Neglected Tropical Diseases Research Articles

Neglected zoonotic helminthiases in wild canids: new insights from South America.

The global threat of neglected tropical diseases (NTDs) constitutes a public health issue in underdeveloped countries. Zoonotic helminthiases are the most common human NTD agents in developing countries in sub-Saharan Africa, Asia, and the Americas, causing a global burden of disease that exceeds that of more recognized infectious diseases such as malaria and tuberculosis. Wild canids are well-known mammals that act as natural reservoirs of zoonotic-relevant helminthiasis worldwide, thus playing a pivotal role in their epidemiology and transmission to humans. Here we evaluate the occurrence of zoonotic gastrointestinal helminths in two Neotropical wild canid species from the Amazonian and Andean regions of Colombia, i.e., the bush dog (Speothos venaticus) and the crab-eating fox (Cerdocyon thous). We recovered tapeworm proglottids from bush dog fecal samples and identified them molecularly as the canine-specific lineage of Dipylidium caninum by using cytochrome c oxidase subunit I (cox1) gene sequences. Moreover, examination of a crab-eating fox during necropsy revealed the presence of non-embryonated eggs of the neglected nematode Lagochilascaris cf. minor, in addition to eggs and gravid proglottids of the cestode Spirometra mansoni. These findings represent the first report of zoonotic-relevant cestodes, i.e., D. caninum ("canine genotype"), S. mansoni, and the nematode L. cf. minor, in bush dogs and crab-eating foxes as final hosts. The occurrence of these zoonotic helminthiases in wild canid species calls for regular monitoring programs to better understand the epidemiology and transmission routes of neglected dipylidiasis, lagochilascariosis, and sparganosis in South America.

Soil-transmitted helminths: A critical review of the impact of co-infections and implications for control and elimination.

Researchers have raised the possibility that soil-transmitted helminth (STH) infections might modify the host's immune response against other systemic infections. STH infections can alter the immune response towards type 2 immunity that could then affect the likelihood and severity of other illnesses. However, the importance of co-infections is not completely understood, and the impact and direction of their effects vary considerably by infection. This review synthesizes evidence regarding the relevance of STH co-infections, the potential mechanisms that explain their effects, and how they might affect control and elimination efforts. According to the literature reviewed, there are both positive and negative effects associated with STH infections on other diseases such as malaria, human immunodeficiency virus (HIV), tuberculosis, gestational anemia, pediatric anemia, neglected tropical diseases (NTDs) like lymphatic filariasis, onchocerciasis, schistosomiasis, and trachoma, as well as Coronavirus Disease 2019 (COVID-19) and human papillomavirus (HPV). Studies typically describe how STHs can affect the immune system and promote increased susceptibility, survival, and persistence of the infection in the host by causing a TH2-dominated immune response. The co-infection of STH with other diseases has important implications for the development of treatment and control strategies. Eliminating parasites from a human host can be more challenging because the TH2-dominated immune response induced by STH infection can suppress the TH1 immune response required to control other infections, resulting in an increased pathogen load and more severe disease. Preventive chemotherapy and treatment are currently the most common approaches used for the control of STH infections, but these approaches alone may not be adequate to achieve elimination goals. Based on the conclusions drawn from this review, integrated approaches that combine drug administration with water, sanitation and hygiene (WASH) interventions, hygiene education, community engagement, and vaccines are most likely to succeed in interrupting the transmission of STH co-infections. Gaining a better understanding of the behavior and relevance of STH co-infections in the context of elimination efforts is an important intermediate step toward reducing the associated burden of disease.

How and why snakebite became a global health priority: a policy analysis

BackgroundSnakebite was added to the WHO neglected tropical disease (NTD) list in 2017, followed by a World Health Assembly resolution in 2018, and an explicit global target being set to...

Antileishmanial activity of 2-amino-thiophene derivative SB-200

Leishmaniasis, presenting the highest number of cases worldwide is one of the most serious Neglected Tropical Diseases (NTDs). Clinical manifestations are intrinsically related to the host's immune response making immunomodulatory substances the target of numerous studies on antileishmanial activity. The currently available drugs used for treatment present various problems including high toxicity, low efficacy, and associated drug resistance. The search for therapeutic alternatives is urgent, and in this context, thiophene derivatives appear to be a promising therapeutic alternative (many have shown promising anti-leishmanial activity). The objective of this study was to investigate the antileishmanial activity of the 2-amino-thiophenic derivative SB-200. The thiophenic derivative was effective in inhibiting the growth of Leishmania braziliensis, Leishmania major, and Leishmania infantum promastigotes, obtaining respective IC50 values of 4.25 μM, 4.65 μM, and 3.96 μM. For L. infantum, it was demonstrated that the antipromastigote effect of SB-200 is associated with cell membrane integrity losses, and with morphological changes observed during scanning and transmission electron microscopy. Cytotoxicity was performed for J774.A1 macrophages and VERO cells, to obtain a CC50 of 42.52 μM and a SI of 10.74 for macrophages and a CC50 of 39.2 μM and an SI of 9.89 for VERO cells. The anti-amastigote activity of SB-200 revealed an IC50 of 2.85 μM and an SI of 14.97 against macrophages and SI of 13.8 for VERO cells. The anti-amastigote activity of SB-200 is associated with in vitro immunomodulation. For acute toxicity, SB-200 against Zophobas morio larvae permitted 100% survival. We conclude that the 2-amino-thiophenic derivative SB-200 is a promising candidate for in vivo anti-leishmania drug tests to evaluate its activity, efficacy, and safety.

Schistosoma and Leishmania: An Untold Story of Coinfection.

A remarkable characteristic of infectious diseases classified as Neglected Tropical Diseases (NTDs) is the fact that they are mostly transmitted in tropical and subtropical regions with poor conditions of sanitation and low access to healthcare, which makes transmission areas more likely to overlap. Two of the most important NTDs, schistosomiasis and leishmaniasis, despite being caused by very different etiological agents, have their pathogenesis heavily associated with immune-mediated mechanisms, and Schistosoma spp. and Leishmania spp. have been shown to simultaneously infect humans. Still, the consequences of Schistosoma-Leishmania coinfections remain underexplored. As the inflammatory processes elicited by each one of these parasites can influence the other, several changes have been observed due to this coinfection in naturally infected humans, experimental models, and in vitro cell assays, including modifications in susceptibility to infection, pathogenesis, prognostic, and response to treatment. Herein, we review the current knowledge in Schistosoma-Leishmania coinfections in both human populations and experimental models, with special regard to how schistosomiasis affects tegumentary leishmaniasis, discuss future perspectives, and suggest a few steps to further improve our understanding in this model of parasite-host-parasite interaction.

Addressing neglected tropical diseases in Africa: a health equity perspective

Africa accounts for over one-third of the global burden of neglected tropical diseases (NTDs). Although continental efforts have been made to combat these diseases, there still exists a significant gap in the fight, ranging from a lack of data to multisectoral participation and, most critically, health inequity. Here, we assess the effort made to combat challenges caused by health disparities to prevent and control neglected tropical diseases. This article engages a health equity view to addressing the need for inclusion in achieving universal health coverage towards eradicating NTDs and outlines strategies to achieve such. Health disparities exist, and there is substantial and irrefutable evidence for them. Inequitable distribution and limited access to basic and essential life resources such as water, housing, toilets, soap, and literacy continue to facilitate the existence of NTDs such as Schistosomiasis, soil-transmitted helminths, and trachoma, the occurrence of which can be avoided if affected populations have better access to those resources. To eradicate NTDs, health disparities must be addressed to provide excellent health care to all populations and adequate universal health coverage for long-term sustainability. NTD programmes need to be data-driven to ensure better decision-making and ensure the inclusion of diverse population groups including women, children, and youths. This will ensure that no one is left behind, drawing upon the sustainable development goals. Community participation and engagement should also be considered as an essential approach to ensure people are at the centre of health programmes and their implementation.

Epidemiological Review: Mapping Cases and Prevalence of Helminthiasis in Indonesia on 2020-2022

Background: Helminthiasis cannot be separated from society in Indonesia. In 2020, the World Health Organization (WHO) classified helminth infections as neglected tropical diseases (NTD) that require large-scale control, because more than 23% of the world's population is infected with helminthiasis. In Indonesia, there are still few articles that comprehensively review the epidemiological mapping of the latest helminthiasis cases. The purpose of writing this article is to map the prevalence of helminthiasis in Indonesia in 2020-2022. This article is a systematic study conducted from January-April 2023. The literature search was carried out through an electronic database. Result: The findings of this study indicate that in the last three years, helminthiasis has not been eliminated in Indonesia. The results of helminth species found to infest communities in several provinces in Indonesia include Ascaris lumbricoides, Trichuris trichiura, Hookworm, Hymenolepis nana, Taenia saginata, Taenia solium, Oxyuris vermicularis, Schistosoma japonicum, Strongiloides stercoralis, and Wuchereria bancrofti. The diagnosis of helminth infestation and infection is confirmed through microscopic examination by finding eggs, larvae, proglottids, and even adult worms that come out spontaneously through defecation. In addition, helminth transmission can occur through food contaminated with worm eggs. The government has tried to control helminthiasis through Permenkes number 15 of 2017 concerning Helminthiasis Management. However, the indicators of achieving the target of reducing the prevalence of intestinal worms to below 10% in each Regency/City as stated in Pasal 3 ayat 2 of the Permenkes have not been fully met. Conclusion: It can be seen in this study that there are still many provinces that have not reached the helminth control target. This condition is especially experienced by high-risk groups, such as children, mining workers, plantation workers, farmers, livestock workers, staff at slaughterhouses, and waste collectors.

A systematic review on maternal-to-infant transfer of drugs through breast milk during the treatment of malaria, tuberculosis, and neglected tropical diseases.

Exclusive breastfeeding of infants under 6 months of age is recommended by the World Health Organization. In 2021, over 300 million combined incident cases of malaria, tuberculosis, and neglected tropical diseases (NTDs) were reported, predominantly in low-income countries. For many of the drugs used as first-line treatments for these conditions, there is limited knowledge on infant exposure through breastfeeding with poorly understood consequences. This review summarized available knowledge on mother-to-infant transfer of these drugs to inform future lactation pharmacokinetic studies. A list of first-line drugs was generated from the latest WHO treatment guidelines. Using standard online databases, 2 independent reviewers searched for eligible articles reporting lactation pharmacokinetics studies and extracted information on study design, participant characteristics, and the mathematical approach used for parameter estimation. A third reviewer settled any disagreements between the 2 reviewers. All studies were scored against the standardized "ClinPK" checklist for conformity to best practices for reporting clinical pharmacokinetic studies. Simple proportions were used to summarize different study characteristics. The most remarkable finding was the scarcity of lactation pharmacokinetic data. Only 15 of the 69 drugs we listed had lactation pharmacokinetics fully characterized. Most studies enrolled few mothers, and only one evaluated infant drug concentrations. Up to 66% of the studies used non-compartmental analysis to estimate pharmacokinetic parameters rather than model-based compartmental analysis. Unlike non-compartmental approaches, model-based compartmental analysis provides for dynamic characterization of individual plasma and breast milk concentration-time profiles and adequately characterizes variability within and between individuals, using sparsely sampled data. The "ClinPK" checklist inadequately appraised the studies with variability in the number of relevant criteria across different studies. A consensus is required on best practices for conducting and reporting lactation pharmacokinetic studies, especially in neglected diseases such as malaria, tuberculosis, and NTDs, to optimize treatment of mother-infant pairs.

ENHANCED PREDICTIVE MODEL FOR SCHISTOSOMIASIS

Neglected Tropical Diseases (NTDs) are wide spread diseases found in many countries in Africa, Asia and Latin America, they are mostly found in tropical areas where people have no access to clean water or safer ways to dispose of human waste. Schistosomiasis is one of the NTDs. Data mining is used in extracting rules to predict certain information in many areas of Information Technology, medical science, biology, education, and human resources. Classification is one of the techniques of Data mining. In this work, we used three classifiers namely; Naïve Bayes, Support Vector Machine and Logistic Regression to design a framework for classifying and predicting the status of Schistosomiasis and its complications in a suspected patient using their clinical data. For the purpose of this study, we considered the parameters: Abdominal, Diarrhea, Bloody_stool, Bloody urine, Swim, Dam_river_ use, Urinating_stool_in_water, Boil_water_use. The framework was trained using data acquired from Federal Medical Centre Katsina and NTD unit of Katsina State ministry of health, to test for performance accuracy. The research shown that out of the three classifiers, Logistic Regression performed better by having 97.8% accuracy.

Perceptions of the roles, impact, challenges and needs of community drug distributors in the control and elimination of neglected tropical diseases in difficult-to-access communities in Ghana

IntroductionThe success of mass drug administration (MDA) campaigns to control and eliminate neglected tropical diseases (NTDs) in Ghana depends, to a large extent, on the essential role community drug distributors (CDDs) play. This study aimed to investigate community’s perceptions of CDDs’ roles, impact of CDDs’ work, challenges faced by CDDs, and views on resources required to enhance CDDs’ work to sustain MDA campaigns.MethodsA cross-sectional qualitative study employing the use of focus group discussions (FGDs) with community members and CDDs in selected NTD endemic communities together with individual interviews with district health officers (DHOs) was conducted. We interviewed 104 people aged 18 and over, purposively selected, through eight individual interviews, and 16 focus group discussions.ResultsParticipants in the community FGDs noted that health education and the distribution of drugs were the main roles of CDDs. Participants also perceived that the work of CDDs had prevented the onset of NTDs, treated symptoms of NTDs, and generally reduced the incidence of infections. In the interviews with CDDs and DHOs, lack of cooperation/non-compliance by community members, demands by community members, lack of working resources and low financial motivation were mentioned as the main challenges to the work of CDDs. Moreover, the provision of logistics and financial motivation for CDDs were identified as factors that will enhance their work.ConclusionsIncorporating more attractive schemes will incentivise CDDs to improve output. Addressing the challenges highlighted is an important step for the work of CDDS to be effective in controlling NTDs in difficult-to-access communities in Ghana.

Scabies- Major Childhood Skin Infestation in Bangladesh - An Updated Review

Background: Globally distributed scabies- a highly prevalent contagious skin disease particularly infests children and elderly population. Since scabies often remain un-recognized/un-diagnosed or under-reported, but >130 million people suffer from scabies, WHO listed it under neglected tropical disease (NTD). Objective(s): This updated review focus on scabies etiology and association with socio-economic profile, water sanitation, personal hygiene, poor living condition, and environmental pollution. However, few plausible risk factors of childhood scabies have also been covered in this review. Methodology: A through computer-based literature search was performed for the period of ~two decades (2000 through 2022) utilizing four familiar search engines: Google Scholar, PubMed, Scopus and Elsevier. The search topics covered: „childhood/adult scabies‟, „etiology‟, „risk factors‟, „monthly income‟, „water sanitation „personal hygiene‟, „living conditions‟ and few others (optional). Findings: Of total 28 published articles reviewed conducted in major lower/mid income countries (LMICs) including some rich and Western ones. Overall findings revealed <12 years-old children were infested more, which was reported in more higher portions from Bangladesh alike other Afro-Asian countries. Scabies is attributed to overcrowded lower socioeconomic community, lack in knowledge/practice of poor personal hygiene, polluted environment/water-sanitation. Clinically, it is associated with intense generalized pruritus causing rash, itching/scratching, particularly during winter season. One of our community-based studies in residential Madrasahs in and around Dhak city/outskirts yielded that sharing habits of daily personal belongings (personal clothing, bed linen /towels, pajamas/lungis, etc.) were main sources of scabies transmission/scabies mite: Sarcoptes Scabiei. Alike our observations, treatment of scabies included Lot. Benzyl benzoate, Monosulfirum cream/soap, Permethrin cream, and, Lot. Ivermectin/cream for severe cases as best effective drugs to eradicate scabies mites which most of the literature agreed to irradicate scabies in ~90% children. Conclusion: Scabies, more in children and elderly people, remains associated with overcrowding, bizarre living, moist/stuffy environment, poor personal hygiene, sharing personal cloths/towels, including other factors like parental sociodemographic status and poorer household income. Public Health policy makers should address immediate intervention to mitigate these factors to ensure effective prevention and control of scabies, both among the children and elderly people. The Journal of Ad-din Women's Medical College; Vol. 10 (1), Jan 2022; p 48-62

Use of the Dermatology Life Quality Index suite of patient-reported outcome measures in skin-related neglected tropical diseases.

Skin-related neglected tropical diseases (NTDs) affect nearly 1 billion people worldwide, contributing to significant physical and psychological morbidity. The DLQI suite of patient-reported outcome measures is widely used to assess the impact of skin diseases on individuals’ health-related quality of life (HRQoL), but it has not been validated for use in skin-related NTDs. The new strategic framework for the control of skin-related NTDs identified the socioeconomic and mental health impact of skin NTDs as research gaps to be addressed. Robust assessments of HRQoL will be an essential part of this research and will require validated appropriate tools, including the DLQI.

Development, standardization, and contextualization of qualitative tools for possible use in the assessment and valuation of snakebite envenomation.

Snakebite envenoming, a neglected tropical disease (NTD), is an important public health problem that is responsible for more than 1 lakh deaths annually across the world. However, the majority of the data in this regard is from health institutions and data from community settings are scarce. The aim of the current study was to develop valid and reliable qualitative tools for assessing the burden of snakebites and the health-seeking behavior of the community. The tools developed thus will serve in creating a community connection and thereby strengthen primary care teams engaged in managing snakebites at the primary care level. A four-step design was used; (a) review of the available literature on the burden of disease, tools used to assess the burden, and the guidelines on snakebite (b) development, laying out, and contextualization of questions/items for the tools (c) pilot testing and establishment of validity. A focus group discussion guide, key informant interview schedule for health professionals, community leaders, and traditional faith healers were matured for the implementation. A reliable and valid qualitative tool was developed to discern the speculations related to snakebites and its management in rural field settings.

Modeling the "F" in "SAFE": The dynamic game of facial cleanliness in trachoma prevention.

Trachoma, a neglected tropical disease (NTDs) caused by bacterium Chlamydia trachomatis, is a leading cause of infectious blindness. Efforts are underway to eliminate trachoma as a public health problem by using the "SAFE" strategy. While mathematical models are now standard tools used to support elimination efforts and there are a variety of models studying different aspects of trachoma transmission dynamics, the "F" component of the strategy corresponding to facial cleanliness has received very little attention so far. In this paper, we incorporate human behavior into a standard epidemiological model and develop a dynamical game during which individuals practice facial cleanliness based on their epidemiological status and perceived benefits and costs. We found that the number of infectious individuals generally increases with the difficulty to access a water source. However, this increase happens only during three transition periods and the prevalence stays constant otherwise. Consequently, improving access to water can help eliminate trachoma, but the improvement needs to be significant enough to cross at least one of the three transition thresholds; otherwise the improved access will have no noticeable effect.

Lymphatic Filariasis Elimination Status: Wuchereria bancrofti Infections in Human Populations after Five Effective Rounds of Mass Drug Administration in Zambia.

Lymphatic filariasis (LF), also commonly known as elephantiasis, is a neglected tropical disease (NTD) caused by filarial parasites. The disease is transmitted via a bite from infected mosquitoes. The bites of these infected mosquitoes deposit filarial parasites, Wuchereria or Brugia, whose predilection site is the lymphatic system. The damage to the lymph system causes swelling in the legs, arms, and genitalia. A mapping survey conducted between 2003 and 2011 determined LF as being endemic in Zambia in 96 out of 116 districts. Elimination of LF is known to be possible by stopping the spread of the infection through large-scale preventive chemotherapy. Therefore, mass drug administration (MDA) with diethylcarbamazine citrate (DEC) (6 mg/kg) and Albendazole (400 mg) for Zambia has been conducted and implemented in all endemic districts with five effective rounds. In order to determine whether LF prevalence has been sufficiently reduced to levels less than 2% antigenemia and less than 1% microfilaremia, a pre-transmission assessment survey (pre-TAS) was conducted. Therefore, post-MDA pre-TAS was conducted between 2021 and 2022 in 80 districts to determine the LF prevalence. We conducted a cross-sectional seroprevalence study involving 600 participants in each evaluation unit (EU) or each district. The study sites (sentinel and spot-check sites) were from districts that were the implementation units (IUs) of the LF MDA. These included 80 districts from the 9 provinces. A total of 47,235 people from sentinel and spot-check locations were tested. Of these, valid tests were 47,052, of which 27,762 (59%) were females and 19,290 (41%) were males. The survey revealed in the 79/80 endemic districts a prevalence of Wb antigens of 0.14% and 0.0% prevalence of microfilariae. All the surveyed districts had an optimum prevalence of less than 2% for antigenaemia, except for Chibombo district. The majority of participants that tested positive for Wuchereria bancrofti (Wb) Antigens (Ag) were those that had 2, 3, and 4 rounds of MDA. Surprisingly, individuals that had 1 round of MDA were not found to have circulating antigens of Wb. The study showed that all the surveyed districts, except for Chibombo, passed pre-TAS. This further implies that there is a need to conduct transmission assessment surveys (TASs) in these districts.

Diagnostic capacity for cutaneous fungal diseases in the African continent.

Cutaneous fungal infections are very common, especially in poorer communities and with intercurrent HIV infection. Determining the fungal pathogen in skin-related fungal neglected tropical diseases (NTDs) determines optimal therapy. We undertook a country survey across many African countries to determine the diagnostic capacity for skin fungal diseases. A detailed questionnaire was delivered to country contacts to collect data on availability, frequency, and location of testing for key diagnostic procedures and followed up with 2 rounds of validation by video call and by confirmation of individual country data confirmation by email. Of 47 countries with data, seven (15%) and 21 (45%) do not offer skin biopsy in the public or private sector, respectively, but 22 (46%) countries do it regularly, mostly in university hospitals. Direct microscopy is often performed in 20 of 48 (42%) countries in the public sector and not done in 10 (21%). Fungal cultures are often performed in 21 of 48 (44%) countries in the public sector but not done in nine (20%) or 21 (44%) in either public or private facilities. Histopathological examination of tissue is frequently used in 19 of 48 (40%) countries but not in nine (20%) countries in the public sector. The cost of diagnostics to patients was a major limiting factor in usage. Major improvements in the availability and use of diagnostic tests for skin, hair, and nail fungal disease are urgently needed across Africa.

How do disease control measures impact spatial predictions of schistosomiasis and hookworm? The example of predicting school-based prevalence before and after preventive chemotherapy in Ghana.

Schistosomiasis and soil-transmitted helminth infections are among the neglected tropical diseases (NTDs) affecting primarily marginalized communities in low- and middle-income countries. Surveillance data for NTDs are typically sparse, and hence, geospatial predictive modeling based on remotely sensed (RS) environmental data is widely used to characterize disease transmission and treatment needs. However, as large-scale preventive chemotherapy has become a widespread practice, resulting in reduced prevalence and intensity of infection, the validity and relevance of these models should be re-assessed. We employed two nationally representative school-based prevalence surveys of Schistosoma haematobium and hookworm infections from Ghana conducted before (2008) and after (2015) the introduction of large-scale preventive chemotherapy. We derived environmental variables from fine-resolution RS data (Landsat 8) and examined a variable distance radius (1-5 km) for aggregating these variables around point-prevalence locations in a non-parametric random forest modeling approach. We used partial dependence and individual conditional expectation plots to improve interpretability of results. The average school-level S. haematobium prevalence decreased from 23.8% to 3.6% and that of hookworm from 8.6% to 3.1% between 2008 and 2015. However, hotspots of high-prevalence locations persisted for both infections. The models with environmental data extracted from a buffer radius of 2-3 km around the school location where prevalence was measured had the best performance. Model performance (according to the R2 value) was already low and declined further from approximately 0.4 in 2008 to 0.1 in 2015 for S. haematobium and from approximately 0.3 to 0.2 for hookworm. According to the 2008 models, land surface temperature (LST), modified normalized difference water index, elevation, slope, and streams variables were associated with S. haematobium prevalence. LST, slope, and improved water coverage were associated with hookworm prevalence. Associations with the environment in 2015 could not be evaluated due to low model performance. Our study showed that in the era of preventive chemotherapy, associations between S. haematobium and hookworm infections and the environment weakened, and thus predictive power of environmental models declined. In light of these observations, it is timely to develop new cost-effective passive surveillance methods for NTDs as an alternative to costly surveys, and to focus on persisting hotspots of infection with additional interventions to reduce reinfection. We further question the broad application of RS-based modeling for environmental diseases for which large-scale pharmaceutical interventions are in place.

Effects of climate change on soil health resulting in an increased global spread of neglected tropical diseases.

Although it is commonly accepted that climate change will increase the range and abundance of neglected tropical diseases (NTDs) through increased rainfall and temperature, the role of soil and influence of soil health on this effect is not well understood. We propose that understanding the influence of climate change on the physical, chemical, and biological characteristics of soils can explain how favourable environmental conditions for NTDs and vectors of NTDs to reproduce form. This, in turn, can assist local public health experts in predicting and managing the spread of NTDs. We also suggest that unlike unpredictable climatic factors, soil health can be directly managed through appropriate land use practices. This viewpoint seeks to start a discussion between soil scientists and healthcare professionals on how to achieve common goals and strategies required to manage the spread of NTDs.

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.

Chagas prevention and control in an endemic area from the Argentinian Gran Chaco Region: Data from 14 years of uninterrupted intervention.

Chagas Disease (ChD) is a Neglected Tropical Disease (NTD) affecting 6 to 7 million people worldwide, mostly from Latin America. In Argentina, a national control program has been implemented since 1962, yet there are still an estimated 1.6 million infected individuals. Control programs were based almost exclusively on entomological surveillance and chemical control of households and were not continuous given a lack of coordination and resources. Argentina´s ChD program was originally vertical and centralized; later, it was partially and, in general, unsuccessfully transferred to the provinces. Herein, we describe the implementation of a control program for ChD with an ecohealth approach in rural settlements around the city of Añatuya, Santiago del Estero. The program included yearly household visits for entomological surveillance and control, health promotion workshops, and structural house improvements. Improved structures included internal and external walls and roofs, as well as the construction of water wells and latrines, and the organization and improvement of peri-domestic structures. Activities were carried out by specifically trained personnel except for house improvements, which were performed by the community, under technical guidance and provision of materials. Data was collected using standardized questionnaires for household characterization, entomological infestation status and chemical control activities. This program was continuously implemented since 2005 with high community participation and adherence, incorporating 13 settlements and 502 households. During the surveillance phase, 4,193 domiciliary inspections were performed, and both the intra- and peri-domestic infestation rate were reduced from 17.9% to 0.2% (P < 0.01) and from 20.4% to 3%, respectively. Additionally, 399 households were structurally improved. The program is still ongoing and, after 14 years of implementation, has built social networks and collaboration between implementers and beneficiaries with a reduction of T. infestans infestation in the intra- and peri-domicile. This reduction, especially inside the household, has enabled access to diagnosis and treatment of the population, with minimal risk of re-infection.