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Barrett MP, Priotto G, Franco JR, Lejon V, Lindner AK. Elimination of human African trypanosomiasis: The long last mile. PLoS Negl Trop Dis 2024; 18:e0012091. [PMID: 38691551 PMCID: PMC11062537 DOI: 10.1371/journal.pntd.0012091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024] Open
Affiliation(s)
- Michael P. Barrett
- School of Infection & Immunity, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Gerardo Priotto
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Jose R. Franco
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Veerle Lejon
- UMR177 Intertryp, Institut de Recherche pour le Développement, CIRAD, University of Montpellier, Montpellier, France
| | - Andreas K. Lindner
- Charité - Universitätsmedizin Berlin, Charité Center for Global Health, Institute of International Health, Berlin, Germany
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Abstract
Trachoma is a neglected tropical disease caused by infection with conjunctival strains of Chlamydia trachomatis. It can result in blindness. Pathophysiologically, trachoma is a disease complex composed of two linked chronic processes: a recurrent, generally subclinical infectious-inflammatory disease that mostly affects children, and a non-communicable, cicatricial and, owing to trichiasis, eventually blinding disease that supervenes in some individuals later in life. At least 150 infection episodes over an individual's lifetime are needed to precipitate trichiasis; thus, opportunity exists for a just global health system to intervene to prevent trachomatous blindness. Trachoma is found at highest prevalence in the poorest communities of low-income countries, particularly in sub-Saharan Africa; in June 2021, 1.8 million people worldwide were going blind from the disease. Blindness attributable to trachoma can appear in communities many years after conjunctival C. trachomatis transmission has waned or ceased; therefore, the two linked disease processes require distinct clinical and public health responses. Surgery is offered to individuals with trichiasis and antibiotic mass drug administration and interventions to stimulate facial cleanliness and environmental improvement are designed to reduce infection prevalence and transmission. Together, these interventions comprise the SAFE strategy, which is achieving considerable success. Although much work remains, a continuing public health problem from trachoma in the year 2030 will be difficult for the world to excuse.
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Hopkins DR, Ijaz K, Weiss A, Roy SL, Ross DA. Reply to: Rethinking disease eradication: putting countries first. Int Health 2021; 13:648-649. [PMID: 34532741 PMCID: PMC8643430 DOI: 10.1093/inthealth/ihab055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/13/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Donald R Hopkins
- The Carter Center, 453 John Lewis Freedom Parkway, Atlanta, GA 30307, USA
| | - Kashef Ijaz
- The Carter Center, 453 John Lewis Freedom Parkway, Atlanta, GA 30307, USA
| | - Adam Weiss
- The Carter Center, 453 John Lewis Freedom Parkway, Atlanta, GA 30307, USA
| | - Sharon L Roy
- Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop H24-3, Atlanta, GA 30329, USA
| | - David A Ross
- The Task Force for Global Health, 330 W. Ponce de Leon Avenue, Decatur, GA 30030, USA
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Weld ED, Astemborski J, Kirk GD, Sulkowski MS, Stephanie K, Rothman R, Solomon SS, Matthews GV, Hsieh YH, Verma M, Traverso G, Swindells S, Owen A, Feld J, Flexner C, Mehta SH, Thomas DL. Preferences of Persons with or at Risk for Hepatitis C for Long-Acting Treatments. Clin Infect Dis 2021; 75:3-10. [PMID: 34699587 DOI: 10.1093/cid/ciab913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Whereas safe, curative treatments for hepatitis C virus (HCV) have been available since 2015, there are still 58 million infected persons worldwide, and global elimination may require new paradigms. We sought to understand the acceptability of long-acting HCV treatment approaches. METHODS A cross-sectional, 43-question survey was administered to 1457 individuals with HCV or at risk of HCV at 28 sites in 9 countries to assess comparative interest in a variety of long-acting strategies in comparison to oral pills. RESULTS Among HCV-positive participants, 37.7% most preferred an injection, 5.6% an implant, and 6% a gastric residence device, as compared to 50.8% who stated they would most prefer taking 1 to 3 pills per day. When compared directly to taking pills, differences were observed in the relative preference for an injection based on age (p<0.001), location (p<0.001), and prior receipt of HCV treatment (p=0.005), but not sex. When an implant was compared to pills, greater preference was represented by women (p=0.01) and adults of younger ages (p=0.012 per 5 years). Among participants without HCV, 49.5% felt that injections are stronger than pills, and 34.7% preferred taking injections to pills. Among those at-risk participants who had received injectable medications in the past, 123 out of 137 (89.8%) expressed willingness to receive one in the future. CONCLUSIONS These data point to high acceptability of long-acting treatments, which for a substantial minority, might even be preferred to pills for the treatment of HCV infection. Long-acting treatments for HCV infection might contribute to global efforts to eliminate hepatitis C.
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Affiliation(s)
- Ethel D Weld
- Department of Medicine, Division of Clinical Pharmacology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Medicine, Division of Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jacqueline Astemborski
- Department of Medicine, Division of Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gregory D Kirk
- Department of Medicine, Division of Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Epidemiology, Division of Infectious Disease Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mark S Sulkowski
- Department of Medicine, Division of Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Katz Stephanie
- Department of Medicine, Division of Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Richard Rothman
- Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sunil S Solomon
- Department of Medicine, Division of Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Yu-Hsiang Hsieh
- Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Malvika Verma
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Giovanni Traverso
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.,Division of Gastroenterology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan Swindells
- Department of Internal Medicine, Section of Infectious Diseases, The University of Nebraska Medical Center, Omaha, NE, USA
| | - Andrew Owen
- Department of Pharmacology and Therapeutics, Centre of Excellence in Long acting Therapeutics (CELT), University of Liverpool, Liverpool, UK
| | - Jordan Feld
- The Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Charles Flexner
- Department of Medicine, Division of Clinical Pharmacology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Medicine, Division of Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shruti H Mehta
- Department of Epidemiology, Division of Infectious Disease Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - David L Thomas
- Department of Medicine, Division of Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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