Neglected Tropical Diseases Research Articles

Factors Associated with the Knowledge, Attitudes, and Practices of Primary Healthcare Workers Regarding Neglected Tropical Diseases with Skin Manifestations in the Dakar Region, Senegal, 2022

Neglected tropical diseases (NTDs) with skin manifestations present a significant health and societal problems challenge worldwide. This study aimed to analyzed factors associated with the knowledge, attitudes and practices (KAPs) of primary healthcare workers (HCW) concerning NTDs with skin manifestations in the Dakar region of Senegal. We conducted a cross-sectional study utilizing a semi-structured questionnaire which was administered to eligible HCW (general practitioners, nurses and midwives) working at the 24 health centers located in the Dakar region. Data were collected using the ODK Collect application (version 2022.3.6). KAPs measures were constructed from questionnaire responses, and bivariate analysis was used to identify associated factors. Of the 187 HCW surveyed, 75.9% were female, with a mean age of 35.1 years (SD: 8.56). The majority of HCWs had a bachelor’s degree (40.6%), were nurses (49.2%) and had between 1- and 10-years of professional experience (52.4%). Regarding their knowledge of NTDs with skin manifestations, only 43.3% of HCW had received initial training on NTDs. The most commonly reported NTDs with skin manifestations were leprosy (53.5%), lymphatic filariasis (51.3%), scabies (49.7%), onchocerciasis (45.5%) and schistosomiasis (42.8%). Television was the main source of information about these NTDs (38.5%). In term of practices, only 47.6% of HCW reported being able to diagnose NTDs with skin. Factors associated with good knowledge regarding NTDs with skin manifestations included having received training on NTDs (p = 0.0015) and more years of professional experience (p = 0.004). In summary, there is a need to strengthen and raise awareness about NTDs with skin manifestations among HCWs and promote quality management of patients in Senegal.

Development of an automated artificial intelligence-based system for urogenital schistosomiasis diagnosis using digital image analysis techniques and a robotized microscope.

Urogenital schistosomiasis is considered a Neglected Tropical Disease (NTD) by the World Health Organization (WHO). It is estimated to affect 150 million people worldwide, with a high relevance in resource-poor settings of the African continent. The gold-standard diagnosis is still direct observation of Schistosoma haematobium eggs in urine samples by optical microscopy. Novel diagnostic techniques based on digital image analysis by Artificial Intelligence (AI) tools are a suitable alternative for schistosomiasis diagnosis. Digital images of 24 urine sediment samples were acquired in non-endemic settings. S. haematobium eggs were manually labeled in digital images by laboratory professionals and used for training YOLOv5 and YOLOv8 models, which would achieve automatic detection and localization of the eggs. Urine sediment images were also employed to perform binary classification of images to detect erythrocytes/leukocytes with the MobileNetv3Large, EfficientNetv2, and NasNetLarge models. A robotized microscope system was employed to automatically move the slide through the X-Y axis and to auto-focus the sample. A total number of 1189 labels were annotated in 1017 digital images from urine sediment samples. YOLOv5x training demonstrated a 99.3% precision, 99.4% recall, 99.3% F-score, and 99.4% mAP0.5 for S. haematobium detection. NasNetLarge has an 85.6% accuracy for erythrocyte/leukocyte detection with the test dataset. Convolutional neural network training and comparison demonstrated that YOLOv5x for the detection of eggs and NasNetLarge for the binary image classification to detect erythrocytes/leukocytes were the best options for our digital image database. The development of low-cost novel diagnostic techniques based on the detection and identification of S. haematobium eggs in urine by AI tools would be a suitable alternative to conventional microscopy in non-endemic settings. This technical proof-of-principle study allows laying the basis for improving the system, and optimizing its implementation in the laboratories.

Global Health Priority Box─Proactive Pandemic Preparedness.

The coronavirus pandemic outbreak of 2019 highlighted the critical importance of preparedness for current and future public health threats (https://www.mmv.org/mmv-open/global-health-priority-box/about-global-health-priority-box). While the main attention for the past few years has been on COVID-19 research, this focus has reduced global resources on research in other areas, including malaria and neglected tropical diseases (NTDs). Such a shift in focus puts at risk the hard-earned progress in global health achieved over the past two decades (https://www.who.int/news-room/spotlight/10-global-health-issues-to-track-in-2021). To address the urgent need for new drugs to combat drug-resistant malaria, emerging zoonotic diseases, and vector control, Medicines for Malaria Venture (MMV) and Innovative Vector Control Consortium (IVCC) assembled a collection of 240 compounds and, in August 2022, launched the Global Health Priority Box (GHPB). This collection of compounds has confirmed activity against emerging pathogens or vectors and is available free of charge. This valuable tool enables researchers worldwide to build on each other's work and save precious time and resources by providing a starting point for the further development of treatments and insecticides. Furthermore, this open access box aligns with two of the many priorities outlined by the World Health Organization (WHO) (https://www.who.int/news-room/spotlight/10-global-health-issues-to-track-in-2021).

The Prospects of Phytomedicines and Nanomedicines to Treat Leishmaniasis: A Comprehensive Review.

The global shift in lifestyle has prompted health agencies to redirect their focus from poverty-related diseases to the emergence of lifestyle diseases prevalent in privileged regions. As a result, these diseases have been labeled as "neglected diseases," receiving limited research attention, funding, and resources. Neglected Tropical Diseases (NTDs) encompass a diverse group of vector-borne protozoal diseases that are prevalent in tropical areas worldwide. Among these NTDs is leishmaniasis, a disease that affects populations globally and manifests as skin abnormalities, internal organ involvement, and mucous-related abnormalities. Due to the lack of effective and safe medicines and vaccines, it is crucial to explore alternative resources. Phytomedicine, which comprises therapeutic herbal constituents with anti-leishmanial properties, holds promise but is limited by its poor physicochemical properties. The emerging field of nanomedicine has shown remarkable potential in revitalizing the anti-leishmanial efficacy of these phytoconstituents. In this investigation, we aim to highlight and discuss key plant constituents in combination with nanotechnology that have been explored in the fight against leishmaniasis.

A canine onchocercosis report from the portuguese west region in 2024: implications for Public Health

Abstract Issue/problem Onchocerca lupi parasitosis, known as onchocercosis, affects dogs, sporadically cats and humans, posing a public health concern due to possible vectors in the environment. This neglected tropical disease(NTD), has no known human cases outside endemic areas. However, recent reports in non-endemic areas raise concerns about future implications. Climate change has increased the potential risk of disease vectors establishing themselves in previously unaffected areas. Description of the problem A case of canine onchocercosis in the West Region of Portugal, made the pet owner look for medical counselling. Primary health care providers contacted the Public Health Unit(PHU) for guidance and actions. There had been no previous reports in this region. In this case report, we explore the potential public health implications, through a one-health approach. Results History of the disease was collected, and travel history of the dog revealed that he had lived in the Algarve during 11 years with only a one-and-a-half-month travel to Italy in this period. Literature review revealed reports of previous cases of oncochercosis in the Iberian Peninsula. Collaboration between the PHU, research institutes, and veterinary authorities led to the assumption of probable transmission in the Algarve. Lessons Increased vector surveillance is needed, especially in areas associated with animal onchocercosis. Proactive measures reduce transmission risks, protecting both humans and animals. Tracking animal cases is vital for understanding regional environmental factors. PHU’s must conduct thorough risk evaluations and maintain assertive risk communication strategies to address public and pet owner concerns effectively. Adopting a One Health approach improves the understanding of the disease dynamics and enables targeted interventions. Key messages • NTD’s transmitted by vectors pose a potential future challenge. This report underscores the need for a One Health approach, with collaborative multidisciplinary efforts to address these challenges. • Furthermore, systematic interaction and reporting between human, animal, and environmental health authorities are crucial to ensure comprehensive surveillance and mitigation strategies.

Leishmaniasis in Humans and Animals: A One Health Approach for Surveillance, Prevention and Control in a Changing World

Leishmaniasis is classified as a neglected tropical disease (NTD), caused by protozoan parasites of the genus Leishmania, which are transmitted to humans and other animals through the bite of infected female phlebotomine sandflies. There are three forms of the disease: cutaneous leishmaniasis (CL) manifested by ulcers and scars; systemic or visceral leishmaniasis (VL), which can lead to life-threatening complications if left untreated; and mucocutaneous leishmaniasis (MCL), which can destroy the mucous membranes of the nose, mouth and throat. Human leishmaniasis is endemic in many countries across Africa, Asia, Southern Europe, the Middle East, and Central and South America. The interconnection of environmental, animal and human health underlies the spread of the Leishmania parasite. Environmental disruptions, such as climate change, deforestation or urbanisation, but also globalisation and migration, significantly affect the distribution and abundance of sand fly vectors and reservoir hosts. Climate change alters the breeding patterns of sandflies and expands their geographic range; deforestation and misuse of large areas disrupt ecosystems, leading to increased human-vector contact; and urbanisation increases the potential for contact between parties, particularly in densely populated areas. Migration of humans and animals, either through natural migration or, for example, the pet trade and breeding, can facilitate the spread of Leishmania parasites. In addition, socio-economic factors, including poverty and lack of access to healthcare, increase the burden of leishmaniasis in vulnerable populations. Due to this multitude of reasons, the geographic distribution of sandflies has expanded to higher latitudes and altitudes in recent years, with a consequent increase in disease burden. Indeed, despite ongoing challenges in the surveillance systems, data from the last available year have shown an increase in many cases in both humans and dogs. This perspective explores the interconnected factors influencing the spread of leishmaniasis worldwide and the epidemiology of the disease. In addition, it illustrates the importance of integrated strategies in a One Health approach: surveillance, prevention and control of vectors, animals and humans.

Characteristics of Diseases in Developing Countries

In the urgent realm of global health, it is imperative to acknowledge and promptly address the distinct characteristics of diseases that afflict developing countries. These nations face a unique set of challenges that contribute to the burden of illness and significantly impact the quality of life for their populations. By promptly exploring the key features of diseases in developing countries, we can better understand the complex interplay between socioeconomic factors and health outcomes [1]. One of the primary characteristics of diseases in developing countries is their disproportionate impact on vulnerable populations. Socio-economic disparities, limited access to healthcare, inadequate sanitation infrastructure, and poor nutrition contribute to the heightened susceptibility of marginalized communities to preventable infectious diseases such as hydatid cysts, malaria, tuberculosis, and diarrheal illnesses. The lack of resources and infrastructure further exacerbates the spread of these diseases, creating a cycle of sickness and poverty [2,3]. Furthermore, the prevalence of neglected tropical diseases (NTDs) is a defining feature of the disease landscape in developing countries. These illnesses, which include dengue fever, Chagas disease, and schistosomiasis, predominantly affect populations in low-resource settings and often go unnoticed on the global health agenda. The burden of NTDs is compounded by limited funding for research and treatment, leaving affected communities without adequate support and interventions [4]. In addition to infectious diseases, non-communicable diseases (NCDs) are on the rise in developing countries, posing a dual burden of illness alongside contagious diseases. Factors such as urbanization, lifestyle changes, and an aging population contribute to the increasing prevalence of conditions like cardiovascular diseases, diabetes, and cancer. The inadequate healthcare infrastructure in many developing countries further hinders NCDs' prevention, diagnosis, and management, leading to poorer health outcomes for those affected [5]. Addressing the characteristics of diseases in developing countries requires a multi-faceted approach that encompasses strengthening the healthcare system, investing in public health infrastructure, and, most importantly, providing equitable access to essential medicines. By ensuring fair access to these medicines, we can work towards achieving health equity and reducing the burden of disease in developing countries.

Opportunities and challenges in utilizing community assets to extend chronic care management in podoconiosis endemic areas: Evidence from Northwestern Ethiopia.

Community-based chronic care intervention is important in the control and prevention of lifelong conditions such as podoconiosis and similar 'intensive disease management' neglected tropical diseases (NTDs). Despite a call for such interventions, few efforts have been made to identify opportunities and challenges related to their implementation. Employing a qualitative approach, this study explored the possibility of engaging community actors, physical places and networks to promote chronic care management in rural Ethiopia. We gathered data from affected individuals, community members, local leaders, health professionals and community health workers between April and May 2022. The study revealed that affected individuals, family members, religious leaders, traditional leaders, and health professionals have the potential to extend chronic care management in rural areas. Houses, churches, schools, and healthcare facilities are suitable venues at which to perform interventions. Strong community solidarity and political will are vital to chronic care interventions, while lack of understanding about chronic conditions, financial constraints, and limited resources at healthcare facilities could pose challenges. Using community assets has great promise for expanding chronic care management with minimal costs and efforts in under resourced areas. Achieving this will require a successful plan to coordinate the collaboration among the agents and settings.

Mammary Schistosomiasis: Malignancy Mimicker or More?

Abstract Introduction/Objective Schistosomiasis is a neglected tropical disease (NTD) which affects more than 200 million people worldwide, with approximately 85% of cases occurring in sub-Saharan Africa. It serves both as an important etiologic agent in the development of carcinomas of many organ systems, as well as a common incidental histological finding in various organs, including the prostate, lung, spine, and liver. Detection of Schistosoma ova in the breast is rare. Here, we present a case of schistosomiasis of the breast in a patient concurrently diagnosed with breast carcinoma of the contralateral breast. Methods/Case Report A 48-year-old Mozambican female presented with a right breast mass, with suspicious microcalcifications detected in the contralateral breast on mammography. Biopsy confirmed invasive ductal carcinoma of no special type (NST) in the right breast and identified Schistosoma ova in the left, notably lacking an associated inflammatory response. A Ziehl-Neelsen special histochemical stain was negative, favoring schistosoma Hematobium species. Results (if a Case Study enter NA) NA Conclusion Our case marks the first in English literature where schistosomiasis was identified in the context of contralateral breast carcinoma, posing the question as to whether there is an association between schistosomiasis and breast carcinoma in our patient. One possible theory suggests hyperestrogenism secondary to Schistosoma infection in the liver. Breast schistosomiasis presenting as microcalcifications poses a diagnostic challenge, as it may clinically and radiologically resemble malignant breast disease. Histopathological diagnosis is crucial to confirm the diagnosis and prevent unnecessary procedures. Contrary to other organ systems, our case highlighted that schistosomiasis in the breast may not be accompanied by any inflammatory response. Definitive conclusions regarding the exact species of schistosomiasis cannot be drawn histologically based solely on H&E findings due to the plane of sectioning; therefore, performing a Ziehl-Neelsen stain is beneficial. As screening mammography increases in endemic areas, a high index of suspicion and further research is warranted.

Diagnosing skin neglected tropical diseases with the aid of digital health tools: A scoping review.

Delays in diagnosis and detection of skin neglected tropical diseases (NTDs) pose obstacles to prompt treatment, which is crucial in preventing disability. Recent developments in digital health have given rise to approaches that could increase access to diagnosis in resource-poor areas affected by skin NTDs. This scoping review provides an overview of current digital health approaches that aim to aid in the diagnosis of skin NTDs and provides an insight into the diverse functionalities of current digital health tools, their feasibility, usability, and the current gaps in research around these digital health approaches. This scoping review included a comprehensive literature search on PubMed, EMBASE and SCOPUS, following the PRISMA guidelines. Eleven studies were included in the review and were analysed using a descriptive thematic approach. Most digital tools were found to be mobile-phone based, such as mobile Health (mHealth) apps, store-and-forward tele-dermatology, and Short Messaging Service (SMS) text-messaging. Other digital approaches were based on computer software, such as tele-dermatopathology, computer-based telemedicine, and real-time tele-dermatology. Digital health tools commonly facilitated provider-provider interactions, which helped support diagnoses of skin NTDs at the community level. Articles which focused on end-user user experience reported that users appreciated the usefulness and convenience of these digital tools. However, the results emphasized the existing lack of data regarding the diagnostic precision of these tools, and highlighted various hurdles to their effective implementation, including insufficient infrastructure, data security issues and low adherence to the routine use of digital health tools. Digital health tools can help ascertain diagnosis of skin NTDs through remote review or consultations with patients, and support health providers in the diagnostic process. However, further research is required to address the data security issues associated with digital health tools. Developers should consider adapting digital health tools to diverse socio-cultural and technical environments, where skin NTDs are endemic. Researchers are encouraged to assess the diagnostic accuracy of digital health tools and conduct further qualitative studies to inform end-user experience. Overall, future studies should consider expanding the geographical and disease scope of research on digital health tools which aid the diagnosis of skin NTDs.

Transition and change: opportunities and challenges of CHW programme reform for community health systems and vertical disease programmes in Liberia

BackgroundGlobally, community health worker (CHW) programmes are critical to addressing health worker shortages and have been recognised as critical pillars within the drive towards universal health coverage (UHC). In 2016, the Liberian Ministry of Health launched the National Community Health Services Policy 2016–2021, which included significant CHW programme reform to address ongoing health workforce capacity gaps in the country. However, little consideration was given to the impact of such reforms on ongoing health interventions that rely heavily on the use of CHW cadres. Our study explores how CHW programme reform in Liberia influenced performance of CHWs involved in the delivery of Neglected Tropical Disease (NTD) programmes to elucidate how health systems reform can impact the delivery of routine health interventions and vice versa.MethodsWe used a qualitative case study approach conducted between March 2017 and August 2018. Our instrumental case study approach uses qualitative methods, including document review of five CHW and NTD program-related policy documents; 25 key informant interviews with facility, county, and national level decision-makers; and 42 life and job histories with CHWs in Liberia. Data were analysed using a thematic framework approach, guided by Kok et al. framework of CHW performance. Data were coded in QRS NVIVO 11 Pro.ResultsOur findings show that CHW programme reform provides opportunities and challenges for supporting enhanced CHW performance. In relation to health system hardware, we found that CHW programme reform provides better opportunities for: formal recognition of CHWs; strengthening capacity for effective healthcare delivery at the community level through improved and formalised training; a more formal supervision structure; and provision of monthly incentives of 70 US dollars. Efficiency gaps in routine intervention delivery can be mitigated through the strengthening of these hardware components. Conversely, supervision deficits in routine CHW functioning can be supported through health interventions. In relation to systems software, we emphasise the ongoing importance of community engagement in CHW selection that is responsive to gendered power hierarchies and accompanied by gendered transformative approaches to improving literacy.ConclusionsThis study shows how CHW programme reform provides opportunities and challenges for health system strengthening that can both positively and negatively impact the functioning of routine health interventions. By working together, CHW programmes and routine health interventions have the opportunity to leverage mutually beneficial support for CHWs, which can enhance overall systems functioning by enhancing CHW performance.

Effective community-based interventions to prevent and control infectious diseases in urban informal settlements in low- and middle-income countries: a systematic review

BackgroundThe impact of rapid urbanization taking place across the world is posing variegated challenges. Especially in terms of communicable disease, the risk is more concentrated in urban poor areas where basic amenities are inadequate. This systematic review synthesizes evidence on the effective community-based interventions (CBIs) aimed at preventing and controlling infectious diseases among the urban poor in low- and middle-income countries (LMICs).MethodsThis systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. A comprehensive search across five major databases was conducted to capture literature on CBIs published between 2011 and 2021. Scientific articles of any design that reported any type of CBIs effective in preventing and controlling infectious diseases (tuberculosis, diarrhea, typhoid, dengue, hepatitis B and C, influenza, and COVID-19) were included. Screening and selection of studies were done by two pairs of independent researchers using the predefined eligibility criteria. The risk of bias in included studies was assessed using the modified checklist outlined in the Cochrane Handbook for Systematic Reviews of Interventions and Effective Public Health Practice Project (EPHPP). Analysis of effective CBIs was guided by the conceptual framework for integrated CBIs for neglected tropical diseases (NTDs), and narrative synthesis was carried out. Geographical restrictions were limited to LMICs and papers published in English.ResultsOut of 18,260 identified papers, 20 studies met the eligibility criteria and were included in this review. Community-based screening and socio-economic support, community-based vector control, behavior change communication, capacity building of the community health workers (CHWs), health education, and e- and m-health interventions were found as effective CBIs. Diversified CBIs were found to be effective for specific diseases, including tuberculosis (TB), diarrhea, dengue, influenza and ARI, and hepatitis B and C. Bundling of interventions were found to be effective against specific diseases. However, it was difficult to isolate the effectiveness of individual interventions within the bundle. The socio-cultural context was considered while designing and implementing these CBIs.ConclusionThe effectiveness of an intervention is inextricably linked to social context, stakeholder dimensions, and broader societal issues. System approach is recommended, emphasizing context-specific, multi-component interventions that address social determinants of health. Integrating these interventions with public health strategies and community involvement is crucial for sustainable outcomes. These findings can guide the design of future interventions for better prevention and control of communicable diseases in urban poor areas.Systematic review registrationPROSPERO CRD42021278689.

An integrated active case detection and management of skin NTDs in yaws endemic health districts in Cameroon, Côte d'Ivoire and Ghana.

Integrated approaches to mapping skin Neglected Tropical Diseases (NTDs) may be cost-effective way to guide decisions on resource mobilization. Pilot studies have been carried out, but large-scale data covering multiple countries endemic for skin NTDs are lacking. Within the LAMP4YAWS project, we collected integrated data on the burden of multiple skin NTDs. From March 2021 to March 2023, integrated case searches for yaws alongside other skin conditions were performed in endemic health districts of yaws in Cameroon, Côte d'Ivoire, and Ghana. Integrated activities included training, social mobilization and active case detection. Initial screening involved a brief clinical examination of participants to determine if any skin conditions were suspected. Cases of skin NTDs were then referred to a health facility for appropriate management. Overall 61,080 individuals screened, 11,387 (18.6%) had skin lesions. The majority of individuals (>90%) examined were children aged 15 years old and under. The proportion of serologically confirmed yaws cases was 8.6% (18/210) in Cameroon, 6.8% (84/1232) in Côte d'Ivoire, and 26.8% (440/1643) in Ghana. Other skin conditions based on clinical examination included: scabies, Buruli ulcer, leprosy, lymphatic filariasis (lymphoedema and hydrocele), tungiasis, and fungal infections. The most common conditions were scabies and superficial fungal infections. In Cameroon, scabies and superficial fungal infections accounted for 5.1% (214/4204) and 88.7% (3730/4204) respectively, 25.2% (1285/5095) and 50.4% (2567/5095) in Côte d'Ivoire. In Ghana, 20% (419/2090) of individuals had scabies but superficial fungal infections were not routinely recorded and were reported in only 1.3% (28/2090). Other skin NTDs were less common across all three countries. This study confirms that integrated screening allows simultaneous detection of multiple skin NTDs, maximising use of scarce resources.

Neglected Tropical Diseases in India: Enhancing POC based Diagnosis towards Elimination

Neglected tropical diseases (NTDs) represent a significant global health challenge, particularly in regions with limited access to healthcare and sanitation facilities. India, with its vast population and diverse landscape, faces a substantial burden of NTDs, including lymphatic filariasis (LF), visceral leishmaniasis (VL), and dengue along with other coinfections. The Government of India has undertaken various initiatives to eliminate these diseases, aligning with global objectives. However, challenges persist, including the need for accurate disease burden estimation, resource allocation, and disease diagnosis.Efforts to eliminate NTDs in India require comprehensive strategies, including mass drug administration and vector control programs. Thus, accurate and accessible diagnostic tools are essential for disease surveillance and treatment monitoring. Point-of-care testing including molecular and serological-based techniques facilitates swift diagnosis and disease surveillance, particularly in resource-limited settings. Thus, by prioritizing investments in innovative diagnostic and therapeutic strategies, India can make significant strides toward improving patient survival and decrease mortality rates.

Harnessing the Power of Curcumin: Evaluating Its Efficacy as an Antileishmanial Agent in the Fight Against Leishmaniasis

Over 100 countries are impacted by the dangerous parasite disease leishmaniasis, which is categorized as a neglected tropical disease (NTD). Protozoan parasites use sandflies and other vectors to spread the disease. Herbal compounds like turmeric curcumin have demonstrated promise in the treatment of parasitic illnesses despite their limited bioavailability and water solubility. From small, self-healing skin lesions to serious intestinal infections, leishmaniasis can cause a wide range of illnesses in humans. Since there isn’t a gold standard test for one type, mucocutaneous leishmaniasis (MCL), it can be difficult to diagnose. Treatments for MCL can be quite harmful, which emphasizes how crucial a correct diagnosis. This study aims to assess the diagnostic performance of PCR (polymerase chain reaction) for MCL and to compare the findings with the authors’ most recent clinical research findings.

Combination Therapy and Phytochemical-Loaded Nanosytems for the Treatment of Neglected Tropical Diseases

Background: Neglected tropical diseases (NTDs), including leishmaniasis, trypanosomiasis, and schistosomiasis, impose a significant public health burden, especially in developing countries. Despite control efforts, treatment remains challenging due to drug resistance and lack of effective therapies. Objective: This study aimed to synthesize the current research on the combination therapy and phytochemical-loaded nanosystems, which have emerged as promising strategies to enhance treatment efficacy and safety. Methods/Results: In the present review, we conducted a systematic search of the literature and identified several phytochemicals that have been employed in this way, with the notable efficacy of reducing the parasite load in the liver and spleen in cases of visceral leishmaniasis, as well as lesion size in cutaneous leishmaniasis. Furthermore, they have a synergistic effect against Trypanosoma brucei rhodesiense rhodesain; reduce inflammation, parasitic load in the myocardium, cardiac hypertrophy, and IL-15 production in Chagas disease; and affect both mature and immature stages of Schistosoma mansoni, resulting in improved outcomes compared to the administration of phytochemicals alone or with conventional drugs. Moreover, the majority of the combinations studied demonstrated enhanced solubility, efficacy, and selectivity, as well as increased immune response and reduced cytotoxicity. Conclusions: These formulations appear to offer significant therapeutic benefits, although further research is required to validate their clinical efficacy in humans and their potential to improve treatment outcomes in affected populations.

Breaking the silence of female genital schistosomiasis in Ghana's health system: A case of health workers within the FAST project.

Female Genital Schistosomiasis (FGS) remains a critical and yet neglected topics in Neglected Tropical Diseases (NTDs), significantly affecting the health of women and girls worldwide. Health workers' knowledge of FGS is vital to the prevention and management of the disease. This study adopted an implementation research approach to identify and address the existing knowledge gap regarding FGS among healthcare workers in Ghana. This study was a 3-year (2020-2022) implementation research applying a pragmatic uncontrolled quasi-experimental study design. The study involved a baseline assessment, FGS training intervention for health workers and student nurses, distribution of FGS educational materials, and an endline assessment. A mixed-method approach was applied to data collection involving health workers from two schistosomiasis endemic districts and across the country. NVIVO 12 and STATA 14 were used for qualitative and quantitative data analysis, respectively. Prior to the intervention, the level of awareness about FGS among health workers was less than 8%, and most participants only understood FGS as merely urogenital schistosomiasis in females. In response to this gap, an FGS education intervention in the form of training of health workers, student nurses alongside the distribution of FGS educational materials were carried out. The intervention enhanced health workers' awareness of FGS to more than 61%, encompassing an enhanced understanding of the disease's signs and symptoms to more than 60%, as well as its management strategies. However, access to praziquantel, the primary treatment, remained a significant challenge. The FGS intervention effectively raised healthcare workers' awareness and knowledge. Expanding training and improving praziquantel access are essential for optimal FGS management. A multi-faceted approach involving individuals, communities, and the healthcare system is necessary for comprehensive FGS prevention and control.

Socio-economic risk factors for intestinal helminthiases in selected endemic communities in Mindanao, the Philippines: a cross-sectional study

Abstract Background Parasitic neglected tropical diseases (NTDs) or ‘infectious diseases of poverty’ continue to affect the poorest communities in the world, including in the Philippines. Socio-economic conditions contribute to persisting endemicity of these infectious diseases. As such, examining these underlying factors may help identify gaps in implementation of control programs. This study aimed to determine the prevalence of schistosomiasis and soil-transmitted helminthiasis (STH) and investigate the role of socio-economic and risk factors in the persistence of these diseases in endemic communities in the Philippines. Methods This cross-sectional study involving a total of 1,152 individuals from 386 randomly-selected households was conducted in eight municipalities in Mindanao, the Philippines. Participants were asked to submit fecal samples which were processed using the Kato-Katz technique to check for intestinal helminthiases. Moreover, each household head participated in a questionnaire survey investigating household conditions and knowledge, attitude, and practices related to intestinal helminthiases. Associations between questionnaire responses and intestinal helminth infection were assessed. Results Results demonstrated an overall schistosomiasis prevalence of 5.7% and soil-transmitted helminthiasis prevalence of 18.8% in the study population. Further, the household questionnaire revealed high awareness of intestinal helminthiases, but lower understanding of routes of transmission. Potentially risky behaviors such as walking outside barefoot and bathing in rivers were common. There was a strong association between municipality and prevalence of helminth infection. Educational attainment and higher “practice” scores (relating to practices which are effective in controlling intestinal helminths) were inversely associated with soil-transmitted helminth infection. Conclusion Results of the study showed remaining high endemicity of intestinal helminthiases in the area despite ongoing control programs. Poor socio-economic conditions and low awareness about how intestinal helminthiases are transmitted may be among the factors hindering success of intestinal helminth control programs in the provinces of Agusan del Sur and Surigao del Norte. Addressing these sustainability gaps could contribute to the success of alleviating the burden of intestinal helminthiases in endemic areas.

Transforming Healthcare in Africa: The Role of Artificial Intelligence in Combatting Infectious Diseases, Neglected Tropical Diseases, and Antimicrobial Resistance

This review article focuses on the role of Artificial Intelligence (AI) in transforming healthcare in Africa, specifically in combatting infectious diseases, Neglected Tropical Diseases (NTDs), and antimicrobial resistance. We provide a comprehensive overview of the significance of AI in the healthcare industry, highlighting its urgency and importance in addressing these specific health challenges in Africa. We begin by discussing the role of AI in infectious disease surveillance and outbreak detection. We explore how AI technology can be employed for real-time tracking and prediction of outbreaks, providing examples of successful AI applications in infectious disease surveillance within the African context. Next, we examine the potential of AI-enabled diagnosis and treatment for faster and more accurate diagnoses of infectious diseases and NTDs. We highlight specific examples of AI applications in diagnosing and treating these diseases in Africa, showcasing the potential of AI to improve clinical outcomes and save lives. Furthermore, we focus on how AI-driven drug discovery and development can expedite the search for new treatments for infectious diseases and combat antimicrobial resistance. We present examples of AI applications in drug discovery within the African context, illustrating the potential for AI to revolutionize the development of effective therapeutics. In addition, we delve into how AI-powered public health interventions can enhance the design and implementation of targeted interventions. We explore how AI can optimize resource allocation and facilitate data-driven decision-making processes, providing examples of AI applications in public health in Africa. Finally, we address the challenges and limitations of implementing AI in combatting infectious diseases, NTDs, and antimicrobial resistance in Africa. We discuss potential barriers and ethical concerns surrounding AI applications in healthcare, aiming to encourage informed and responsible utilization of AI technologies. Overall, this review emphasizes the importance and potential of AI in combatting infectious diseases, NTDs, and antimicrobial resistance in Africa. It positions AI as a catalyst for revolutionizing healthcare in the region, leading to more effective disease surveillance, diagnosis, treatment, drug discovery, and public health interventions.

Spatial-temporal distribution of neglected tropical diseases burdens in China from 2005 to 2020

BackgroundOut of the 21 neglected tropical diseases (NTDs) listed by the World Health Organization, 15 affect the People’s Republic of China. Despite significant achievements in controlling NTDs, comprehensive assessments of the disease burden based on actual case data and detailed information on spatial and temporal dynamics are still lacking. This study aims to assess the disease burden and spatial–temporal distribution of NTDs in China from 2005 to 2020, to provide a reference for the formulation of national health agendas in line with the global health agenda, and guide resource allocation.MethodsThe number of cases and deaths of major NTDs in China from 2005 to 2020 were downloaded from the China Public Health Science Data Center (https://www.phsciencedata.cn/Share/index.jsp) of the Chinese Center for Disease Control and Prevention and relevant literatures. Simplified formulas for disability-adjusted life years (DALYs) helped estimate the years of life lost (YLLs), years lived with disability (YLDs), and total DALYs. Spatial autocorrelation analysis of the average NTDs burden data for the years 2005 to 2020 was evaluated using Moran's I statistic.ResultsChina's overall NTDs burden decreased significantly, from 245,444.53 DALYs in 2005 to 18,984.34 DALYs in 2020, marking a reduction of 92.27%. In 2005, the DALYs caused by schistosomiasis and rabies represent a substantial proportion of the total disease burden, accounting for 65.37% and 34.43% respectively. In 2015, Hunan and Sichuan provinces had the highest diversity of NTDs, with 9 and 8 number of different NTDs reported respectively. And the highest disease burden was observed in Sichuan (242,683.46 DALYs), Xizang Zizhiqu (178,318.99 DALYs) and Guangdong (154,228.31 DALYs). The “high-high” clustering areas of NTDs were mainly in China's central and southern regions, as identified by spatial autocorrelation analysis.ConclusionsChina has made unremitting efforts in the prevention and control of NTDs, and the disease burden of major NTDs in China has decreased significantly. Using the One Health concept to guide disease prevention and control in the field to effectively save medical resources and achieve precise intervention.Graphical abstract