NEGLECTED TROPICAL DISEASES INTERVENTION FOR PREVENTION, CONTROL, ELIMINATION AND ERADICATION
Neglected tropical diseases (NTDs) are a diverse group of tropical infections which are common in low-income populations in developing regions of Africa, Asia, and the America. They are caused by a variety of pathogens such as viruses, bacteria, protozoa and helminths. These diseases are common in 149 countries, affecting more than 1.4 billion people (including more than 500 million children) and costing developing economies billions of dollars every year. In addition to their impact on health, NTDs contribute to an immense social and economic burden resulting from social stigma, physical disabilities, disfigurement, blindness, discrimination, loss of social status, malnutrition, growth failure, and impaired cognitive development. Five public-health interventions which are; preventive chemotherapy, innovative and intensified disease management (IDM), effective vector control, the provision of safe drinking-water, basic sanitation and hygiene as well asinvolvement of veterinary public health were recommended in the roadmap to accelerate the work on prevention, control, elimination, and eradication of neglected tropical diseases. Some challenges inherent in sustaining the drive to overcome the global impact of neglected tropical diseases include global economic constraints, lack of expertise in prevention and control of individual neglected tropical disease, hindrances to the availabilityofadequate quantities of essential medicines, lack of proper estimate of the actual cost of expanding implementation activities. To sustain the drive to overcome the global impact, it is essential to among others; prioritize prevention, control, elimination and eradication of neglected tropical diseases in national health, political and development agendas as well as sustain the development and updating of evidence-based norms, standards, policies, guidelines and strategies for prevention, control and elimination of neglected tropical diseases
TABLE OF CONTENTS
Title page i
Chapter One: Introduction 1
Chapter Two:Intervention For Prevention, Control And Elimination Of
Neglected Tropical Diseases 5
2.1 Intervention for Prevention NTDs 5
2.2 Prevention of NTDs 6
2.2.1 Preventive Chemotherapy 6
2.2.2 Periconceptional multivitamin supplementation 8
2.3 Elimination and Eradication 8
2.3.1 Principles of elimination and eradication NTDs 8
2.3.2 The London Declaration 9
2.3.3 Case studies in NTD eradication 10
2.4 Control of NTDs 13
2.4.1 Innovative and Intensified Disease Management (IDM) 13
2.4.2 The Provision of safe Drinking-water, Basic Sanitation
and Hygiene 14
2.4.3 Involvement of Veterinary Public Health 14
Chapter Three: Sustenance Of The Drive To Overcome The Global
Impact Of Neglected Tropical Diseases 19
3.1 Actions Necessary for the Sustenance of the Drive to Overcome
The Global Impact of Neglected Tropical Diseases 19
Neglected tropical diseases (NTDs) are a diverse group of tropical infections which are common in low-income populations in developing regions of Africa, Asia, and the Americas. They are caused by a variety of pathogens such as viruses, bacteria, protozoa and helminths. These diseases are contrasted with the big three infectious diseases (HIV/AIDS, tuberculosis, and malaria), which generally receive greater treatment and research funding (Hotez, 2013). In sub-Saharan Africa, the effect of these diseases as a group is comparable to malaria and tuberculosis (Hotez and kamatz, 2017). NTD co-infection can also make HIV/AIDS and tuberculosis more deadly (Mike, 2016).
In some cases, the treatments are relatively inexpensive. For example, the treatment for schistosomiasis is US$0.20 per child per year (National Public radio, 2006). Nevertheless, in 2010 it was estimated that control of neglected diseases would require funding of between US$2 billion and US$3 billion over the subsequent five to seven years (Hotez, 2010). Some pharmaceutical companies have committed to donating all the drug therapies required, and mass drug administration (for example Mass deworming) has been successfully accomplished in several countries (Reddy et al., 2007). However, preventive measures are often more accessible in the developed world, but not universally available in poorer areas (Hotez, 2009).
Within developing countries, neglected tropical diseases affect the poor in society. In countries such as these, the burdens of neglected tropical diseases are often overshadowed by other public health issues. However, many of the same issues put populations at risk in developed as developing nations. For example, other problems can stem from poverty which expose individuals to the vectors of these disease, such as lack of adequate housing (Hotez, 2012).
What makes NTDs different from non-neglected diseases is that these diseases are disablers rather than killers. Indeed, these infections are co-endemic: an individual may be infected with more than one NTD in addition to other well-known diseases such as HIV, tuberculosis, and malaria. (Hotez et al., 2014) For example, the parasite infection schistosomiasis can make women and girls more susceptible to HIV infection, saps micronutrients and iron from developing children to stunt their growth, and renders children less likely to attend school. A chronic helminth parasite infection known as lymphatic filariasis (LF) may reduce vaccine efficacy by broadly modulating the immune system. LF causes severe swelling (lymphedema) in 40 million people rendering them socially stigmatized and largely unable to work. In addition to schistosomiasis and LF, many more NTDs are characterized by chronic disabilities, increased susceptibility to infectious and non-infectious diseases, social stigma, and an economic burden on the individual, the family, and the country (World Health Organization. 2017).
Twenty neglected tropical diseases are prioritized by the World Health Organization (WHO), though other organizations define NTDs differently. Chromoblastomycosis and other deep mycoses, scabies and other ectoparasites and snakebite envenoming were added to the list in 2017 (WHO, 2017). These diseases are common in 149 countries, affecting more than 1.4 billion people (including more than 500 million children) (DNDi, 2018) and costing developing economies billions of dollars every year (WHO, 2017). They resulted in 142,000 deaths in 2013—down from 204,000 deaths in 1990 (GBD, 2014). Of these 20, two were targeted for eradication (dracunculiasis (guinea-worm disease) by 2015 and yaws by 2020), and four for elimination (blinding trachoma, human African trypanosomiasis, leprosy and lymphatic filariasis by 2020) (WHO, 2015).
In addition to their impact on health, NTDs contribute to an immense social and economic burden resulting from social stigma, physical disabilities, disfigurement, blindness, discrimination, loss of social status, malnutrition, growth failure, and impaired cognitive development. All of these interrelated outcomes perpetuate the cycle of poverty by preventing individuals from leading productive lives, and by adversely affecting families, communities, and countries as a whole. However, many of these diseases are preventable, and could be eliminated with improved sanitation, vector control, available treatments, and mass drug administration (MDA) campaigns.
The World Health Organization (WHO) classified NTDs into two groups: preventive chemotherapy and transmission control (PCT) NTDs, and innovative and intensified disease management (IDM) NTDs (World Health Organization, 2017). The most prominent examples of NTDs that have been allocated to the PCT group are lymphatic filariasis, onchocerciasis, schistosomiasis, and soil-transmitted helminthiasis; the main tool for their control is the periodic administration of efficacious, safe, and inexpensive (usually donated) drugs to entire at-risk populations. IDM, on the other hand, focuses on those NTDs that currently lack appropriate tools for large-scale use. These diseases include Buruli ulcer, Chagas disease, human African trypanosomiasis, and leishmaniasis (Rosenberg, Utzinger and Addiss, 2016).
Climate change and global warming are increasing the likelihood and spread of many vector-borne diseases, including malaria, dengue fever, Chagas disease, leishmaniasis, filariasis, onchocerciasis, schistosomiasis, and trypanosomiasis (Githeko et al., 2000). At the 70th World Health Assembly (WHA) held in Geneva, Switzerland in May 2017, a resolution was adopted on a Global Vector Control Response for 2017–2030 that aims to prevent, detect, report and respond to outbreaks of vector-borne diseases worldwide through an integrated, comprehensive approach (Alonso, 2017).
This seminar dwells on the intervention for prevention, control elimination and eradication. This reviews the health challenges of neglected tropical diseases with an objective of updating the knowledge base of neglected tropical diseases for effective control and elimination among the population.
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