1
|
Savioli L. Conditional cash transfers for neglected tropical diseases. The Lancet Global Health 2022; 10:e1097. [PMID: 35839809 PMCID: PMC9296653 DOI: 10.1016/s2214-109x(22)00253-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/13/2022] [Accepted: 05/18/2022] [Indexed: 12/02/2022] Open
|
2
|
Molyneux DH, Asamoa-Bah A, Fenwick A, Savioli L, Hotez P. The history of the neglected tropical disease movement. Trans R Soc Trop Med Hyg 2021; 115:169-175. [PMID: 33508096 PMCID: PMC7842098 DOI: 10.1093/trstmh/trab015] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 01/07/2021] [Accepted: 01/13/2021] [Indexed: 01/05/2023] Open
Abstract
The history of the neglected tropical disease movement is seen through the lens of authors who worked during the last 4 decades in different roles and in different settings, from Western-based laboratories to clinical roles in endemic countries and in critical policy roles in the World Health Organization (WHO). The authors seek to identify key players from the introduction of the word 'neglected' by the late Kenneth Warren in his Rockefeller Foundation-supported Great Neglected Diseases of Mankind movement through to the more recent developments after the London Declaration of 2012. The role of the various actors-endemic countries, major pharmaceutical companies, the WHO, non-government development organizations, bilateral donors and academia-are discussed. The critical events and decisions are highlighted that were essential enabling factors in creating a viable and successful movement and with a resultant massive global public health and antipoverty impact. The importance of advocacy is emphasized in creating the momentum to establish a globally recognized public health 'brand' as a target in the United Nations Sustainable Development Goals.
Collapse
Affiliation(s)
- David H Molyneux
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | | | - Alan Fenwick
- School of Public Health Imperial College Norfolk Place W2 1PG, UK
| | - Lorenzo Savioli
- P.O. Box 267, Chake Chake, Pemba Island, Zanzibar, United Republic of Tanzania
| | - Peter Hotez
- National School of Tropical Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| |
Collapse
|
3
|
Savioli L, Albonico M, Daumerie D, Lo NC, Stothard JR, Asaolu S, Tchuem Tchuenté LA, Anderson RM. Review of the 2017 WHO Guideline: Preventive chemotherapy to control soil-transmitted helminth infections in at-risk population groups. An opportunity lost in translation. PLoS Negl Trop Dis 2018; 12:e0006296. [PMID: 29698486 PMCID: PMC5919405 DOI: 10.1371/journal.pntd.0006296] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Lorenzo Savioli
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | | | - Denis Daumerie
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Nathan C. Lo
- Division of Epidemiology, Stanford University, Stanford, California, United States of America
| | - J. Russell Stothard
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Samuel Asaolu
- Department of Zoology, Obafemi Awolowo University, Ife, Nigeria
| | | | - Roy M. Anderson
- London Centre for Neglected Tropical Disease Research (LCNTDR), Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, United Kingdom
| |
Collapse
|
4
|
Affiliation(s)
- Lorenzo Savioli
- Former Director, Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.
| | - Denis Daumerie
- Former Programme Manager, Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| |
Collapse
|
5
|
Affiliation(s)
- Marco Albonico
- Centre for Tropical Diseases, S Cuore Hospital, Negrar, Verona, Italy
| | - Lorenzo Savioli
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| |
Collapse
|
6
|
Savioli L, Albonico M, Colley DG, Correa-Oliveira R, Fenwick A, Green W, Kabatereine N, Kabore A, Katz N, Klohe K, LoVerde PT, Rollinson D, Stothard JR, Tchuem Tchuenté LA, Waltz J, Zhou XN. Building a global schistosomiasis alliance: an opportunity to join forces to fight inequality and rural poverty. Infect Dis Poverty 2017; 6:65. [PMID: 28330495 PMCID: PMC5363045 DOI: 10.1186/s40249-017-0280-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 03/06/2017] [Indexed: 01/24/2023] Open
Abstract
Schistosomiasis, one of the 17 neglected tropical diseases listed by the World Health Organization, presents a substantial public health and economic burden. Of the 261 million people requiring preventive chemotherapy for schistosomiasis in 2013, 92% of them lived in sub-Saharan Africa and only 12.7% received preventive chemotherapy. Moreover, in 2010, the WHO reported that schistosomiasis mortality could be as high as 280 000 per year in Africa alone.In May 2012 delegates to the sixty-fifth World Health Assembly adopted resolution WHA65.21 that called for the elimination of schistosomiasis, and foresees the regular treatment of at least 75% of school age children in at-risk areas. The resolution urged member states to intensify schistosomiasis control programmes and to initiate elimination campaigns where possible.Despite this, in June 2015, schistosomiasis was indicated to have the lowest level of preventive chemotherapy implementation in the spectrum of neglected tropical diseases. It was also highlighted as the disease most lacking in progress. This is perhaps unsurprising, given that it was also the only NTD with access to drug donations but without a coalition of stakeholders that collaborates to boost commitment and implementation.As a consequence, and to ensure that the WHO NTDs Roadmap Targets of 2012 and World Health Assembly Resolution WHA65.21 are met, the Global Schistosomiasis Alliance (GSA) has been set up. Diverse and representative, the GSA aims to be a partnership of endemic countries, academic and research institutions, international development agencies and foundations, international organizations, non-governmental development organizations, private sector companies and advocacy and resource mobilisation partners. Ultimately, the GSA calls for a partnership to work for the benefit of endemic countries by addressing health inequity and rural poverty.
Collapse
Affiliation(s)
| | - Marco Albonico
- Center for Tropical Diseases, Sacro Cuore Hospital - WHO Collaborating Centre on strongyloidiasis and other intestinal parasitic infections, Negrar, Verona Italy
| | - Daniel G. Colley
- Schistosomiasis Consortium for Operational Research and Evaluation, The University of Georgia, Athens, Georgia USA
| | - Rodrigo Correa-Oliveira
- Centro de Pesquisas René Rachou – Fiocruz, Belo Horizonte, Brazil and Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - Alan Fenwick
- Department of Infectious Disease Epidemiology, SCI, Imperial College, London, UK
| | - Will Green
- Trinity College Cambridge, Cambridge, UK
| | | | | | - Naftale Katz
- Research Center René Rachou – Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | | | | | - David Rollinson
- Life Sciences Department, The Natural History Museum, London, UK
| | - J. Russell Stothard
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA UK
| | | | | | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases Chinese Center for Disease Control and Prevention, Shanghai, China
| |
Collapse
|
7
|
Abstract
The concept of neglected tropical diseases (NTDs) emerged more than a decade ago and has been recognised as a valid way to categorise diseases that affect the poorest individuals. Substantial progress in control and elimination has been achieved and policy momentum has been generated through continued bilateral, philanthropic, and non-governmental development organisation (NGDO) support, and donations of drugs from pharmaceutical companies. WHO has defined a Roadmap to reach 2020 targets, which was endorsed by member states in a World Health Assembly Resolution in 2013. NTDs have been included within the Sustainable Development Goal targets and are a crucial component of universal health coverage, conceptualised as "leaving no one behind". WHO reported that more than 1 billion people in 88 countries have benefited from preventive chemotherapy in 2014. The research agenda has defined the need for affordable products (diagnostics, drugs and insecticides). However challenges such as insecurity and weak health systems continue to prevail in the poorest countries, inhibiting progress in scaling up and also in achieving Roadmap goals.
Collapse
Affiliation(s)
- David H Molyneux
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK.
| | - Lorenzo Savioli
- Global Schistosomiasis Alliance, Chavannes de Bogis, Switzerland
| | - Dirk Engels
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| |
Collapse
|
8
|
Lo NC, Addiss DG, Hotez PJ, King CH, Stothard JR, Evans DS, Colley DG, Lin W, Coulibaly JT, Bustinduy AL, Raso G, Bendavid E, Bogoch II, Fenwick A, Savioli L, Molyneux D, Utzinger J, Andrews JR. A call to strengthen the global strategy against schistosomiasis and soil-transmitted helminthiasis: the time is now. Lancet Infect Dis 2016; 17:e64-e69. [PMID: 27914852 DOI: 10.1016/s1473-3099(16)30535-7] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 11/17/2016] [Accepted: 11/22/2016] [Indexed: 01/01/2023]
Abstract
In 2001, the World Health Assembly (WHA) passed the landmark WHA 54.19 resolution for global scale-up of mass administration of anthelmintic drugs for morbidity control of schistosomiasis and soil-transmitted helminthiasis, which affect more than 1·5 billion of the world's poorest people. Since then, more than a decade of research and experience has yielded crucial knowledge on the control and elimination of these helminthiases. However, the global strategy has remained largely unchanged since the original 2001 WHA resolution and associated WHO guidelines on preventive chemotherapy. In this Personal View, we highlight recent advances that, taken together, support a call to revise the global strategy and guidelines for preventive chemotherapy and complementary interventions against schistosomiasis and soil-transmitted helminthiasis. These advances include the development of guidance that is specific to goals of morbidity control and elimination of transmission. We quantify the result of forgoing this opportunity by computing the yearly disease burden, mortality, and lost economic productivity associated with maintaining the status quo. Without change, we estimate that the population of sub-Saharan Africa will probably lose 2·3 million disability-adjusted life-years and US$3·5 billion of economic productivity every year, which is comparable to recent acute epidemics, including the 2014 Ebola and 2015 Zika epidemics. We propose that the time is now to strengthen the global strategy to address the substantial disease burden of schistosomiasis and soil-transmitted helminthiasis.
Collapse
Affiliation(s)
- Nathan C Lo
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA; Division of Epidemiology, Stanford University School of Medicine, Stanford, CA, USA.
| | - David G Addiss
- Children Without Worms, Task Force for Global Health, Decatur, GA, USA
| | - Peter J Hotez
- Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development, National School of Tropical Medicine at Baylor College of Medicine, Houston, TX, USA; Department of Biology, Baylor University, Waco, TX, USA; James A Baker III Institute for Public Policy, Rice University, Houston, TX, USA
| | - Charles H King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, USA
| | - J Russell Stothard
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Darin S Evans
- United States Agency for International Development, Global Health, Washington, DC, USA
| | - Daniel G Colley
- Center for Tropical and Emerging Global Diseases and the Department of Microbiology, University of Georgia, Athens, GA, USA
| | - William Lin
- Global Public Health, Johnson & Johnson, New Brunswick, NJ, USA
| | - Jean T Coulibaly
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Amaya L Bustinduy
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Giovanna Raso
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Eran Bendavid
- Division of General Medical Disciplines, Stanford University, Stanford, CA, USA; Center for Health Policy and the Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA, USA
| | - Isaac I Bogoch
- Department of Medicine, University of Toronto, Toronto, ON, Canada; Division of Internal Medicine and Infectious Diseases, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Alan Fenwick
- Schistosomiasis Control Initiative, Imperial College London, London, UK
| | - Lorenzo Savioli
- Global Schistosomiasis Alliance, Chavannes de Bogis, Switzerland
| | - David Molyneux
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Jason R Andrews
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA
| |
Collapse
|
9
|
Stothard JR, Loxton N, Rollinson D, Mgeni AF, Khamis S, Ameri H, Ramsan M, Savioli L. The transmission status of Bulinus on Zanzibar Island (Unguja), with implications for control of urinary schistosomiasis. Annals of Tropical Medicine & Parasitology 2016. [DOI: 10.1080/00034983.2000.11813517] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
10
|
Montresor A, Addiss D, Albonico M, Ali SM, Ault SK, Gabrielli AF, Garba A, Gasimov E, Gyorkos T, Jamsheed MA, Levecke B, Mbabazi P, Mupfasoni D, Savioli L, Vercruysse J, Yajima A. Methodological Bias Can Lead the Cochrane Collaboration to Irrelevance in Public Health Decision-Making. PLoS Negl Trop Dis 2015; 9:e0004165. [PMID: 26492178 PMCID: PMC4619606 DOI: 10.1371/journal.pntd.0004165] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Antonio Montresor
- Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - David Addiss
- Children Without Worms, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Marco Albonico
- WHO Collaborating Centre for Neglected Tropical Diseases, Public Health Laboratory Ivo de Carneri, Zanzibar, United Republic of Tanzania
| | - Said Mohammed Ali
- WHO Collaborating Centre for Neglected Tropical Diseases, Public Health Laboratory Ivo de Carneri, Zanzibar, United Republic of Tanzania
| | - Steven K. Ault
- Neglected Infectious Diseases, Pan American Health Organization, World Health Regional Office for the Americas, Washington, DC, United States of America
| | - Albis-Francesco Gabrielli
- Neglected Tropical Diseases, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Amadou Garba
- Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Elkhan Gasimov
- Malaria, Other Vectorborne and Parasitic Diseases, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Theresa Gyorkos
- WHO Collaborating Centre for Research and Training in Parasite Epidemiology and Control, Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Mohamed Ahmed Jamsheed
- Vector-Borne and Neglected Tropical Diseases Control, World Health Organization Regional Office for South-East Asia, New Delhi, India
| | - Bruno Levecke
- WHO Collaborating Centre for the Monitoring of Anthelminthic Drug Efficacy for Soil-Transmitted Helminthiasis, Department of Virology, Parasitology and Immunology, University of Ghent, Ghent, Belgium
| | - Pamela Mbabazi
- Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Denise Mupfasoni
- Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Lorenzo Savioli
- Global Schistosomiasis Alliance and Public Health Laboratory Ivo de Carneri, Zanzibar, United Republic of Tanzania
| | - Jozef Vercruysse
- WHO Collaborating Centre for the Monitoring of Anthelminthic Drug Efficacy for Soil-Transmitted Helminthiasis, Department of Virology, Parasitology and Immunology, University of Ghent, Ghent, Belgium
| | - Aya Yajima
- Malaria, Other Vectorborne and Parasitic Diseases, World Health Organization, Regional Office for Western Pacific, Manila, Philippines
| |
Collapse
|
11
|
Affiliation(s)
- Lorenzo Savioli
- The Global Schistosomiasis Alliance, 1279 Chavannes de Bogis, Switzerland; Public Health Laboratory-Ivo de Carneri, Ministry of Health of Zanzibar, Zanzibar, Tanzania.
| | - Alan Fenwick
- Schistosomiasis Control Initiative, Department of Infectious Diseases Epidemiology, Imperial College London, London, UK
| | - David Rollinson
- Life Sciences Department, Natural History Museum, London, UK
| | | | - Shaali Makame Ame
- Public Health Laboratory-Ivo de Carneri, Ministry of Health of Zanzibar, Zanzibar, Tanzania
| |
Collapse
|
12
|
Savioli L, Velayudhan R. Small bite, big threat: World Health Day 2014. East Mediterr Health J 2014; 20:217-218. [PMID: 24952116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Lorenzo Savioli
- Director, Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Raman Velayudhan
- Coordinator, Vector Ecology and Management, Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| |
Collapse
|
13
|
|
14
|
Smith CS, Noordeen SK, Richardus JH, Sansarricq H, Cole ST, Soares RC, Savioli L, Aerts A, Aertsh A, Baruaf S. A strategy to halt leprosy transmission. Lancet Infect Dis 2014; 14:96-8. [PMID: 24457165 DOI: 10.1016/s1473-3099(13)70365-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Cairns S Smith
- Institute of Applied Health Sciences, School of Medicine and Dentistry, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK.
| | | | | | | | - Stewart T Cole
- Global Health Institute, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | | | - Lorenzo Savioli
- Department of Control of Neglected Tropical Diseases, WHO, Geneva, Switzerland
| | | | - Ann Aertsh
- Novartis Foundation for Sustainable Development, Basel, Switzerland
| | | |
Collapse
|
15
|
Affiliation(s)
- Melody Tan
- Department of Bioengineering, Rice University, Houston, Texas, United States of America
| | - Rita Kusriastuti
- Vector Borne and Neglected Tropical Diseases Unit, South-East Asia Regional Organization (SEARO), World Health Organization, New Delhi, India
- * E-mail: (RK); (LS); (PH)
| | - Lorenzo Savioli
- Department of Neglected Tropical Diseases, World Health Organization (WHO), Geneva, Switzerland
- * E-mail: (RK); (LS); (PH)
| | - Peter J. Hotez
- Departments of Pediatrics and Microbiology and Molecular Virology, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America
- Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development, Houston, Texas, United States of America
- James A. Baker III Institute for Public Policy, Rice University, Houston, Texas, United States of America
- * E-mail: (RK); (LS); (PH)
| |
Collapse
|
16
|
Affiliation(s)
- Lorenzo Savioli
- From the Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva
| |
Collapse
|
17
|
Montresor A, Gabrielli AF, Engels D, Daumerie D, Savioli L. Has the NTD community neglected evidence-based policy? PLOS NTDs 2013 expert commentary of the viewpoint by Nagpal S, Sinclair D, Garner P. PLoS Negl Trop Dis 2013; 7:e2299. [PMID: 23875037 PMCID: PMC3708845 DOI: 10.1371/journal.pntd.0002299] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Antonio Montresor
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.
| | | | | | | | | |
Collapse
|
18
|
Montresor A, Gabrielli AF, Yajima A, Lethanh N, Biggs BA, Casey GJ, Tinh TT, Engels D, Savioli L. Markov model to forecast the change in prevalence of soil-transmitted helminths during a control programme: a case study in Vietnam. Trans R Soc Trop Med Hyg 2013; 107:313-8. [PMID: 23471919 DOI: 10.1093/trstmh/trt019] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND A mathematical model based on the Markov methodology to predict the change in prevalence of soil-transmitted helminth (STH) infections during public health control activities is not available, but would be an extremely efficient planning tool. METHOD We used the parasitological data collected during a deworming and iron supplementation programme for women of child-bearing age conducted in Vietnam between 2006 and 2011 to develop a Markov transition probability model. The transition probabilities were calculated from the observed changes in prevalence in the different classes of intensity for each STH species during the first year of intervention. The model was then developed and used to estimate the prevalence in year 2, 3, 4 and 5 for each STH species and for 'any STH infection'. The prevalence predicted by the model was then compared with the prevalence observed at different times during programme implementation. RESULTS The comparison between the model-predicted prevalence and the observed prevalence proved a good fit of the model. CONCLUSIONS We consider the Markov transition probability model to be a promising method of predicting changes in STH prevalence during control efforts. Further research to validate the model with observed data in different geographical and epidemiological settings is suggested to refine the prediction model.
Collapse
Affiliation(s)
- Antonio Montresor
- Department of Control of Neglected Tropical Diseases, World Heath Organization, Avenue Appia 20, 1211 Geneva, Switzerland.
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Abstract
Huge increases in funding for international health over the past two decades have led to a proliferation of donors, partnerships, and health organisations. Over the same period, the global burden of non-communicable diseases has increased absolutely and relative to communicable diseases. In this changing landscape, national programmes for the control of HIV/AIDS, tuberculosis, malaria, and neglected tropical diseases must be reinforced and adapted for three reasons: the global burden of these communicable diseases remains enormous, disease control programmes have an integral and supporting role in developing health systems, and the health benefits of these control programmes go beyond the containment of specific infections. WHO's traditional role in promoting communicable disease control programmes must also adapt to new circumstances. Among a multiplicity of actors, WHO's task is to enhance its normative role as convenor, coordinator, monitor, and standard-setter, fostering greater coherence in global health.
Collapse
Affiliation(s)
- Christopher Dye
- HIV/AIDS, Tuberculosis, Malaria & Neglected Tropical Diseases Cluster, World Health Organization, CH-1211 Geneva 27, Switzerland.
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Knopp S, Mohammed KA, Ali SM, Khamis IS, Ame SM, Albonico M, Gouvras A, Fenwick A, Savioli L, Colley DG, Utzinger J, Person B, Rollinson D. Study and implementation of urogenital schistosomiasis elimination in Zanzibar (Unguja and Pemba islands) using an integrated multidisciplinary approach. BMC Public Health 2012; 12:930. [PMID: 23110494 PMCID: PMC3533998 DOI: 10.1186/1471-2458-12-930] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 10/11/2012] [Indexed: 12/29/2022] Open
Abstract
Background Schistosomiasis is a parasitic infection that continues to be a major public health problem in many developing countries being responsible for an estimated burden of at least 1.4 million disability-adjusted life years (DALYs) in Africa alone. Importantly, morbidity due to schistosomiasis has been greatly reduced in some parts of the world, including Zanzibar. The Zanzibar government is now committed to eliminate urogenital schistosomiasis. Over the next 3–5 years, the whole at-risk population will be administered praziquantel (40 mg/kg) biannually. Additionally, snail control and behaviour change interventions will be implemented in selected communities and the outcomes and impact measured in a randomized intervention trial. Methods/Design In this 5-year research study, on both Unguja and Pemba islands, urogenital schistosomiasis will be assessed in 45 communities with urine filtration and reagent strips in 4,500 schoolchildren aged 9–12 years annually, and in 4,500 first-year schoolchildren and 2,250 adults in years 1 and 5. Additionally, from first-year schoolchildren, a finger-prick blood sample will be collected and examined for Schistosoma haematobium infection biomarkers. Changes in prevalence and infection intensity will be assessed annually. Among the 45 communities, 15 were randomized for biannual snail control with niclosamide, in concordance with preventive chemotherapy campaigns. The reduction of Bulinus globosus snail populations and S. haematobium-infected snails will be investigated. In 15 other communities, interventions triggering behaviour change have been designed and will be implemented in collaboration with the community. A change in knowledge, attitudes and practices will be assessed annually through focus group discussions and in-depth interviews with schoolchildren, teachers, parents and community leaders. In all 45 communities, changes in the health system, water and sanitation infrastructure will be annually tracked by standardized questionnaire-interviews with community leaders. Additional issues potentially impacting on study outcomes and all incurring costs will be recordedand monitored longitudinally. Discussion Elimination of schistosomiasis has become a priority on the agenda of the Zanzibar government and the international community. Our study will contribute to identifying what, in addition to preventive chemotherapy, needs to be done to prevent, control, and ultimately eliminate schistosomiasis, and to draw lessons for current and future schistosomiasis elimination programmes in Africa and elsewhere. Trial registration ISRCTN48837681
Collapse
Affiliation(s)
- Stefanie Knopp
- Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, Cromwell Road, London, SW7 5BD, UK
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Montresor A, Gabrielli AF, Chitsulo L, Ichimori K, Mariotti S, Engels D, Savioli L. Preventive chemotherapy and the fight against neglected tropical diseases. Expert Rev Anti Infect Ther 2012; 10:237-42. [PMID: 22339196 DOI: 10.1586/eri.11.165] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Preventive chemotherapy is the public health strategy recommended by the WHO against a set of neglected tropical diseases that includes four groups of helminth infections (lymphatic filariasis, onchocerciasis, schistosomiasis and soil-transmitted helminthiasis) and one chlamydial (trachoma) infection. This article presents the characteristics of preventive chemotherapy interventions directed against each disease targeted by this strategy and provides an update on the status of their implementation worldwide.
Collapse
Affiliation(s)
- Antonio Montresor
- Department of Control of Neglected Tropical Diseases, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland.
| | | | | | | | | | | | | |
Collapse
|
22
|
Hanson C, Weaver A, Zoerhoff KL, Kabore A, Linehan M, Doherty A, Engels D, Savioli L, Ottesen EA. Integrated implementation of programs targeting neglected tropical diseases through preventive chemotherapy: identifying best practices to roll out programs at national scale. Am J Trop Med Hyg 2012; 86:508-513. [PMID: 22403327 DOI: 10.4269/ajtmh.2012.11-1589] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
In 2006 the U.S. Agency for International Development (USAID) established the Neglected Tropical Disease (NTD) Control Program to support national governments in developing successful, cost-efficient NTD programs that integrate disease-specific programs into coordinated national initiatives, in accord with the World Health Organization recommendations. A 3-stage "roll-out package" has been developed for effectively integrating and scaling up such programs to full-national scale. Stage-1 lays the groundwork-identifying NTD leadership within the Ministry of Health, conducting a national Situation Analysis, formulating a multiyear Plan of Action, and undertaking a funding gap analysis. Stage-2 focuses on scaling up the integrated NTD program-convening national stakeholder meetings, developing annual work plans, carrying out disease mapping, and establishing monitoring and evaluation activities. Stage-3 aims at ensuring effective management-identifying clear roles and responsibilities for partners, and creating a central coordinating mechanism. Assessment and reassessment of these complex NTD programs that target literally billions of people are essential to establish "best practice" strategies for long-term public health success.
Collapse
|
23
|
Hanson C, Weaver A, Zoerhoff KL, Kabore A, Linehan M, Doherty A, Engels D, Savioli L, Ottesen EA. Integrated implementation of programs targeting neglected tropical diseases through preventive chemotherapy: identifying best practices to roll out programs at national scale. Am J Trop Med Hyg 2012; 86. [PMID: 22403327 PMCID: PMC3284372 DOI: 10.4269/ajtmh.2012.11-0589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
In 2006 the U.S. Agency for International Development (USAID) established the Neglected Tropical Disease (NTD) Control Program to support national governments in developing successful, cost-efficient NTD programs that integrate disease-specific programs into coordinated national initiatives, in accord with the World Health Organization recommendations. A 3-stage "roll-out package" has been developed for effectively integrating and scaling up such programs to full-national scale. Stage-1 lays the groundwork-identifying NTD leadership within the Ministry of Health, conducting a national Situation Analysis, formulating a multiyear Plan of Action, and undertaking a funding gap analysis. Stage-2 focuses on scaling up the integrated NTD program-convening national stakeholder meetings, developing annual work plans, carrying out disease mapping, and establishing monitoring and evaluation activities. Stage-3 aims at ensuring effective management-identifying clear roles and responsibilities for partners, and creating a central coordinating mechanism. Assessment and reassessment of these complex NTD programs that target literally billions of people are essential to establish "best practice" strategies for long-term public health success.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Eric A. Ottesen
- *Address correspondence to Eric A. Ottesen, RTI International, 805 15 Street NW, Suite 601, Washington, DC. E-mail:
| |
Collapse
|
24
|
Hotez PJ, Savioli L, Fenwick A. Neglected tropical diseases of the Middle East and North Africa: review of their prevalence, distribution, and opportunities for control. PLoS Negl Trop Dis 2012; 6:e1475. [PMID: 22389729 PMCID: PMC3289601 DOI: 10.1371/journal.pntd.0001475] [Citation(s) in RCA: 218] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The neglected tropical diseases (NTDs) are highly endemic but patchily distributed among the 20 countries and almost 400 million people of the Middle East and North Africa (MENA) region, and disproportionately affect an estimated 65 million people living on less than US$2 per day. Egypt has the largest number of people living in poverty of any MENA nation, while Yemen has the highest prevalence of people living in poverty. These two nations stand out for having suffered the highest rates of many NTDs, including the soil-transmitted nematode infections, filarial infections, schistosomiasis, fascioliasis, leprosy, and trachoma, although they should be recognized for recent measures aimed at NTD control. Leishmaniasis, especially cutaneous leishmaniasis, is endemic in Syria, Iran, Iraq, Libya, Morocco, and elsewhere in the region. Both zoonotic (Leishmania major) and anthroponotic (Leishmania tropica) forms are endemic in MENA in rural arid regions and urban regions, respectively. Other endemic zoonotic NTDs include cystic echinococcosis, fascioliasis, and brucellosis. Dengue is endemic in Saudi Arabia, where Rift Valley fever and Alkhurma hemorrhagic fever have also emerged. Great strides have been made towards elimination of several endemic NTDs, including lymphatic filariasis in Egypt and Yemen; schistosomiasis in Iran, Morocco, and Oman; and trachoma in Morocco, Algeria, Iran, Libya, Oman, Saudi Arabia, Tunisia, and the United Arab Emirates. A particularly noteworthy achievement is the long battle waged against schistosomiasis in Egypt, where prevalence has been brought down by regular praziquantel treatment. Conflict and human and animal migrations are key social determinants in preventing the control or elimination of NTDs in the MENA, while local political will, strengthened international and intersectoral cooperative efforts for surveillance, mass drug administration, and vaccination are essential for elimination.
Collapse
Affiliation(s)
- Peter J. Hotez
- Departments of Pediatrics and Molecular Virology & Microbiology, and National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America
- Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development, Houston, Texas, United States of America
- * E-mail: (PJH); (AF)
| | - Lorenzo Savioli
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Alan Fenwick
- Schistosomiasis Control Initiative and Department of Infectious Disease Epidemiology, Imperial College, St. Mary's Campus, London, United Kingdom
- * E-mail: (PJH); (AF)
| |
Collapse
|
25
|
Montresor A, Engels D, Chitsulo L, Gabrielli A, Albonico M, Savioli L, Lammie P. The appropriate indicator should be used to assess treatment failure in STH infections. Am J Trop Med Hyg 2011; 85:579-80; author reply 581. [PMID: 21896826 PMCID: PMC3163888 DOI: 10.4269/ajtmh.2011.11-0317a] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
26
|
|
27
|
Affiliation(s)
- Peter J Hotez
- Department of Microbiology, Immunology, and Tropical Medicine, George Washington University and Sabin Vaccine Institute, Washington, DC 20037, USA.
| | | | | | | |
Collapse
|
28
|
Narain JP, Dash AP, Parnell B, Bhattacharya SK, Barua S, Bhatia R, Savioli L. Elimination of neglected tropical diseases in the South-East Asia Region of the World Health Organization. Bull World Health Organ 2010; 88:206-10. [PMID: 20428388 DOI: 10.2471/blt.09.072322] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Revised: 01/26/2010] [Accepted: 01/27/2010] [Indexed: 11/27/2022] Open
Abstract
The neglected tropical diseases (NTDs), which affect the very poor, pose a major public health problem in the South-East Asia Region of the World Health Organization (WHO). Although more than a dozen NTDs affect the region, over the past five years four of them in particular - leprosy, lymphatic filariasis, visceral leishmaniasis (kala-azar) and yaws - have been targeted for elimination. These four were selected for a number of reasons. First, they affect the WHO South-East Asia Region disproportionately. For example, every year around 67% of all new leprosy cases and 60% of all new cases of visceral leishmaniasis worldwide occur in countries of the region, where as many as 850 million inhabitants are at risk of contracting lymphatic filariasis. In addition, several epidemiological, technological and historical factors that are unique to the region make each of these four diseases amenable to elimination. Safe and effective tools and interventions to achieve these targets are available and concerted efforts to scale them up, singly or in an integrated manner, are likely to lead to success. The World Health Assembly and the WHO Regional Committee, through a series of resolutions, have already expressed regional and global commitments for the elimination of these diseases as public health problems. Such action is expected to have a quick and dramatic impact on poverty reduction and to contribute to the achievement of the Millennium Development Goals. This paper reviews the policy rationale for disease control in the WHO South-East Asia Region, the progress made so far, the lessons learnt along the way, and the remaining challenges and opportunities.
Collapse
Affiliation(s)
- Jai P Narain
- Department of Communicable Diseases, World Health Organization Regional Office for South-East Asia, IP Estate, Mahatama Gandhi Road, New Delhi 110002, India.
| | | | | | | | | | | | | |
Collapse
|
29
|
Affiliation(s)
- Peter J Hotez
- Sabin Vaccine Institute and George Washington University, Washington, DC 20037, USA.
| | | | | | | |
Collapse
|
30
|
Affiliation(s)
- Dirk Engels
- Department of Neglected Tropical Diseases, World Health Organization, Geneva.
| | | |
Collapse
|
31
|
Kasturiratne A, Wickremasinghe AR, de Silva N, Gunawardena NK, Pathmeswaran A, Premaratna R, Savioli L, Lalloo DG, de Silva HJ. The global burden of snakebite: a literature analysis and modelling based on regional estimates of envenoming and deaths. PLoS Med 2008; 5:e218. [PMID: 18986210 PMCID: PMC2577696 DOI: 10.1371/journal.pmed.0050218] [Citation(s) in RCA: 1080] [Impact Index Per Article: 67.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Accepted: 09/22/2008] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Envenoming resulting from snakebites is an important public health problem in many tropical and subtropical countries. Few attempts have been made to quantify the burden, and recent estimates all suffer from the lack of an objective and reproducible methodology. In an attempt to provide an accurate, up-to-date estimate of the scale of the global problem, we developed a new method to estimate the disease burden due to snakebites. METHODS AND FINDINGS The global estimates were based on regional estimates that were, in turn, derived from data available for countries within a defined region. Three main strategies were used to obtain primary data: electronic searching for publications on snakebite, extraction of relevant country-specific mortality data from databases maintained by United Nations organizations, and identification of grey literature by discussion with key informants. Countries were grouped into 21 distinct geographic regions that are as epidemiologically homogenous as possible, in line with the Global Burden of Disease 2005 study (Global Burden Project of the World Bank). Incidence rates for envenoming were extracted from publications and used to estimate the number of envenomings for individual countries; if no data were available for a particular country, the lowest incidence rate within a neighbouring country was used. Where death registration data were reliable, reported deaths from snakebite were used; in other countries, deaths were estimated on the basis of observed mortality rates and the at-risk population. We estimate that, globally, at least 421,000 envenomings and 20,000 deaths occur each year due to snakebite. These figures may be as high as 1,841,000 envenomings and 94,000 deaths. Based on the fact that envenoming occurs in about one in every four snakebites, between 1.2 million and 5.5 million snakebites could occur annually. CONCLUSIONS Snakebites cause considerable morbidity and mortality worldwide. The highest burden exists in South Asia, Southeast Asia, and sub-Saharan Africa.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Lorenzo Savioli
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - David G Lalloo
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - H. Janaka de Silva
- Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
- * To whom correspondence should be addressed. E-mail:
| |
Collapse
|
32
|
Hotez PJ, Molyneux DH, Fenwick A, Savioli L, Takeuchi T. A Global Fund to Fight Neglected Tropical Diseases: is the G8 Hokkaido Toyako 2008 Summit ready? PLoS Negl Trop Dis 2008; 2:e220. [PMID: 18365038 PMCID: PMC2268747 DOI: 10.1371/journal.pntd.0000220] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2008] [Accepted: 03/04/2008] [Indexed: 11/25/2022] Open
Affiliation(s)
- Peter J. Hotez
- Department of Microbiology, Immunology, and Tropical Medicine, The George Washington University and Sabin Vaccine Institute, Washington, D.C., United States of America
- * E-mail: or
| | | | - Alan Fenwick
- Schistosomiasis Control Initiative, Imperial College London, United Kingdom
| | - Lorenzo Savioli
- Department of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Tsutomu Takeuchi
- Department of Tropical Medicine and Parasitology, Keio University, Tokyo, Japan
| |
Collapse
|
33
|
Albonico M, Allen H, Chitsulo L, Engels D, Gabrielli AF, Savioli L. Controlling soil-transmitted helminthiasis in pre-school-age children through preventive chemotherapy. PLoS Negl Trop Dis 2008; 2:e126. [PMID: 18365031 PMCID: PMC2274864 DOI: 10.1371/journal.pntd.0000126] [Citation(s) in RCA: 167] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2007] [Accepted: 10/16/2007] [Indexed: 12/05/2022] Open
Abstract
Pre-school age children account for 10%–20% of the 2 billion people worldwide who are infected with soil-transmitted helminths (STHs): Ascaris lumbricoides (roundworm), Trichuris trichiura (whipworm), and Ancylostoma duodenale/Necator americanus (hookworms). Through a systematic review of the published literature and using information collated at World Health Organization headquarters, this paper summarizes the available evidence to support the recommendation that pre-school children should be included in regular deworming programmes. The first section describes the burden of STH disease in this age group, followed by a summary of how infection impacts iron status, growth, vitamin A status, and cognitive development and how STHs may exacerbate other high mortality infections. The second section explores the safety of the drugs themselves, given alone or co-administered, drug efficacy, and the importance of safe administration. The third section provides country-based evidence to demonstrate improved health outcomes after STH treatment. The final section provides country experiences in scaling up coverage of pre-school children by using other large scale public health interventions, including vitamin A programmes, immunization campaigns, and Child Health days. The paper concludes with a number of open research questions and a summary of some of the operational challenges that still need to be addressed.
Collapse
|
34
|
Affiliation(s)
- Peter J Hotez
- Sabin Vaccine Institute, and the Department of Microbiology, Immunology, and Tropical Medicine, George Washington University, Washington, DC 20037, USA.
| | | | | | | | | | | | | |
Collapse
|
35
|
Goodman D, Haji HJ, Bickle QD, Stoltzfus RJ, Tielsch JM, Ramsan M, Savioli L, Albonico M. A comparison of methods for detecting the eggs of Ascaris, Trichuris, and hookworm in infant stool, and the epidemiology of infection in Zanzibari infants. Am J Trop Med Hyg 2007; 76:725-31. [PMID: 17426179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Abstract
This study compared five methods for detecting the eggs of the human parasitic geohelminths Ascaris, Trichuris, and hookworm in infant stool, and describes the epidemiology of infection in infants from a parasite-endemic area. A total of 424 infants 5-11 months old were enrolled from three villages on Pemba Island, Zanzibar. Methods used included the Kato-Katz technique, formol ethyl acetate sedimentation, modified formol ethyl acetate sedimentation, modified Wisconsin floatation, and simple gravity sedimentation. Of methods used alone, Wisconsin floatation and simple gravity sedimentation each provided the highest sensitivity for detecting eggs of these three geohelminths (89.6%). Of methods used in combination, the Kato-Katz technique/simple gravity sedimentation and Wisconsin floatation/simple gravity sedimentation each provided the highest sensitivity (99.0%). Prevalence of geohelminth infection was 26.5%. Between five and nine months of age the mean prevalence was 9.4%, while at 10 and 11 months of age the mean prevalence was 43.4%. Village prevalence varied from 3.6% to 43.8%. Infant geohelminth infection can occur at a high prevalence, and what method is best depends on research specifics.
Collapse
Affiliation(s)
- David Goodman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Albonico M, Mathema P, Montresor A, Khakurel B, Reggi V, Pandey S, Savioli L. Comparative study of the quality and efficacy of originator and generic albendazole for mass treatment of soil-transmitted nematode infections in Nepal. Trans R Soc Trop Med Hyg 2006; 101:454-60. [PMID: 17129592 PMCID: PMC5619640 DOI: 10.1016/j.trstmh.2006.09.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2006] [Revised: 08/28/2006] [Accepted: 09/04/2006] [Indexed: 11/25/2022] Open
Abstract
The quality and efficacy of two locally manufactured generic albendazole (ABZ) products (Curex and Royal Drug) used for deworming children in Nepal since 1999 were tested against the originator product (GlaxoSmithKline (GSK)). The study included disintegration and dissolution testing according to the Indian Pharmacopoeia (IP) and the United States Pharmacopeia (USP), respectively, as well as a randomised controlled clinical trial comparing cure rates (CR) and egg reduction rates (ERR) for Ascaris lumbricoides, Trichuris trichiura and hookworm infections. Stool samples from 1277 children were examined before and 21 days after treatment. For A. lumbricoides, GSK (97.0%) and Royal Drug (95.0%) ABZ achieved significantly higher CRs than Curex ABZ (82.6%); however, all products achieved ERRs >90%. For T. trichiura, Curex ABZ showed significantly lower ERRs (63.2%). For hookworms, GSK ABZ performed significantly better (CR 74.3%, ERR 87.1%) than Royal Drug ABZ (CR 53.3%, ERR 80.8%) and Curex ABZ (CR 50.7%, ERR 73.1%). Only the GSK product passed both disintegration and dissolution tests according to the IP and USP. Both generic products failed the dissolution tests. Curex ABZ showed poor disintegration. Despite its lower efficacy, the cheaper Curex product achieved good results in controlling morbidity due to soil-transmitted helminth infections. This study shows that the cost effectiveness of drugs used in mass deworming campaigns should not be inferred on the basis of a single quality testing parameter.
Collapse
Affiliation(s)
- Marco Albonico
- Fondazione Ivo de Carneri, Via IV Marzo 14, 10122 Torino, Italy.
| | | | | | | | | | | | | |
Collapse
|
37
|
Abstract
The global strategy for the control of soil-transmitted helminthiasis, based on regular anthelminthic treatment, health education and improved sanitation standards, is reviewed. The reasons for the development of a control strategy based on population intervention rather than on individual treatment are explained. The evidence and experience from control programmes that created the basis for (i) the definition of the intervention package, (ii) the identification of the groups at risk, (iii) the standardization of the community diagnosis and (iv) the selection of the appropriate intervention for each category in the community are discussed. How to best deliver the appropriate intervention, the impact of the control measures on morbidity and on indicators such as school attendance, cognitive development and productivity are presented. The factors influencing the cost-benefits of helminth control are also considered. The recent progress on the control of soil-transmitted helminth infections is illustrated. Research needs are analysed in relation to the most recent perceptions from private-public partnerships involved in helminth control. The way forward for the control of soil-transmitted helminth infections is described as a multi-disease approach that goes beyond deworming and fosters a pro-poor strategy that supports the aims of the Millennium Development Goals.
Collapse
|
38
|
Gabrielli AF, Allen H, Engels D, Savioli L. Deworming: adding public health education to the equation. Trends Parasitol 2006; 22:455-6. [PMID: 16876481 DOI: 10.1016/j.pt.2006.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2006] [Revised: 07/10/2006] [Accepted: 07/17/2006] [Indexed: 11/17/2022]
|
39
|
Engels D, Savioli L. Reconsidering the underestimated burden caused by neglected tropical diseases. Trends Parasitol 2006; 22:363-6. [PMID: 16798088 DOI: 10.1016/j.pt.2006.06.004] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2006] [Revised: 05/19/2006] [Accepted: 06/02/2006] [Indexed: 10/24/2022]
Abstract
It is generally acknowledged that the burden caused by neglected tropical diseases needs to be reassessed. Not only are there several important diseases unaccounted for, but new information suggests they have a more substantial impact on health than initially thought. Looking at the tropical diseases as a group makes sense: they tend to cluster in the same poor populations and, to make progress with their control, they will have to be dealt with in an integrated manner. Measuring the effect of such integrated control is likely to reveal the real impact of tropical diseases on human health and wellbeing.
Collapse
Affiliation(s)
- Dirk Engels
- Department of Neglected Tropical Diseases, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland.
| | | |
Collapse
|
40
|
Savioli L, Engels D, Daumerie D, Jannin J, Alvar J, Asiedu K, Gastellu-Etchegorry M, Simarro P, Mariotti SP. Response from Savioli and colleagues from the Department of Neglected Tropical Diseases, World Health Organization. PLoS Med 2006; 3:e283. [PMID: 16789805 PMCID: PMC1481645 DOI: 10.1371/journal.pmed.0030283] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | - Pere Simarro
- 1World Health OrganizationDepartment of Control of Neglected Tropical Diseases, GenevaSwitzerland
| | - Silvio P Mariotti
- 2World Health OrganizationChronic Disease Prevention and Management, GenevaSwitzerland
| |
Collapse
|
41
|
Gabrielli AF, Ramsan M, Naumann C, Tsogzolmaa D, Bojang B, Khoshal MH, Connolly M, Stothard JR, Montresor A, Savioli L. Soil-transmitted helminths and haemoglobin status among Afghan children in World Food Programme assisted schools. J Helminthol 2006; 79:381-4. [PMID: 16336723 PMCID: PMC5630093 DOI: 10.1079/joh2005316] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In recent years there have been major socio-economic changes within Afghanistan such that the present public health burden of soil-transmitted helminths (STH), especially that within school-aged children, remains to be determined. A baseline parasitological survey was therefore carried out in four defined areas of Afghanistan to better assess the distribution, prevalence and intensity of STH infections prior to a nationwide de-worming campaign beginning within World Food Programme assisted schools. A cross-sectional examination of 1001 children aged between 8 and 15 years old revealed that approximately half (47.2%) were infected with at least one STH. Infections with Ascaris lumbricoides were most widespread (40.9%) and elevated prevalences were detected in urban environments; for example, schoolchildren in Kabul were more likely to be infected (OR=2.2, 95% CI 1.6-3.0) than elsewhere and these infections were often of higher intensity (OR=7.6, 95% CI 4.9-11.8). Trichuris trichiura (9.9%) and hookworms (0.7%), previously unknown from Afghanistan, were encountered. The blood haemoglobin concentration of surveyed children was also assessed: 4% resulted to be anaemic (Hb<11 g dl(-1)), and 0.4% to be severely anaemic (Hb<7 g dl(-1)).
Collapse
Affiliation(s)
- A F Gabrielli
- Public Health Laboratory Ivo de Carneri, Pemba Island, Zanzibar, Tanzania.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Savioli L, Smith H, Thompson A. Giardia and Cryptosporidium join the 'Neglected Diseases Initiative'. Trends Parasitol 2006; 22:203-8. [PMID: 16545611 DOI: 10.1016/j.pt.2006.02.015] [Citation(s) in RCA: 499] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2005] [Revised: 02/10/2006] [Accepted: 02/28/2006] [Indexed: 11/17/2022]
Abstract
Giardia and Cryptosporidium are ubiquitous enteric protozoan pathogens that infect humans, domestic animals and wildlife worldwide. Both pathogens are significant causes of diarrhea and nutritional disorders in institutional and community settings. They are also significant waterborne pathogens. In developing regions of the world, Giardia and Cryptosporidium constitute part of the complex group of parasitic, bacterial and viral diseases that impair the ability to achieve full potential and impair development and socio-economic improvements. All diseases included in the WHO Neglected Diseases Initiative have a common link with poverty and, as the current view is to take a comprehensive approach to all these diseases, both Giardia and Cryptosporidium were included in 2004. Our current state of knowledge of Giardia and Cryptosporidium is summarized here, and some important questions are raised that need to be addressed if control strategies are to be effective.
Collapse
Affiliation(s)
- L Savioli
- Coordinator, Parasitic Diseases and Vector Control (PVC), Communicable Diseases Control, Prevention and Eradication (CPE), World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland
| | | | | |
Collapse
|
43
|
|
44
|
|
45
|
Curtale F, Hassanein YAEW, Savioli L. Control of human fascioliasis by selective chemotherapy: design, cost and effect of the first public health, school-based intervention implemented in endemic areas of the Nile Delta, Egypt. Trans R Soc Trop Med Hyg 2005; 99:599-609. [PMID: 15935413 DOI: 10.1016/j.trstmh.2005.03.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2004] [Revised: 03/23/2005] [Accepted: 03/23/2005] [Indexed: 11/21/2022] Open
Abstract
Human fascioliasis is becoming a serious public health problem with a number of endemic areas identified in different countries. The viability of humans as definitive hosts has been experimentally demonstrated, and there is now a need to control the human infection along with the veterinary infection. In 1998, following reports on high prevalence among children in the Nile Delta, the Egyptian Ministry of Health and Population launched the first public health, school-based intervention to control human fascioliasis. An innovative selective treatment approach, with chemotherapy targeted to specific high risk age groups and villages, was adopted. First, high prevalence districts were identified by a regional baseline survey, then screening and selective treatment of all schoolchildren took place in high prevalence villages within those districts. From 1998 to 2002 the programme screened almost 36000 schoolchildren, in six districts, treating 1280 cases of human fascioliasis. Prevalence in the endemic area was reduced from 5.6 to 1.2%. The control intervention is described in detail, including data on cost. The targeted, selective chemotherapy approach was appropriate in addressing low prevalence infection, effective in reducing prevalence rates and transmission of the disease, and in the present situation, more cost-effective than mass distribution.
Collapse
Affiliation(s)
- Filippo Curtale
- Directorate General for Development Cooperation, Ministry of Foreign Affaires, Italian Embassy, Cairo, Egypt.
| | | | | |
Collapse
|
46
|
Affiliation(s)
- Lorenzo Savioli
- Parasitic Diseases and Vector Control, WHO, 1211 Geneva 27, Switzerland.
| | | | | |
Collapse
|
47
|
Albonico M, Wright V, Ramsan M, Haji HJ, Taylor M, Savioli L, Bickle Q. Development of the egg hatch assay for detection of anthelminthic resistance in human hookworms. Int J Parasitol 2005; 35:803-11. [PMID: 15885696 DOI: 10.1016/j.ijpara.2005.02.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2004] [Revised: 02/25/2005] [Accepted: 02/25/2005] [Indexed: 11/16/2022]
Abstract
Evidence of development and rapid spread of anthelminthic resistance in veterinary nematodes raises concern that the increasingly frequent treatments used in chemotherapy-based programmes to control human soil-transmitted helminths may select resistant worms. The aim of this study was to adapt, refine, and evaluate the Egg Hatch Assay (EHA) test, which has been used for veterinary nematodes, for field testing of benzimidazole (BZ) susceptibility/resistance in human hookworms. A second objective was to use this EHA to assess whether a population of worms resistant to mebendazole (MBZ) has built up in a sub-population of frequently treated children in Pemba Island. Stools from 470 school children enrolled in the first (Standard 1) and in the fifth (Standard 5) class were examined at baseline and at 21 days after treatment with 500 mg MBZ or placebo tablets. Standard 1 children had never received any MBZ treatment whilst Standard 5 children had received a total of 13 rounds of treatment. The EHA, involving culture of purified eggs with increasing drug concentrations showed that, for thiabendazole (TBZ), the mean ED(50)s (concentrations required to prevent 50% of the viable eggs from hatching) for all children at baseline were 0.079 microg/ml at 48h and 0.120 microg/ml at 72h (P<0.001). For MBZ, the mean ED(50)s for all children at baseline were 0.895 microg/ml at 48h and 1.50 microg/ml at 72h (P<0.001). For TBZ and for MBZ the ED(50) from Standard 1 were similar to those from Standard 5 children both at 48 and at 72h. At the follow-up for TBZ and for MBZ, there was no significant difference between the ED(50) from children who had received MBZ and children treated with placebo. In Pemba, TBZ ED(50) values of children non-exposed (Standard 1) and of children exposed (Standard 5) to MBZ treatment, and data from children treated with MBZ and placebo indicate that a drug-resistant worm population has not built up within treated individuals, and that periodic treatment has not yet selected for widespread BZ resistance, at least at the threshold detectable by the EHA in this study. However, ED(50) values for strains isolated from Mafia island, an area never exposed to BZ treatment were lower than for Pemba, suggesting lowered sensitivity of hookworm eggs recovered from Pembian children towards BZ.
Collapse
Affiliation(s)
- Marco Albonico
- Ivo de Carneri Foundation, Via IV Marzo 14, 10122 Torino, Italy.
| | | | | | | | | | | | | |
Collapse
|
48
|
Abstract
In the 1970s and early 1980s indirect diagnosis of urinary schistosomiasis, using urinalysis reagent strips for proteinuria and haematuria, was proposed as a possible alternative to the more accurate but very time-consuming parasitological methods. The recent experience o f the Schistosomiasis Control Programme for Pemba Island, which used a combination of (1) observations o f grossly bloody urine specimens, (2) results from reagent strips for measuring haematuria, and (3) treatment with praziquantel, is the first large-scale example o f a simple, inexpensive and promising alternative for controlling the morbidity caused by this parasite.
Collapse
Affiliation(s)
- L Savioli
- Lorenzo Savioli is in charge of the Schistosomiasis Control Programme, PO Box 122, Chake Chake, Pemba Island, Zanzibar, Tanzania
| | | |
Collapse
|
49
|
|
50
|
Albonico M, Engels D, Savioli L. Monitoring drug efficacy and early detection of drug resistance in human soil-transmitted nematodes: a pressing public health agenda for helminth control. Int J Parasitol 2005; 34:1205-10. [PMID: 15491582 DOI: 10.1016/j.ijpara.2004.08.001] [Citation(s) in RCA: 142] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2004] [Revised: 08/19/2004] [Accepted: 08/19/2004] [Indexed: 11/22/2022]
Abstract
Control of soil-transmitted helminth infection and elimination of lymphatic filariasis by periodic chemotherapy increase drug pressure for possible occurrence of resistance against single dose anthelminthics. In veterinary practice, frequent treatment of closed populations has led to a serious problem of anthelminthic drug resistance which is now largely irreversible. Reduced efficacy of single dose drugs against nematodes of humans should be taken as early warnings to tackle the issue in due time. Research and development of sensitive tools for monitoring and early detection of drug resistance is urgently needed to sustain the benefits of helminth control programs gained so far. A concerted action with international partners and the creation of a network of scientists to address this issue is the next pressing public health issue for helminth control.
Collapse
Affiliation(s)
- Marco Albonico
- Fondazione Ivo de Carneri, Via IV Marzo 14, 10122 Torino, Italy.
| | | | | |
Collapse
|