common NTDs, but no increase in ODA for NTDs between 2008 and 2012. The allocation of ODA still does not reflect the respective importance of these diseases.

Aboriginal Populations and Their Neglected Tropical Diseases

Although Aboriginal people make up a small percentage of the worlds population, they are disproportionately affected by poverty and neglected tropical diseases (NTDs). Unless prioritized, Aboriginal populations may be the last to receive access to essential medicines as part of global NTD elimination efforts. An estimated 370 million people are today classified as belonging to Indigenous or Aboriginal groups [1], [2]. According to Gracey and King, included among the major criteria defining these populations are self-identification as belonging to an Indigenous group historical ties to specified geographic areas and natural resources, frequently followed by external invasion or colonization a distinct culture with beliefs and ceremonies and resolve to maintain ancestral environments and manage their own affairs [1]. However, there is not universal agreement on what constitutes an Aboriginal group, leading in some cases to exclusion or further marginalization [1]. As a whole, Aboriginal populations are disproportionately impoverished, accounting for 15 of global poverty even though they comprise only 5 of the global population [3]. Poverty, especially rural poverty, and its associated poor housing and sanitation, environmental degradation, inadequate or improper nutrition, forced migrations, and lack of access to health care, combine and synergize to create a number of adverse health consequences for Aboriginal populations [1], [2]. These include a spectrum of non-communicable diseases such as diabetes, obesity, hypertension, and cardiovascular disease (frequently related to tobacco consumption), as well as interpersonal violence and suicide often linked to alcohol and drugs [1], [2]. Aboriginal populations are also disproportionately affected by infectious diseases, especially infections of the skin (e.g., impetigo and tungiasis), eye (e.g., trachoma), and ear (e.g., acute and chronic otitis), dental caries, respiratory and urinary tract infections, and diarrheal diseases [1]. Neglected tropical diseases (NTDs) are especially common among Aboriginal populations. Shown in Table 1 are five representative groups of Aboriginal peoples and their major NTDs. The most common NTDs are intestinal helminth and protozoan infections zoonotic parasitic infections neglected bacterial infections such as trachoma, leprosy, and yaws and a number of important vector-borne illnesses, including malaria and dengue. Many, but not all, are included in the list of 17 NTDs as defined by the World Health Organization [4]; others are on the expanded list of diseases as defined by PLOS Neglected Tropical Diseases [5]. Table 1 Major Aboriginal populations and their neglected tropical diseases (NTDs).

Global trends in neglected tropical disease control and elimination: impact on child health

The neglected tropical diseases (NTDs) are a group of 17 lesser known chronic infections which predominantly affect poor and disenfranchised communities. There are a number of NTDs that cause significant...

The global burden of neglected tropical diseases

The first comprehensive study on the global burden of disease and risk factors was commissioned by the World Bank in 1992. A follow-up study was performed in 2005, and another iteration was commissioned by the World Health Organization in 2010, due for publication in 2011. The author suggests that the global burden of neglected tropical diseases (NTDs) has been seriously underestimated. The way forward is the integration of control efforts, with programmes coming together to deliver a package of drugs against NTDs. Barriers to continent-wide coverage of drugs against NTDs are political will (missing in those countries with poor governance), funding (approximately half of the $1.5-2 billion is needed) and human resources. However, if the donors who give so much to malaria, tuberculosis and human immunodeficiency virus would share just 10% of the amount allocated to the big three, the most common NTDs could become diseases of the past. This could well happen within 7 years, and the targets of GET2020 (Global Elimination of Trachoma by 2020) to eliminate trachoma and GAELF (the Global Alliance to Eliminate Lymphatic Filariasis) to eliminate lymphatic filariasis by 2020 are achievable.

An Interfaith Dialogue on the Neglected Tropical Diseases

An Interfaith Dialogue on the Neglected Tropical Diseases

Enlarging the “Audacious Goal”: Elimination of the world's high prevalence neglected tropical diseases

The high prevalence neglected tropical diseases (NTDs) exhibit a global disease burden that exceeds malaria, tuberculosis, and other better known global health conditions; they also represent a potent force in trapping the world's poorest people in poverty. Through extremely low cost national programs of disease mapping and mass drug administration (MDA) for the seven most common NTDs, integrated NTD control and elimination efforts are now in place in more than 14 countries through the support of the United States Agency for International Development (USAID), the British Department for International Development (DFID), and the Global Network for NTDs and its partners. The World Health Organization (WHO) estimates that in 2008 some 670 million people in 75 countries received NTD treatments through these and other sponsored programs. With continued successes the next decade could witness the global elimination of blinding trachoma, human Africa trypanosomiasis (HAT), lymphatic filariasis (LF), onchocerciasis, trachoma, and leprosy as public health problems, in addition to the eradication of dracunculiasis. For other high prevalence NTDs, including hookworm infection, schistosomiasis, Chagas disease and leishmaniasis, new drugs and vaccines may still be required. Increasingly it is recognized that the high prevalence NTDs exhibit extensive geographic overlap and polyparasitism is commonly found throughout the world's low income countries. Therefore, global elimination will also require integrated packages of drugs together with vaccine-linked chemotherapy. Ultimately, the global elimination of the high prevalence NTDs will require continued large-scale support from the U.S. Government and selected European governments, however, the emerging market economies, such as Brazil, China, India, Mexico, and Nigeria, and wealthy countries in the Middle East will also have to substantially contribute.

Unleashing “Civilian Power”: A New American Diplomacy through Neglected Tropical Disease Control, Elimination, Research, and Development

In a November/December 2010 article published in the influential journal Foreign Affairs, United States Secretary of State Hilary Rodham Clinton articulated a new vision for American diplomacy and development through the strengthening of what she terms ‘‘civilian power’’ [1]. Stated briefly, the new doctrine calls for the creation of a new cadre of civilian experts who could jointly pursue diplomacy and international development for purposes of solving global challenges related to health, agriculture and food insecurity, environmental degradation, drugs and organized crime, energy, and climate change [1]. Through joint programs between the US Department of State and its United States Agency for International Development (USAID) and the additional hiring of more than 1,000 Foreign and Civil Service Officers in each organization, and reflecting the results of a new Quadrennial Diplomacy and Development Review, in the coming years the State Department and USAID would now work more closely to enhance global development in the context of diplomacy. The world’s conflict and post-conflict zones and fragile states would represent key targets for international development efforts [1]. In this new doctrine, Secretary Clinton proposes that together the State Department and USAID would establish a premier global civilian service for responding to complex diplomatic and development challenges [1]. Achieving such an ambitious goal would also mandate that USAID look beyond its walls to embrace business, philanthropist, and citizen groups, with dual emphases on partnering with some of the large emerging market economies (EMEs), i.e., China, India, Indonesia, Nigeria, Pakistan, Russia, and South Africa, for joint problem solving, and harnessing selected technologies, such as rapidly expanding cell phone access, for establishing a sustainable and lasting impact [1]. The control and elimination of the world’s major neglected tropical diseases (NTDs) represents a substantive global health and economic challenge, yet one that with a well-coordinated assault in the mode as proposed by Secretary Clinton could become the first major victory for civilian power. The NTDs are the most common infections of the world’s poor, and almost all of the ‘‘bottom billion,’’ i.e., the 1.4 billion people, who live on no money, are infected with one or more NTD [2,3]. In addition to causing a level of global disability that compares with that of HIV/AIDS or malaria, NTDs actually cause poverty through their ability to impair child development, pregnancy outcomes, and agricultural productivity and food security [3]. These diseases also destabilize communities and promote civil and international conflicts [4]. There are a number of reasons why taking on the NTDs would be a worthy early first test for civilian power. It is now possible to control or in some cases eliminate one or more of the seven most common NTDs, i.e., ascariasis, hookworm infection, trichuriasis, schistosomiasis, lymphatic filariasis, onchocerciasis, and trachoma, through mass drug administration using a ‘‘rapid impact package’’ of drugs that are either donated by the major pharmaceutical companies or available as low cost generics and administered as a part of national control programs [2,3,5]. Mass drug administration for NTDs through rapid impact is one of the lowest cost and cost-efficient mechanisms for both improving maternal child health [6] and lifting the bottom billion out of poverty [3]. The United States government (USG), through its Global Health Initiative (GHI) and USAID’s NTD Program, is already providing financial support for 12 national NTD programs, more than all other countries combined, with additional programs scheduled in the coming years [7]. With assistance from the Department of State, the USAID NTD Program can now reach out to the major EMEs listed above in order to join forces on global NTD control efforts. A USAID–EMEs link makes sense on two fronts: First, it has already been noted that Nigeria has the largest number people infected with the seven NTDs among the sub-Saharan African countries, while South Africa suffers from high rates of some of the soil-transmitted helminth infections and schistosomiasis [8]. Similarly, China, India, Indonesia, and Pakistan have the largest number of ascariasis, trichuriasis, hookworm, lymphatic filariasis, and trachoma cases, as well as other NTDs such as leprosy in Asia [9,10]. Working jointly with experts from USAID and other branches of the USG and GHI, a focused effort on NTDs in the EMEs could ultimately double the total number of at-risk populations receiving rapid impact packages. In addition, China invests billions of dollars in sub-Saharan Africa annually and could also make substantial contributions

New Antipoverty Drugs, Vaccines, and Diagnostics: A Research Agenda for the US President's Global Health Initiative (GHI)

On May 5, 2009, the Obama Administration announced its intention to launch an ambitious United States governmental strategy for global health [1–3]. The US Global Health Initiative (GHI) proposes US$63 billion over 6 years (FY 2009–FY 2014), US$10.5 billion annually on average, approximately 70% of which would be spent on the US President’s Emergency Plan for AIDS Relief (PEPFAR) [1]. If appropriated each year by Congress, the GHI would represent a significant response to calls by the Institute of Medicine of the National Academies for the US government (USG) to invest US$15 billion annually on development assistance for global health by 2012 [3]. In its current form, most of GHI is devoted to direct implementation of existing treatments and preventive interventions for the ‘‘big three diseases,’’ i.e., HIV/ AIDS, malaria, and tuberculosis, especially the delivery of antiretroviral drugs and other prevention measures, antimalarial drugs and bednets, and direct observed therapy, respectively, as well as other critical interventions to improve maternal and child health and strengthen health systems [1,3]. There is also an unprecedented commitment to provide treatments for the neglected tropical diseases (NTDs), with US$65 million committed in FY2010 for rapid impact packages and related measures targeting the seven most common NTDs, which comprise the most prevalent infections affecting the world’s poor [4–8].

Parasitic Diseases: Chemotherapy with a Twist

The neglected tropical diseases (NTDs) consist of a group of parasitic and bacterial infections that affect 120% of the world’s current population. Up to 90% of those affected live in remote, rural areas or in urban slums in Africa, Asia, and Latin America, areas that are characterized by a vicious circle of sustained poverty and endemic diseases that makes people unable to care for themselves. The overall aim of the Millennium Development Goals approach [1] is to lift 1 billion of the least privileged people out of such situations, promising substantial benefits for vulnerable populations around the world. Control of the NTDs is a critical component of this endeavour and should be dealt with at an early stage, because it would have immediate knock-on effects on other health-related conditions, such as malaria morbidity and human immunodeficiency virus transmission. Soon after the creation of the People’s Republic of China, Chairman Mao Zedong initiated his celebrated campaign against the most common NTDs by famously attacking the snail, which is the intermediate host of schistosomiasis, in his poem “Farewell to the God of Plague” [2].

The Neglected Tropical Diseases and Their Devastating Health and Economic Impact on the Member Nations of the Organisation of the Islamic Conference

Founded in 1969, the Organisation of the Islamic Conference (OIC) is comprised of 57 nations that together represent the second largest international organization after the United Nations [1]. According to their Web site, the OIC serves as the “collective voice of the Muslim world,” both protecting its interests and settling conflicts and disputes between member states [1]. In addition to several important and prosperous oil- and gas-producing nations in the Middle East, the OIC nations also include some of the world's poorest countries as well as large middle-income countries with regions of great poverty (Figure 1). In these geographic areas of poverty are also found some of the highest infection rates and endemicity of the neglected tropical diseases (NTDs). Shown in Table 1 is the estimated prevalence of six of the most common NTDs among the most populous OIC member states [2]–[8]. Each of the 28 countries listed has a population that exceeds 10 million people; together they account for more than 90% of the populations living in the OIC.