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Multilateral Commitments Made at African Union Summit & Other NTD News

News roundup

This news roundup is a collection of headlines and other items on neglected tropical diseases, and does not reflect the work or the views of the Neglected Tropical Diseases Support Center. 

Sightsavers

Irma, from Guinea-Bissau, used to suffer from trachoma, but says surgery has made a huge difference to her life.

SIGHTSAVERS

Lymphatic filariasis

Elimination of lymphatic filariasis in west African urban areas: is implementation of mass drug administration necessary?

Benjamin G. Koudou et al.
The Lancet Infectious Diseases
Evidence shows that transmission levels are low and that effective mass drug distribution is difficult to implement, with assessments suggesting that specific control measures against filariasis in such dynamic settings is not an effective use of limited resources. Instead, we recommend that individuals who have clinical disease or who test positive for W bancrofti infection in surveillance activities should be offered antifilarial drugs through a passive surveillance approach, as well as morbidity management for their needs. We also recommend that more precise studies are done, so that mass drug administration in urban areas is considered if sustainable transmission is found to be ongoing

Economic evaluations of lymphatic filariasis interventions: a systematic review and research needs

Lukyn M. Gedge et al.
Parasites & Vectors
In this paper, we perform a rigorous systematic review of the economic evaluations of lymphatic filariasis interventions have been conducted. We demonstrate that the standard interventions to control lymphatic filariasis are consistently found to be highly cost-effective. This finding has important implications for advocacy groups and potential funders. However, there are several important inconsistencies and research gaps that need to be addressed as we move forward towards the 2020 elimination goals.

New tool saves Dar, Addis 21bn/- in treatment of elephantiasis

Marc Nkwame
Daily News (Tanzania)
Tanzania and Ethiopia have saved over 21bn/- in elephantiasis treatment, thanks to a newly developed mapping tool by the Task Force for Global Health and its partners. Under the mapping tool, the two countries have reduced the number of districts that need Mass Drug Administration (MDA) for the disease. The 30th African Union (AU) Heads of State Summit in Ethiopia heard yesterday that Tanzania and Ethiopia recently employed the new mapping tool in 55 low-prevalence districts to confirm the findings of the World Health Organisation (WHO) approach, which called for MDA in all 55 districts.

Onchocerciasis

Identifying co-endemic areas for major filarial infections in sub-Saharan Africa

Jorge Cano et al.
Parasites & Vectors
This work aims to combine previously published predictive risk maps for onchocerciasis, LF and loiasis to (i) explore the scale of spatial heterogeneity in co-distributions, (ii) delineate target populations for different treatment strategies, and (iii) quantify populations at risk of [serious adverse events, or] SAEs across the continent.. . . These maps are intended to initiate discussion around the potential for tailored treatment strategies, and highlight populations at risk of SAEs. Further work is required to test and refine strategies in programmatic settings, providing the empirical evidence needed to guide efforts towards the 2020/2025 goals and beyond.

Moxidectin vs. Ivermectin for Onchocerciasis

Mary E. Wilson
NEJM Journal Watch
Moxidectin is clearly superior to ivermectin in clearing microfilariae and could accelerate onchocerciasis elimination. Geographic areas with loiasis-onchocerciasis coinfection present a challenge, but the recently described “test-and-not-treat” approach offers a path to treat some coinfected patients. If progeny of poorly responsive onchocerca parasites are selected by repeated mass treatment campaigns, their emergence could threaten existing programs. By rapidly eliminating these microfilariae, moxidectin may also reduce their transmission. An editorialist notes benefits from longer duration of effect. Higher clinical effectiveness could potentially increase participation of local residents in campaigns.

Schistosomiasis

Underestimation of the global burden of schistosomiasis

Charles H. King and Alison P. Galvani
The Lancet
Schistosomiasis was ranked in the top ten for [age-standardized years lived with disability, or] YLDs in six sub-Saharan countries but was now reported to account for only 1·496 million YLD worldwide (down from the 2·472 million YLD estimated in the 2015 GBD Study);2 we think that the apparent drop is an artifact caused by underestimation of the effects of schistosoma infections and because of several limitations to the methods in the new [Global Burden of Disease, or] GBD calculations.

Pills, philanthropy and parasitic worms

Ellen Agler and Warren Lancaster
The Guardian
Burundi was selected for Legatum’s trial investment due to its size and feasibility, and schistosomiasis was chosen as one of the diseases to target. . . In the four years of this programme, Burundi reached 90% of school children at risk of schistosomiasis through eight rounds of MDA. At the end of the programme in 2011, national prevalence of schistosomiasis had been reduced from 12% to 1.4%. These efforts to control schistosomiasis showed enough promise of ending the disease that Burundi was selected as a pilot country by the Schistosomiasis Consortium for Operation Research and Evaluation (Score) to assess the potential of moving beyond control to elimination.

Schistosomiasis and Infertility in East Africa

Patricia Woodall and Michael Kramer
The American Journal of Tropical Medicine and Hygiene
In this cross-sectional multilevel semi-ecologic study, interpolated prevalence maps for S. haematobium and Schistosoma mansoni in East Africa were created using data from two open-access Neglected Tropical Diseases Databases. Prevalence was extracted to georeferenced survey sample points for Demographic and Health Surveys for Ethiopia, Kenya, Tanzania, and Uganda for 2000 and 2010. Exploratory spatial analyses showed that infertility was not spatially random and mapped the clustering of infertility and its co-location with schistosomiasis. . . Living in high compared with absent S. mansoni locations did not affect the odds of infertility. Infertility appears to be associated spatially with S. haematobium.

Decreased Sensitivity of Schistosoma sp. Egg Microscopy in Women and HIV-Infected Individuals

Soledad Colombe et al.
The American Journal of Tropical Medicine and Hygiene
It has been postulated that impaired host immunity due to HIV infection reduces parasite egg excretion. Schistosoma/HIV interactions have also been shown to differ by sex. . . Our study is the first to report that women with Schistosoma infection excrete fewer eggs than men for a given worm burden, regardless of HIV the status. These findings suggest that guidelines for use of microscopy to diagnose Schistosoma infections in HIV-infected individuals and in women merit reconsideration.

Real-time PCR diagnosis of Schistosoma japonicum in low transmission areas of China

Pei He et al.
Infectious Diseases of Poverty
It is of critical importance to find and treat people and to identify animals with low-level infections if the National Control Programme for China is to achieve schistosomiasis elimination. . . The qPCR assay exhibited a high level of sensitivity in the detection of S. japonicum infections. With both the human and bovine samples, a significantly higher prevalence was determined using the qPCR assay (11.06% humans, 24.73% bovines) than with the [miracidium hatching test, or] MHT (0.93% humans, 7.69% bovines).

Historical perspective: Revisiting the St. Lucia Project, a multi-year comparison trial of schistosomiasis control strategies

Julianne A. Ivy, Charles H. King, Joseph A. Cook and Daniel G. Colley
PLOS Neglected Tropical Diseases
With good reason, mass drug administration is now the mainstay of schistosomiasis morbidity control. But when chemotherapy fails to prevent reinfection, alternative control methods must be considered to interrupt transmission. The Marquis Valley chemotherapy trial was significantly enhanced when supplemented with snail control, and Cul de Sac and South Richefond obtained impressive results by supplementing snail control or WASH-related measures with chemotherapy.

Fiocruz joins consortium for schistosomiasis research

Alexandre Mattos
Fiocruz
On 8 December, the European & Developing Countries Clinical Trials Partnership (EDCTP) and The Global Health Innovative Technology Fund (GHIT) announced that they will be co-funding the Phase III clinical study conducted by the Pediatric Praziquantel Consortium. This study aims to provide clinical data and support for registration of a new praziquantel (PZQ) tablet formulation to treat schistosomiasis in preschool-aged children in sub-Saharan Africa. The Institute of Drug Technology (Farmanguinhos/Fiocruz) will be the partner responsible for producing this drug against schistosomiasis.

Soil-Transmitted Helminthiasis

Helminth lifespan interacts with non-compliance in reducing the effectiveness of anthelmintic treatment

Sam H. Farrell and Roy M. Anderson
Parasites & Vectors
Our analysis suggests that achieving reductions in the level of systematic non-compliance may be of particular benefit in mass drug administration programmes treating the longer-lived helminth parasites, and highlights the need for improved data collection in understanding the impact of compliance.

Current epidemiological evidence for predisposition to high or low intensity human helminth infection: a systematic review

James E. Wright, Marleen Werkman, Julia C. Dunn and Roy M. Anderson
Parasites & Vectors
This review has found consistent evidence of predisposition to heavy (and light) infection for certain human helminth species. However, further research is needed to identify reasons for the reported differences between demographic groups. Molecular epidemiological methods associated with whole genome sequencing to determine ‘who infects whom’ may shed more light on the factors generating predisposition.

Interrupting seasonal transmission of Schistosoma haematobium and control of soil-transmitted helminthiasis. . .

Yves-Nathan T. Tian-Bi et al.
BMC Public Health
This cluster-randomised intervention trial will elucidate whether in an area with seasonal transmission, the four different treatment schemes can interrupt S. haematobium transmission and control soil-transmitted helminthiasis. Lessons learned will help to guide schistosomiasis control and elimination programmes elsewhere in Africa.

Expanding molecular diagnostics of helminthiasis: Piloting use of the GPLN platform for surveillance. . .

COUNTDOWN
The COUNTDOWN project and its partners in Ghana from the Global Polio Laboratory Network (GPLN) and the Council for Scientific and Industrial Research (CSIR) conceived the innovative idea of using faecal samples already collected for polio testing, to also screen for Neglected Tropical Diseases (NTDs) such as schistosomiasis and soil-transmitted helminthiasis (STH). These diseases impact nearly a billion people worldwide. In a paper published in PLoS NTDs, the team from Ghana and the UK screened 448 samples to identify helminth infections. “The study demonstrates a potential way forward in the monitoring and control of neglected tropical diseases that could be adapted and included in the legacy plan of the Global Polio Laboratory Network.” says LSTM’s Dr Emily Adams and the paper’s senior author, “we are excited at the prospect of working with this team as we go forward.’

Effect of dewatering and composting on helminth eggs removal from lagooning sludge under semi-arid climate

Bouchra El Hayany et al.
Environmental Science and Pollution Research
In this work, we assessed the drying and composting effectiveness of helminth eggs removal from sewage sludge of a lagoon wastewater treatment plant located in Chichaoua city (Morocco). . . After 105 days of treatment by composting, we noted a total reduction of helminth eggs in the order of 97.5, 97.83, and 98.37% for mixtures M1, M2, and M3, respectively.

STH Advisory Committee Annual Meeting 2017: Report and Recommendations

STH Coalition
The STH Advisory Committee states the following in support of the proposed comprehensive M&E Framework recommendation: Urges WHO to clarify the ultimate goal/endpoint for STH. This will frame strategies and interventions – e.g. how morbidity in each risk group (i.e. pre-school age children, school-age children, and women of reproductive age) is assessed; Standardize, where possible, survey designs and unites of analysis in the interest of data comparability and interpretation across countries and populations; Encourages countries to conduct and use parasite-specific prevalence and intensity mapping after multiple years of MDA. These data should be made available to STH partners; Consider inclusion of refugee and migrant populations in the M&E Framework; and Supports commitments made by the STH Coalition, partners, donors, and CWW to assist national programs to develop and implement activities necessary to achieve the WHO goal of elimination of STH as a public health problem.

Trachoma

Eyes to the island: Car Nicobar's victory over hyperendemic trachoma

Lalitha Sridhar
The Hindu
A public health project in Car Nicobar set out to eliminate a rare occurrence of hyperendemic trachoma, an infectious condition known to cause blindness. Lalitha Sridhar reports on how an indigenous community, with the help of doctors, battled the odds to beat an invisible adversary.

Ethiopia to Conduct Assessment on Trachoma to Meet Elimination Date

Ethopian News Agency
Neglected Tropical Diseases Team Leader at the Ministry, Nebiyou Negussu told ENA that the assessment will identify methods, ways as well as actions the country should apply to eliminate blindness caused trachoma by 2020. According to him, the assessment will be broad that will look into the depth of drug resistance infection and review of environmental hygiene system. “The fifteen days assessment will be conducted in ten selected woredas vulnerable to the disease, so that if we well understand the situation of the disease in this selected woredas we can understand the situation in other parts of the country”, the team leader said.

The United States Congratulates Lao PDR for Eliminating Trachoma

U.S. Embassy in Laos
U.S. Ambassador Rena Bitter joined Lao government officials at a January 26 ceremony at the Don Chan Palace to officially recognize the Lao PDR for becoming the fifth endemic country globally to have eliminated trachoma as a public health problem. . . Over the past five years, the U.S. Government, through the U.S. Agency for International Development (USAID), has invested $ 2.7 million in the Lao PDR to combat neglected tropical diseases, like trachoma.

Cross-cutting

Heads of State demonstrate leadership on NTDs at the African Union

Uniting to Combat Neglected Tropical Diseases
On January 28 at the African Union summit, heads of state and ministers reviewed progress on neglected tropical diseases as part of the African Leaders Malaria Alliance (ALMA) scorecard for the first time at the annual ALMA event. . . By adding NTDs to the scorecard, African leaders are making a public commitment to hold themselves accountable for progress on these diseases.

African leaders make neglected tropical diseases a top health priority

Healio
African leaders made a public commitment to treat neglected tropical diseases as a top health priority on the same level as malaria. . . "My government is determined to make sure we can take 'neglected' out of these diseases," Ethiopian Prime Minister Hailemariam Desalegn said in a news release.

Africa: The Middle-Class Can Help End Neglected Tropical Diseases

Carl Manlan
AllAfrica
Creating wealth on the continent requires us to end NTDs and close the health gap that limits, stifles, and ends good economic opportunities for too many. . . Africa’s middle-class will spend an estimated US$ 1.4 trillion by 2020. What if they put some of that money toward ending the five most common NTDs: lymphatic filariasis, intestinal worms, onchocerciasis (river blindness), trachoma and schistosomiasis? These can be treated for less than US$ 0.50 cents as the delivery cost per person per year. And the good news is that they don’t need to know how to pronounce the names of the diseases to invest to end them.

Momentum is growing in the battle against NTDs, but we cannot be complacent

Simon Bush
Sightsavers
With just two years to go to deliver the pledges made in the London Declaration, we must re-focus our efforts and prepare to adapt our approach to challenges that lie ahead. . . Part of our responsibility as a development organisation is to help ensure that programmes have long-term benefits. I believe the key to this is ensuring communities are involved and have ownership at every stage of the process

Sierra Leone News: Moving towards NTD elimination

Mohamed Kabba
Awoko
[Monitoring and Evaluation Officer Abdul] Conteh said they are providing treatments and drug across the country in the first quarter of the year and in the second quarter pointing that they have been using Praziquantel, Albendazole and Ivermectin. He said presently the country has moved from 68% prevalence to 20% on lymphatic filariesis, and from 50-20% on Schistosomiasis and 18% on soil-transmitted helminthes.

VIDEO: How we're tracking medical donations across the world

Christian Schröter
TED
What if you could track donations of medicines that help treat over one billion of the world's poorest people against neglected tropical diseases, the same way you track the package you order on Amazon? Working with supply chain experts from around the world, biochemist Christian Schröter developed a method for tracking medical donations from the warehouse to places like the back country of Mozambique -- all using something as simple as a cellphone.

Other

Leprosy Remains Prevalent in 24 Latin America Countries

TeleSur
Leprosy continues to plague 24 out of 35 countries in Latin America with Health Ministries registering an average of 27,000 new cases yearly. In Colombia alone, almost 400 cases were reported last year. Deputy director of the national Ministry of Health, Jose Valderrama, warned that, though the number of those infected have decreased, leprosy continues to be a serious concern for the nation.

Big strides are being made in the push for affordable, effective antivenoms

Andreas Hougaard Laustsen and Timothy Patrick Jenkins
The Conversation
The WHO has recently established a working group on snakebite envenoming that aims to develop a strategy for prevention and treatment of snakebite. Finally, snakebite is on the World Health Assembly’s agenda for the first time this year, receiving support from the Kofi Annan Foundation.

The Long and Winding Worm, 1986-2018

Bill Brieger
Tropical Health Matters
Besides Guinea Worm, only polio and malaria have received calls for eradication (malaria for the second time in history). One wonders if even small pox could be eradicated in today’s world of conflicted and failed states – the last case of smallpox was in Somalia. Both Ethiopia and Chad border South Sudan’s civil conflicts.

Bill Gates vs. Malaria

Raj Kumar
Devex
Gates is not interested in a silver bullet, a single tool. “Malaria is a very complex disease and understanding the etiology and the resistance, and do you do mass test and treat, do you do MDA [mass drug administration],” he begins. He basks in the complexity of the disease itself — how the various species of plasmodia morph and change and evade easy elimination — and the multifaceted way it must be fought. “Basically we’re trying to get rid of the human reservoir,” he says, before launching into an extended analysis of why that’s no small feat.

Six WHO African Countries Awarded a Prize for their Achievements Against Malaria

AllAfrica
“Elimination of malaria and NTDs requires - above all - political leadership, from the highest level to leadership of programmes, resource mobilization, and intersectoral and cross-border collaboration”, said Dr. Mashidisio Moeti, WHO Regional Director for Africa. “We need all actors on board – communities, governments, donors, pharmaceutical companies and academic institutions to achieve our malaria and NTD goals, and ultimately the Sustainable Development Goals (SDG) ‘to ensure healthy lives and promote wellbeing for all at all ages’”, she added. During the ALMA Forum, six (6) WHO African countries received an award: Algeria and Comoros for being on track to reach the 2020 global malaria milestone; Madagascar, Senegal, The Gambia, Zimbabwe for having a decrease of more than 20 % malaria cases and malaria related deaths in the period 2015-2016.

Building a shared future in a fractured world starts with education and health

Julia Gillard and Tedros Adhanom Ghebreyesus
Devex
Investing in education and health is not charity. If we did not know this already, a report released by the advocacy group Global Citizen and the bank Credit Suisse at Davos reminds us of two vital statistics. First, if all children were to leave school with the ability to read, there would be a 12 percent decrease in global poverty levels. . . And the world’s top economists estimate that every $1 spent on health yields up to $20 in full-income growth within a generation.

Upcoming Events

International Day of Women and Girls in Science
February 11
United Nations
In order to achieve full and equal access to and participation in science for women and girls, and further achieve gender equality and the empowerment of women and girls, the United Nations General Assembly adopted resolution A/RES/70/212 declaring 11 February as the International Day of Women and Girls in Science.

Improving Women’s Health: HIV, Contraception, Cervical Cancer and Schistosomiasis
March 15,  New York, NY
The New York Academy of Sciences
The symposium will focus on three key areas of intersection between HIV and broader sexual and reproductive health and rights; cervical cancer, hormonal contraception, and female genital schistosomiasis.  In all three areas, recent scientific advances raise the possibility of enhancing women’s health and wellbeing through closer collaboration and engagement between women, their health care providers and health programmers, and policy makers. Furthermore, lessons learned from AIDS activism and advocacy, in terms of demand creation and the right to health, can strengthen the broader community response.

Operational Research Call on Women of Reproductive Age
February 21
STH Coalition
Please join us for our first quarterly Operational Research Call of 2018. Dr. Theresa Gyorkos will be presenting on the topic of Women of Reproductive Age (WRA), following new deworming guidance published in September 2017.

ISNTD Festival
March 27, London, UK
The ISNTD Festival brings together the best in communication, arts, entertainment and science to help complex public health messages reach patients, the public and global health professionals worldwide.

World Vaccine Washington
April 3-5, Washington, DC
Make sure you are at the forefront of the vaccines industry. No matter where your interest lies, we have content, networking and potential partners for you. By bringing eight events together under one roof, you get to choose the sessions which are the most applicable to help your business plan for the future of vaccine research, development and manufacture.

Multilateral Initiative on Malaria 
April 15-18, Dakar, Senegal
The Multilateral Initiative on Malaria (MIM) was established in 1997 with a mission to strengthen and sustain through collaborative research and training, the capacity of malaria-endemic countries in Africa to carry out research that is required to develop and improve tools for malaria control and to strengthen the research-control interphase.

GAELF10 Meeting
June 13-15, New Delhi, India
The 10th Meeting of the Global Alliance to Eliminate Lymphatic Filariasis (GAELF)

ISNTD d³
June 25-26, London, UK
ISNTD d3 will bring togther experts from within drug discovery and clinical trials to drive the debate and foster new partnerships & alliances leading to tangible outcomes in terms of new therapies to combat these diseases.

Eradicate Malaria World Congress 2018
July 1-5,  Melbourne, Australia
The inaugural World Congress on Malaria - Eradicate Malaria 2018 - will bring together the broad global community including implementers, scientists, funders, governments, policy makers and those directly affected by the disease. The aim is to bring the broad spectrum of the malaria world together for the first time, to further galvanise the effort for the eradication of malaria.

NNN 2018 
September 24-26, Addis Ababa, Ethiopia
We are delighted to announce the dates for the 9th NNN annual conference, subject to venue availability.

67th Annual ASTMH Meeting 
October 28 - November 1,New Orleans, Louisiana
The ASTMH Annual Meeting draws tropical medicine and global health professionals representing academia, government, non-profits, philanthropy, NGOs, industry, military and private practice. The meeting is designed for researchers, professors, government and public health officials, military personnel, travel clinic physicians, practicing physicians in tropical medicine, students and all health care providers working in the fields of tropical medicine, hygiene and global health. 

Women Deliver 2019 Conference 
June 3-6, 2018, Vancouver, Canada
The Women Deliver 2019 Conference – the world’s largest gathering on the health, rights, and wellbeing of women and girls – will serve as a fueling station for advocates working to achieve a more gender equal world. In the summer of 2019, over 6,000 world leaders, influencers, advocates, academics, activists, and journalists will flock to Vancouver with dreams of accelerating progress girls and women everywhere.