Integrated control of neglected tropical diseases in Africa

Neglected tropical diseases (NTD) are the ‘other diseases’ of Millennium Development Goal 6 that have received little attention from policy-makers and politicians who over focus on HIV, tuberculosis and malaria. They include many medically diverse diseases that are strongly associated with poverty. NTDs include bacterial, viral, protozoan and helminth infections that have plagued humanity since antiquity. Globally, over one billion people suffer from one or more NTDs and about 500,000 people die from them every year. Neglected Tropical Diseases are widespread in Africa due, in part, to the low socio-economic status of rural populations. Many countries are endemic with of 5 or more NTDs including schistosomiasis, soil-transmitted helminths (STH), lymphatic filariasis, onchocerciasis and trachoma, as well as zoonotic disease such as human African trypanosomiasis, rabies, tick borne relapsing fevers, echinococcus (hydatid), taeniosis (cysticercosis), brucellosis and plague, with a large part of the population at risk of co-infection with 2 or more of these diseases. Fortunately, control strategies as well as diagnostic tools and the availability of safe and effective drugs exist for the NTDs responsible for the greatest burden in Africa: lymphatic filariasis, onchocerciasis, STH and schistosomiasis. The World Health Organization has developed a strategy, Preventive Chemotherapy and Transmission Control (PCT), which is geared towards the implementation of large-scale mass drug administration. The objective of PCT is to provide national programmes with technical guidelines that emphasize a coordinated, cost-effective approach to the implementation of national elimination and control activities where preventive chemotherapy is the main tool, i.e. regular anthelminthic drug administration to all people at risk of morbidity due to helminthic diseases, starting early in life. The availability of rapid diagnostic tools and donations of several drugs from pharmaceutical companies, and the reduced price of other essential antihelminthic drugs has catalysed the rapid expansion of chemotherapy-based control programmes for NTDs. The main challenges to PTC in Africa include poor health service infrastructure in post conflict countries and cost-effective approaches for integrating the individual vertical programmes targeting specific diseases. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive