Tuesday, January 22, 2013

Neglected Tropical Diseases: An Update From the WHO

Distribution of soil-transmitted helminths (STHs) and proportion
of children requiring preventive chemotherapy; where we practice
in Honduras STHs are a major problem (www.who.int)
The World Health Organization (WHO) just released its second report on Neglected Tropical Diseases (NTDs); this is a 152 page document outlining the global response to combatting NTDs. The WHO also released a one page summary of this report's findings which can be found here.

As I have previously noted, NTDs include a group of seventeen tropical infections, mostly worms, that are associated with high morbidity (things such as poor growth and mental development in children, pregnancy complications) but low mortality. Despite their major negative effects on health they do not receive much "press" (as opposed to better known diseases such as malaria, HIV and tuberculosis). It is estimated that 1 in 6 people in the world currently suffer from an NTD. 

Global improvements in access to STH therapy have occurred over
the past few years (www.who.int)
In our work in Honduras we focus on decreasing the burden of NTDs, specifically, soil-transmitted helminths (intestinal worms). We estimate that somewhere between 30-70% of the patients we see are infected with one or more of these worms. We provide anti-helminthic therapy according to WHO guidelines, with the hopes of decreasing the overall burden of these infections in the population at large. According to the WHO, "deworming school-aged children is probably the most economically efficient public health activity that can be implemented in any low-income country."

Overall the WHO document is positive, noting recent improvements in combatting NTDs globally. Two diseases have been targeted for elimination, including guinea worm disease in 2015 and yaws in 2020. Global coverage for many other NTDs has improved in recent years, as well. Although there have been significant advances over the past few years, there is still a great deal of work to be done. 

The report also highlights the global dengue problem; the incidence of this disease has increased 30-fold in the past 50 years, and sustainable preventive measures need to be adopted globally to prevent continued spread of this mosquito-borne illness. 

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