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Selected Topics - Tropical Health
Categories
Events
Global policies and related documents
- A Human Rights Approach to Neglected Tropical Diseases
"Neglected tropical diseases (NTDs) affect one billion people in the world, often the most vulnerable populations living in poor rural areas in low-income countries. NTDs can result in lifelong disabilities and even death. They constitute a source of social stigma, discrimination and poverty. Affected populations often do not have access to treatment and preventive measures, and research and development has been insufficient. In recent years, there is growing attention to NTDs as both a public health, and human rights issue. This WHO Information sheet (also available in French and Spanish) on a human rights-based approach to neglected tropical diseases, aims to raise understanding and knowledge among health planners, human rights groups, development partners and civil society organisations."
- Neglected Tropical Diseases: Hidden Successes, Emerging Opportunities
"During meetings in Berlin and Geneva in 2004 and 2005, WHO with its partners developed a conceptual framework to move away from a purely disease-centred approach to an integrated one tackling selected neglected tropical diseases as a group. WHO will take this agenda forward using a threepronged approach: broader coverage with rapid-impact interventions (especially against helminth infections), strengthened vector control to reduce transmission of several diseases, and improved surveillance and high-quality care of diseases such as leishmaniasis and sleeping sickness. WHO will also address the particularities and obstacles of neglected tropical disease control in humanitarian emergencies, where mortality and morbidity are higher than usual. Research and development, including operational research, will underpin activities in all areas. Such an approach would permit the rapid expansion of currently limited access to existing safe and effective treatments that can be given to tackle a number of infections often afflicting the same individual. It would be carried out on a proactive basis targeted at the poor population at risk, protecting them from the irreversible effects of these infections in adulthood. It would reduce burden to locally manageable levels. It will make the most efficient use of human and financial resources and existing infrastructures. This population-based approach is compatible with a human rights agenda as it is non-discriminatory and ethical. The strategy would help achieve some of the Millennium Development Goals as it is propoor and enhances human capital by protecting millions of people from debilitating diseases, with considerable collateral benefits on education and productivity." Also available in French.
- Working to overcome the global impact of neglected tropical diseases
"Neglected tropical diseases (NTDs) blight the lives of a billion people worldwide and threaten the health of millions more. These ancient companions of poverty weaken impoverished populations, frustrate the achievement of health in the Millennium Development Goals and impede global development outcomes. A more reliable evaluation of their significance to public health and economies has convinced governments, donors, the pharmaceutical industry and other agencies, including nongovernmental organizations (NGOs), to invest in preventing and controlling this diverse group of diseases. Global efforts to control “hidden” diseases, such as dracunculiasis (guinea-worm disease), leprosy, schistosomiasis, lymphatic filariasis and yaws, have yielded progressive health gains including the imminent eradication of dracunculiasis. Since 1989 (when most endemic countries began reporting monthly from each endemic village), the number of new dracunculiasis cases has fallen from 892 055 in 12 endemic countries to 3190 in 4 countries in 2009, a decrease of more than 99%. The World Health Organization (WHO) recommends five public-health strategies for the prevention and control of NTDs: preventive chemotherapy; intensified case-management; vector control; the provision of safe water, sanitation and hygiene; and veterinary public health (that is, applying veterinary sciences to ensure the health and well-being of humans). Although one approach may predominate for control of a specific disease or group of diseases, evidence suggests that more effective control results when all five approaches are combined and delivered locally. Activities to prevent and control NTDs are included in the policies and budgets of many endemic countries. This has led to the development of interventions that are appropriate to existing health systems, often with the support of implementing partners." [World Health Organization, 14 October 2010]
Reports, guidelines and projects
- Asymmetries of Poverty: Why Global Burden of Disease Valuations Underestimate the Burden of Neglected Tropical Diseases
"The disability-adjusted life year (DALY) initially appeared attractive as a health metric in the Global Burden of Disease (GBD) program, as it purports to be a comprehensive health assessment that encompassed premature mortality, morbidity, impairment, and disability. It was originally thought that the DALY would be useful in policy settings, reflecting normative valuations as a standardized unit of ill health. However, the design of the DALY and its use in policy estimates contain inherent flaws that result in systematic undervaluation of the importance of chronic diseases, such as many of the neglected tropical diseases (NTDs), in world health."
- Comoros: Cholera
"The cholera epidemic had started to spread around the Comoros islands on 25 February, 2007. However, it was in August, 2007 that the rates of infection peaked sharply with a caseload of 1,480 as at 13 November. By the end of the month, 1,554 had been affected and 29 deaths reported on the islands of Grande Comore (Ngazidja) and Moheli both islands having a total population of 395,312." [International Federation of Red Cross and Red Crescent Societies, DREF Bulletin, No. MDRKM001, 28 March 2008]
- Control of Neglected Tropical Diseases
"The neglected tropical diseases are a group of 13 major disabling conditions that are among the most common chronic infections in the world's poorest people. A blueprint for the control or elimination of the seven most prevalent neglected tropical diseases — ascariasis, trichuriasis, hookworm infection, schistosomiasis, lymphatic filariasis, trachoma, and onchocerciasis — has been established by a group of private, public, and international organizations working together with pharmaceutical partners and national ministries of health. Through the newly established Global Network for Neglected Tropical Diseases, with updated guidelines for drug administration issued by the World Health Organization (WHO), partnerships are coordinating their activities in order to launch a more integrated assault on these conditions. If new resources are made available, as recommended by the Commission for Africa, a scaled-up approach to simple interventions could lead to sustainable decreases in poverty in some of the world's poorest countries. These decreases would represent a major success story for the United Nations Millennium Declaration."
- Delivering Malaria Control to Those in Need: How to Succeed in a Time of Renewed Hope
A report from a UK parliamentary committee says no child or adult should die of malaria given the availability of the very effective tools both to prevent and treat the disease. The report, authored by Professor Christopher Whitty of the London School of Hygiene & Tropical Medicine with the assistance of Dr Sylvia Meek of Malaria Consortium, says the millions of deaths annually are largely due to failure of delivery of these tools to those who need them, particularly the poorest, and especially children. The effect of improved delivery on malaria control has clearly been shown in countries such as Ethiopia, Rwanda and Eritrea, and the report calls for existing failures to be addressed in order to defeat the disease.
- Entomologic Investigations of a Chikungunya Virus Epidemic in the Union of the Comoros, 2005
From January to April 2005, an epidemic of chikungunya virus (CHIKV) illness occurred in the Union of Comoros. Entomological studies were undertaken during the peak of the outbreak, from March 11 to March 31, aimed at identifying the primary vector(s) involved in transmission so that appropriate public health measures could be implemented. Adult mosquitoes were collected by backpack aspiration and human landing collection in homes and neighborhoods of clinically ill patients. Water-holding containers were inspected for presence of mosquito larvae. Adult mosquitoes were analyzed by RT-PCR and cultivation in cells for the presence of CHIK virus and/or nucleic acid. A total of 2,326 mosquitoes were collected and processed in 199 pools. The collection consisted of 62.8% Aedes aegypti, 25.5% Culex species, and 10.7% Aedes simpsoni complex, Eretmapodites spp and Anopheles spp. Seven mosquito pools were found to be positive for CHIKV RNA and 1 isolate was obtained. The single CHIKV mosquito isolate was from a pool of Aedes aegypti and the minimum infection rate (MIR) for this species was 4.0, suggesting that Ae. aegypti was the principal vector responsible for the outbreak. This was supported by high container (31.1%), household (68%), and Breteau (126) indices, with discarded tires (58.8%) and small cooking and water storage vessels (31.1%) registering the highest container indices. [author abstract] [The American Journal of Tropical Medicine and Hygiene, 2008, vol. 78, no. 1, pp.77-82]
- Epidemiology of Chagas Disease in Ecuador. A Brief Review
Chagas disease is a complex public health problem that has been underestimated in Ecuador. Here we review the relevant published information, and present unpublished and new data that help to understand the current Chagas disease epidemiological situation and its evolution in the country. Three main characteristics have been identified: (i) persistence of Trypanosoma cruzi transmission in already known foci; (ii) a marked endemicity in some urban areas of Guayaquil; and (iii) the transformation of new Amazon foci into truly endemic areas. The situation in other suspect areas remains uncertain. Five Triatominae species have been implicated in the transmission of T. cruzi to people in Ecuador (Triatoma dimidiata, Rhodnius ecuadoriensis, R. pictipes, R. robustus and Panstrongylus geniculatus), but some others may also play a role in some areas (P. rufotuberculatus, P. howardi, T. carrioni and P. chinai). Other Triatominae reported seem to have little or no epidemiological relevance (T. venosa, T. dispar, Eratyrus mucronatus, E. cuspidatus, P. lignarius and Cavernicola pilosa). High frequency of acute cases and severe chronic disease has been observed. Although cardiomyopathy is more frequent, serious digestive disease is also present. It is estimated that around 120,000-200,000 people may be infected. 2.2 to 3.8 million people are estimated to live under transmission risk conditions. [author abstract] [Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 94, Suppl. I: 387-393, 1999]
- Intensifying the fight against malaria: the World Bank's booster program for malaria control in Africa
"This [2008 World Bank] document describes the purpose and context of the Booster Program, its first three years of operation and the proposed design of phase two of the program. Phase two seeks to build on the successes of and lessons learned from phase one and to enable the World Bank to play its expected role in scaling up and sustaining malaria control interventions to reach the new ambitious but achievable global goal set by the Roll Back Malaria (RBM) Partnership, of eliminating malaria as a major public health problem in Africa by 2015. The Bank has subscribed fully to this agenda, as illustrated by statements made by senior management in several public forums."
- Lessons from the Pacific programme to eliminate lymphatic filariasis: a case study of 5 countries
Background: Lymphatic Filariasis (LF) is an important Neglected Tropical Disease, being a major cause of disability worldwide. The Global Programme to Eliminate Lymphatic Filariasis aims to eliminate LF as a public health problem by the year 2020, primarily through repeated Mass Drug Administration (MDA). The Pacific region programme commenced in 1999. By June 2007, five of the eleven countries classified as endemic had completed five MDA campaigns and post-MDA prevalence surveys to assess their progress. We review available programme data and discuss their implications for other LF elimination programs in developing countries. Methods: Reported MDA coverage and results from initial surveys and post-MDA surveys of LF using the immunochromatographic test (ICT) from these five Pacific Island countries (Tonga, Niue, Vanuatu, Samoa and Cook Islands) were analysed to provide an understanding of their quality and programme progress towards LF elimination. Denominator data reported by each country programme for 2001 was compared to official sources to assess the accuracy of MDA coverage data. Results: Initial survey results from these five countries revealed an ICT prevalence of between 2.7 and 8.6 percent in individuals tested prior to commencement of the programme. Country MDA coverage results varied depending on the source of denominator data. Of the five countries in this case study, three countries (Tonga, Niue and Vanuatu) reached the target prevalence of <1% antigenaemia following five rounds of MDA. However, endpoint data could not be reliably compared to baseline data as survey methodology varied. Conclusion: Accurate and representative baseline and post-campaign prevalence data is crucial for determining program effectiveness and the factors contributing to effectiveness. This is emphasised by the findings of this case study. While three of the five Pacific countries reported achieving the target prevalence of <1% antigenaemia, limitations in the data preclude identification of key determinants of this achievement. [author abstract] [BMC Infectious Diseases 2009, 9: 92]
- Measuring the Burden of Neglected Tropical Diseases: The Global Burden of Disease Framework
"Reliable, comparable information about the main causes of disease and injury in populations, and how these are changing, is a critical input for debates about priorities in the health sector. Traditional sources of information about the descriptive epidemiology of diseases, injuries, and risk factors are generally incomplete, fragmented, and of uncertain reliability and comparability. The Global Burden of Disease (GBD) study has provided a conceptual and methodological framework to quantify and compare the health of populations using a summary measure of both mortality and disability, the disability-adjusted life year (DALY). This paper describes key features of the Global Burden of Disease analytic approach, which provides a standardized measurement framework to permit comparisons across diseases and injuries, as well as risk factors, and a systematic approach to the evaluation of data."
- Microdistribution of Sylvatic Triatomine Populations in Central-Coastal Ecuador
Chagas disease is a serious public health problem in Ecuador, where nearly 230,000 individuals show Trypanosoma cruzi infection. Sylvatic T. cruzi transmission is a threat to current control strategies. This is because of the possibility of house reinfestation by sylvatic triatomines after insecticide treatment. This work quantiŞed the spatial distribution of triatomines in sylvatic habitats and its relationship with nearby human dwellings. A simple random sampling design using live-baited traps and manual searches for triatomines was used in areas near human communities in Manabí province, Ecuador, during June and July 2007. We identified risk factors associated with triatomine density using generalized linear models, and developed predictive maps for triatomine density interpolation. There were 345 triatomines belonging to the species Rhodnius ecuadoriensis and Panstrongylus howardi collected in sylvatic areas. Spatial analyses revealed an aggregated distribution pattern of the sylvatic triatomine populations (clustered mostly at a distance smaller than 100 m). Generalized linear models showed that the distance from the nearest house, nest type, and height from ground level were the main factors explaining triatomine densities. Squirrel nests (Sciurus stramineus), located in plants other than palms, above 5 m and close to the domicile presented higher infestation. Interpolation maps of triatomine microdistribution are presented as potential tools to predict triatomine occurrence. The presence of sylvatic populations and the synanthropic tendency of the vectors highlight the need for continuous active and passive entomological surveillance for the long-term control of Chagas disease. [author abstract] [Journal of Medical Entomology, Vol. 47, no. 1, pp.80-88, January 2010]
- Outbreak(s) of Ebola Hemorrhagic Fever, Congo and Gabon, October 2001 to July 2002
"Congo, Gabon and others countries in Central Africa should ensure, as a priority, the design and implementation of national plans to improve preparedness for epidemic-prone diseases, including Ebola, and to strengthen an integrated disease surveillance system." [Canada Communicable Diseases Report, Volume 29-15, 1 August 2003]
- The Neglected Tropical Diseases of Latin America and the Caribbean: A Review of Disease Burden and Distribution and a Roadmap for Control and Elimination
"The neglected tropical diseases (NTDs) represent some of the most common infections of the poorest people living in the Latin American and Caribbean region (LAC). Because they primarily afflict the disenfranchised poor as well as selected indigenous populations and people of African descent, the NTDs in LAC are largely forgotten diseases even though their collective disease burden may exceed better known conditions such as of HIV/AIDS, tuberculosis, or malaria. Based on their prevalence and healthy life years lost from disability, hookworm infection, other soil-transmitted helminth infections, and Chagas disease are the most important NTDs in LAC, followed by dengue, schistosomiasis, leishmaniasis, trachoma, leprosy, and lymphatic filariasis. On the other hand, for some important NTDs, such as leptospirosis and cysticercosis, complete disease burden estimates are not available. The NTDs in LAC geographically concentrate in 11 different sub-regions, each with a distinctive human and environmental ecology. In the coming years, schistosomiasis could be eliminated in the Caribbean and transmission of lymphatic filariasis and onchocerciasis could be eliminated in Latin America. However, the highest disease burden NTDs, such as Chagas disease, soil-transmitted helminth infections, and hookworm and schistosomiasis co-infections, may first require scale-up of existing resources or the development of new control tools in order to achieve control or elimination. Ultimately, the roadmap for the control and elimination of the more widespread NTDs will require an inter-sectoral approach that bridges public health, social services, and environmental interventions… Rather than a strictly disease-centered approach, comprehensive public policies aimed at community development and poverty reduction will be adopted. These policies will be then implemented at the local level through the mobilization and involvement of various agencies under the responsibility of different government sectors (inter-sectoral action) so that they can come together in a synergistic and synchronic manner. Together with strong social participation and appropriate technologies, the inter-sectoral action completes the three pillars advocated in a primary health care strategy and will contribute towards health systems strengthening."
Educational resources
- TropIKA.net: Tropical Diseases Research to Foster Innovation & Knowledge Application
The Special Programme for Research and Training in Tropical Diseases (TDR) has established TropIKA.net as a global knowledge management electronic portal to share essential information and to facilitate identification of priority needs and major research gaps in the field of infectious diseases of poverty. TropIKA.net is a web-based platform for the acquisition, review and sharing of current information and knowledge on: Public health research needs and scientific opportunities; Research-based evidence in support of control and policy; High profile research activities and control projects; International research funding and support opportunities; and Potential innovations for interventions and control of infectious diseases of poverty.
Organisations and Networks
UN and multinational
Government
- Swiss Tropical Institute
"Founded in 1943 to carry out teaching and research, and to provide services. It is financed by grants from the Canton of Basel-Stadt and the Swiss Federal Government, and to a large extent (75%) by its own income from the provision of medical services, services in support of international health, grants for research projects from the Swiss National Science Foundation and other bodies, and foundations. The Institute is also a partner in a number of development projects overseas. This work is largely financed by the Swiss Agency for Development and Cooperation (SDC)"
Non Government
- Australian Centre for International and Tropical Health
The ACITH is a collaborative venture involving The University of Queensland (UQ) and The Queensland Institute of Medical Research (QIMR). Its mission is to improve the health of populations in Australia and internationally through excellence in education, research and service.
- Australasian College of Tropical Medicine
The ACTM was founded in 1991. Membership includes many eminent professionals working in various fields related to tropical medicine. The College is "committed to the development of tropical medicine and is working with professionals to help manage the glocal burden of tropical disease and injury through networking, research and development".
- American Society of Tropical Medicine & Hygiene
The ASTMH is the principal organization of the US representing scientists, clinicians, and others with interests in the prevention and control of tropical diseases through research and education.
- International Federation for Tropical Medicine
The Federation was formed in 1984 with the support of the Rockefeller Foundation. It has representatives from 10 major tropical medicine societies including the Australasian College of Tropical Medicine.
- Malaria Foundation
Provides rich resources on malaria and represents global networking against malaria
- Prince Leopold Institute of Tropical Medicine
The ITM is situated in Antwerp, Belgium. It commenced its research activities in Brussels in 1906. It aims to be "one of the world's leading institutes for training, research and assistance in tropical medicine and health care in developin countries".
Academic Institutions with particular focus in this area
Key Conferences, conference and workshop reports
Conference reports
Journals, Newsletters, Forums
Bibliographies, Libraries
Public health bookshops
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