Chagas disease (CD) is endemic in the Americas, being present in 21 countries, where it affects about 6 million
people.(1) With such relevant numbers of people affected and disability adjusted life years lost, CD is a poverty-related
and poverty-promoting disease.
Although data describe a relevan
...
t ongoing public health problem for the American continent, significant results
in the interruption of transmission has been achieved by coordinated multi-country programs. In particular, the
Southern Cone Initiative (SCI), officially formalised in November 1991 by the Ministers of Health of Argentina, Brazil, Bolivia, Chile, Paraguay and Uruguay, has shown how a well-designed control program can significantly reduce
CD transmission.(2) Before this initiative, in these countries, there were 11 million infected persons and 50 million at
risk, 62% of the infected individuals of the whole continent.
more
Schistosomiasis is widely recognized as a disease that is socially determined. An understanding of the social and behavioural factors linked to disease transmission and control should play a vital role in designing policies and strategies for schistosomiasis prevention and control. To this must be a
...
dded the awareness that schistosomiasis is also a disease of poverty. It still survives in poverty-stricken, remote areas where there is little or no safe water or sanitation, and health care is scarce or non-existent. For a variety of complex reasons, many of which are addressed in this book, the disease is particularly prevalent in sub-Saharan Africa, and persists in certain areas of rural China. This concern for human behaviour in an environment of poverty echoes the concerns of the new research priority for “diseases of poverty” identified by the Special Programme for Research & Training in Tropical Diseases.
more
The sub-Saharan African region, carries 90% of the over 250 million cases of schistosomiasis occurring worldwide. In this region, after Nigeria, Tanzania is second country having the highest cases of schistosomiasis and approximately 51.5%0 of the Tanzanian population is either exposed or live in ar
...
eas with high risk of exposure. The country is endemic to both Schistosoma mansoni and Schistosoma haematobium, these infections are common in communities characterised with limited access to water, sanitation, hygienic practices and health services. Schistosoma mansoni infection is associated with hepatosplenic disease characterised with hepatomegaly, splenomegaly, progressive periportal fibrosis (PPF) which can lead to portal hypertension and its related sequelae, mainly ascites, liver surface irregularities, oesophageal varices and haematemesis. The main consequences of S. haematobium infection are haematuria, dysuria, nutritional deficiencies, urinary bladder lesions, hydronephrosis, urinary bladder squamous cell carcinoma and in children, growth retardation. Preventive chemotherapy using mass drug administration (MDA) of praziquantel targeting primary school aged children is the main strategy for controlling schistosomiasis in Tanzania.
more
Epidemiological Update
Dengue
7 February 2020
Situation summary
In the Region of the Americas, between epidemiological week (EW) 1 and EW 521 of 2019, a total of 3,139,335 cases of dengue have been reported (321.58 cases per 100,000 population), including 1,538 deaths. Of the total cases, 1,367,
...
353 (43.6%) were laboratory-confirmed and 28,169 (0.9%) were classified as severe dengue. The case-fatality rate was 0.049%.
more
This document focuses on the management of patients affected by gambiense HAT and
constitutes an update to the WHO therapeutic guidance issued in 2013. The main changes in recommendations concern the criteria and methods for deciding the treatment among the new set of therapeutic options and the pa
...
rticular conditions that apply to treatment with fexinidazole, as outlined below. Because HAT is a serious, life-threatening disease and because the efficacy of fexinidazole depends on swallowing the medicine after an appropriate intake of food as well as on completing the full 10-day
treatment schedule, the recommendations regarding fexinidazole administration are considered key elements that must be carefully followed. When the conditions listed in these guidelines are not met for any individual patient, the alternative available treatments should be prescribed.
more
Conflicts and disasters, including pandemics, affect women and men in all their diversity differently, and women and girls often suffer the most. Crisis-related hardships combine and compound pre-existing disadvantages, for example, they often cause women’s working conditions to worsen while incre
...
asing their overall workload and care responsibilities. At the same time, crises can give rise to changes that enable women to take up roles that were previously available only to men, and crises can open opportunities to address existing gender-based discrimination and violations of rights.
more
Schistosomiasis is a helminthic infection and one of the neglected tropical diseases (NTDs). It is caused by blood flukes of the genus Schistosoma. It is an important public health problem, particularly in poverty-stricken areas, especially those within the tropics and subtropics. It is estimated th
...
at at least 236 million people worldwide are infected, 90% of them in sub-Saharan Africa, and that this disease causes approximately 300,000 deaths annually. The clinical manifestations are varied and affect practically all organs. There are substantial differences in the clinical presentation, depending on the phase and clinical form of schistosomiasis in which it occurs. Schistosomiasis can remain undiagnosed for a long period of time, with secondary clinical lesion. Here, we review the clinical profile of schistosomiasis. This information may aid in the development of more efficacious treatments and improved disease prognosis.
more
The development of this target product profile (TPP) was led by the WHO Department of Control of Neglected Tropical Diseases (NTD) following standard WHO guidance for TPP development. In order to identify and prioritize diagnostic needs, a WHO NTD Diagnostics Technical Advisory Group (DTAG) was form
...
ed, and different subgroups were created to advise on specific NTDs, including a subgroup working on the human African trypanosomiasis (HAT) diagnostic innovation needs. This group of independent experts included leading scientists, public health officials and endemic-country end-user representatives. Standard WHO Declaration of Interest procedures were followed. A landscape analysis of the available products and of the development pipeline was conducted, and the salient areas with unmet needs were identified.
more
A clear understanding of the knowledge, attitudes and practices (KAP) of a particular community is necessary in order to improve control of human African trypanosomiasis (HAT).New screening and diagnostic tools and strategies were introduced into South Sudan, as part of integrated delivery of primar
...
y healthcare. Knowledge and awareness on HAT, its new/improved screening and diagnostic tools, the places and processes of getting a confirmatory diagnosis and treatment are crucial to the success of this strategy.
more
Localized cutaneous leishmaniasis and its evolving forms (diffuse cutaneous leishmaniasis, mucosal leishmaniasis and cutaneous leishmaniasis recidivans), together with the sequela of visceral leishmaniasis (post-kala-azar dermal leishmaniasis), account for about one million cases of dermal leishmani
...
ases per year worldwide. Although not lethal, the dermal leishmaniases cause chronic, disfiguring skin lesions which are an important cause of morbidity and stigma.
more
Leishmaniasis is a climate-sensitive disease. Changes in temperature, rainfall, and humidity can have strong impacts on
the sandfly vector, altering their distribution and influencing their survival and population sizes. Increased temperatures shorten vector development time, reduce Leishmania para
...
site incubation time, and increase vector biting rates, allowing transmission
in areas not previously endemic for the disease. Poor and
marginalized communities will be hit disproportionately harder by
the effects of climate change, and droughts, famines, and floods
can also lead to displacement and migration of immunologically
naive people to areas where leishmaniasis is endemic, posing a
threat of leishmaniasis outbreaks.
more
Sleeping sickness is controlled by case detection and treatment but this often only reaches less than 75% of the population. Vector control is capable of completely interrupting HAT transmission but is not used because of expense. We conducted a full scale field trial of a refined vector control tec
...
hnology. From preliminary trials we determined the number of insecticidal tiny targets required to control tsetse populations by more than 90%. We then carried out a full scale, 500 km2 field trial covering two HAT foci in Northern Uganda (overall target density 5.7/km2). In 12 months tsetse populations declined by more than 90%. A mathematical model suggested that a 72% reduction in tsetse population is required to stop transmission in those settings. The Ugandan census suggests population density in the HAT foci is approximately 500 per km2. The estimated cost for a single round of active case detection (excluding treatment), covering 80% of the population, is US$433,333 (WHO figures). One year of vector control organised within country, which can completely stop HAT transmission, would cost US$42,700. The case for adding this new method of vector control to case detection and treatment is strong. We outline how such a component could be organised.
more
Research and Reports in Tropical Medicine 2022:13 25–40.
Chagas disease (CD) is caused by the parasite Trypanosoma cruzi, and it is endemic in Central, South America, Mexico and the South of the United States. It is an important cause of early mortality and morbidity, and it is associated with po
...
verty and stigma. A third of the cases evolve into chronic cardiomyopathy and gastrointestinal disease. This review proposes strategies to address challenges faced by non-endemic countries
more
An interregional meeting on leishmaniasis among neighbouring endemic
countries in the Eastern Mediterranean, African and European regions was organized by the World Health Organization (WHO) Regional Office for the Eastern
Mediterranean in Amman, Jordan, from 23 to 25 September 2018. The meeting w
...
as attended by representatives from the health ministries of Albania, Georgia, Greece, Iran (Islamic Republic of), Iraq, Jordan, Lebanon, Morocco, Pakistan, Saudi Arabia, Sudan, Syrian Arab Republic and Tunisia. Representatives from Afghanistan, Algeria and Libya were unable to attend. The Secretariat comprised staff from WHO headquarters, WHO regional offices in the Eastern Mediterranean, Africa and Europe, WHO country offices in Iraq, Pakistan, Syrian Arab Republic and Yemen, and WHO temporary advisors from Spain and Tunisia.
more
Despite a historical association with poor tolerability, a comprehensive review on safety of antileishmanial chemotherapies is lacking. We carried out an update of a previous systematic review of all published clinical trials in visceral leishmaniasis (VL) from 1980 to 2019 to document any reported
...
serious adverse events (SAEs).
more
Scabies is a skin infection that is a result of direct skin to skin contact and is primarily mediated by close and extended contact with scabies infested person. Scabies occurs worldwide among people of all ages, races, genders and social classes and has been identified as a neglected tropical infec
...
tious disease. Globally, it affects more than 130 million people at any time.
more
This project aimed to reduce the risk of vector-borne infection with Chagas disease by
controlling triatomine bugs, the vectors transmitting the parasite of Chagas disease, and
establishing an epidemiological surveillance system with community participation.
Snakebite envenoming constitutes a serious medical condition that primarily affects residents of rural communities in Africa, Asia, Latin America, and New Guinea. It is an occupational, environmental, and domestic health hazard that exacerbates the already impoverished state of these communities. Co
...
nservative estimates indicate that, worldwide, more than 5 million people suffer snakebite every year, leading to 25,000–125,000 deaths, while an estimated 400,000 people are left with permanent disabilities.
more
In one of his final essays, statesman and former United Nations secretary general Kofi Annan said, ‘Snakebite is the most important tropical disease you’ve never heard of’. Mr. Annan firmly believed that victims of snakebite envenoming should be recognised and afforded greater efforts at impro
...
ved prevention, treatment, and rehabilitation. During the last years of his life, he advocated strongly for the World Health Organisation (WHO) and the global community to give greater priority to this disease of poverty and its victims.
more
Snakebite is an acute life threatening time limiting medical emergency. It is a preventable public
health hazard often faced by rural population in tropical and subtropical countries with heavy
rainfall and humid climate.