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Looking Back on a Year of Success & 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. 

 Three is the Magic Number (for NTDs!)

It was a BIG year for eliminating neglected tropical diseases (NTDs) as a public health problem in three USAID-supported countries. Ghana (link is external) and Nepal (link is external) said goodbye to trachoma, the leading infectious cause of blindness, and lymphatic filariasis (elephantiasis) got kicked to the curb by Vietnam.

COLLAGE: LIZ EDDY/USAID

PHOTOS: RTI INTERNATIONAL

Lymphatic filariasis

Health sector’s nine outstanding events in 2018

Vietnam Plus
Vietnam eliminates lymphatic filariasis: The [World Health Organization, or] WHO announced that Vietnam has eliminated lymphatic filariasis as a public health problem. On October 8, 2018, at the 69th session of the WHO Regional Committee for the Western Pacific held in Manila, the Philippines, WHO Director-General Tedros Adhanom Dhebreyesus and WHO Chief Representative in the Western Pacific Dr. Shin Young-soo presented Vietnam with a certificate recognizing the country’s elimination of lymphatic filariasis, bringing the total number of regional nations that have successfully eradicated the disease to 11.

Progress towards lymphatic filariasis elimination in Ghana from 2000-2016: analysis of microfilaria prevalence data. . .

Nana-Kwadwo Biritwum et al.
bioRxiv
Ghana started its national programme to eliminate lymphatic filariasis (LF) in 2000, with mass drug administration (MDA) with ivermectin and albendazole as main strategy. . . The MDA programme of the Ghana Health Services has reduced mf prevalence in sentinel sites below the 1% threshold in 81/98 endemic districts in Ghana, yet 15 communities within 13 districts (MDA ongoing) had higher prevalence than this threshold during the surveys in 2013 and 2014. These districts may need to intensify interventions to achieve the WHO 2020 target.

Onchocerciasis

PCR-coupled sequencing achieves specific diagnosis of onchocerciasis in a challenging clinical case. . .

Amy Crowe et al.
Infection, Genetics and Evolution
This study demonstrates the utility of a PCR-based DNA sequencing approach to make a specific diagnosis of onchocerciasis in a returned traveller. Although a clinical diagnosis was not possible, the surgical excision of a suprascapular nodule from this patient, combined with an histological examination of this nodule and PCR-based sequencing of DNA from a nematode from this lesion solved the case. The analysis of DNA sequence data confirmed the presence of Onchocerca volvulus infection, supporting an effective treatment-clinical management strategy for the patient.

Onchocerciasis-associated epilepsy

M. Teresa Galán-Puchades
The Lancet Infectious Diseases
In the context of the ongoing debate about the degree of responsibility of Onchocerca volvulus in human cases of epilepsy, Cédric Chesnais and colleagues support a relationship between O volvulus microfilariae and the development of epilepsy. . . To confirm the role of Wolbachia spp in onchocerciasis-associated epilepsy, anti-wolbachia treatment should be administered in affected areas, therefore preventing the release of bacteria and the subsequent consequences that might ensue after treatment with anti-microfilarial drugs in microfilaria populations with high wolbachia burden.

Onchocerciasis-associated epilepsy – Authors' reply

Cédric B. Chesnais and Michel Boussinesq
The Lancet Infectious Diseases
Galán-Puchades hypothesises that Wolbachia spp released during the natural death of O volvulus (adults or microfilariae) induce inflammatory processes that trigger epilepsy, which would indeed justify distinguishing wolbachia from the worm in our study. Should this hypothesis be true, the release of Wolbachia spp into the blood after treatment with diethylcarbamazine or ivermectin (a demonstrated occurrence)3 would, as Galán-Puchades suggests, induce an epidemic of seizures after mass treatment with these drugs. However, such an event has never been reported with either drug, even in populations with extremely high microfilarial densities (eg, the Vina valley in northern Cameroon). On the contrary, a decrease in seizure frequency was reported after the first ivermectin distribution in the Kabarole focus, Uganda

From Fascinating to Disturbing — 10 things you should know about onchocerciasis

Daniel Cohn and Laura Cane
Medium
Significant progress against oncho has been led by African organizations, including the Onchocerciasis Control Programme in West Africa (1974–2002) and the African Programme for Onchocerciasis Control (APOC, 1995–2015), initially through vector control and more recently through preventive mass treatment. These programs enabled thousands of community health workers (often volunteers) to distribute the medicine, ivermectin, using a simple measuring stick, called a dose pole, to figure out correct dosing based on height — an alternative to weight, where scales are not available. This was one of the earliest large-scale uses of the dose pole.

Schistosomiasis

Repeated doses of Praziquantel in Schistosomiasis Treatment (RePST) – single versus multiple praziquantel treatments. . .

P.T. Hoekstra et al.
BMC Infectious Diseases
Most studies assessing [praziquantel, or] PZQ efficacy have used relatively insensitive parasitological diagnostics, such as the Kato-Katz (KK) and urine-filtration methods, thereby overestimating cure rates (CRs). This study aims to determine the efficacy of repeated PZQ treatments against Schistosoma mansoni infection in school-aged children in Côte d’Ivoire using the traditional KK technique, as well as more sensitive antigen- and DNA-detection methods.

Translating preventive chemotherapy prevalence thresholds for Schistosoma mansoni from the Kato-Katz technique. . .

Oliver Bärenbold et al.
PLOS Neglected Tropical Diseases
The moderate sensitivity of POC-CCA, even for very light S. mansoni infections where the sensitivity of Kato-Katz is very low, and the identified relationship between Kato-Katz and POC-CCA prevalence thresholds render the latter diagnostic tool useful for surveillance and initial estimation of elimination of S. mansoni. For prevalence below 10% based on a duplicate slide Kato-Katz thick smear, we suggest using POC-CCA including trace results to evaluate treatment needs and propose new intervention thresholds that need to be validated in different settings.

Schistosomiasis is associated with incident HIV transmission and death in Zambia

Kristin M. Wall et al.
PLOS Neglected Tropical Diseases
This study explored the association between schistosome infections (a disease caused by parasitic flatworms, also known as ‘snail fever’, which is very common throughout sub-Saharan Africa) and human immunodeficiency virus (HIV). We found in Lusaka, the capital of Zambia, that schistosome infections were associated with transmission of HIV from adult men and women, and schistosome infections were also associated with increased HIV acquisition in adult women. We additionally found that schistosome infections were associated with death in HIV+ adult women.

Schistosomiasis and soiltransmitted helminthiases: numbers of people treated in 2017

The World Health Organization
Weekly Epidemiological Record
In 2017, 98.7 million people (81.8 million SAC and 16.9 million adults) received PC for schistosomiasis, and 743 million received PC for STH (188 million preSAC, 410.1 million SAC and 127.9 million women of reproductive age treated during lymphatic filariasis (LF) elimination programmes and an estimated 17 million treated in maternal and child health services.10 In relation to the targets of the neglected tropical disease (NTD) roadmap, the coverage of SAC with PC was 68% for schistosomiasis and 68.8% for STH; coverage of preSAC with PC for STH was 69%.

Soil-Transmitted Helminthiasis

Human Hookworm Infection Enhances Mycobacterial Growth Inhibition and Associates With Reduced Risk of Tuberculosis Infection

Matthew K. O'Shea et al.
Frontiers in Immunology
Soil-transmitted helminths and Mycobacterium tuberculosis frequently coincide geographically and it is hypothesized that gastrointestinal helminth infection may exacerbate tuberculosis (TB) disease by suppression of Th1 and Th17 responses. However, few studies have focused on latent TB infection (LTBI), which predominates globally. We performed a large observational study of healthy adults migrating from Nepal to the UK (n = 645). Individuals were screened for LTBI and gastrointestinal parasite infections. . . These data provide a potential alternative explanation for the reduced prevalence of LTBI among individuals with hookworm infection, and possibly an anti-mycobacterial role for helminth-induced eosinophils.

Prevalence of intestinal parasites and the absence of soil-transmitted helminths in Añatuya, Santiago del Estero, Argentina

Maria Victoria Periago et al.
Parasites & Vectors
Intestinal parasites (IP) have been reported in point studies from different provinces of Argentina. The presence of soil-transmitted helminths (STH) was detected in many of these studies, including varied prevalences of all five species of STH in the north were the climate is more appropriate for transmission. Nonetheless, Argentina lacks a comprehensive prevalence map of STH. Therefore, the objective of this study was to determine the prevalence of intestinal parasites, focusing on STH, in rural and peri-urban areas of Añatuya, Santiago del Estero Province and identifying risk factors for their transmission.

Odds, challenges and new approaches in the control of helminthiasis, an Asian study

Marcello Otake Sato et al.
Parasite Epidemiology and Control
Great changes in the landscapes of endemic areas, such as construction of dams, can change the fauna and the lifestyle of local people. Those changes can improve infrastructure, but it can also lead to social vulnerability. The challenge, then, is to conceive new and directed control programs for helminthiasis based on multi- and transdisciplinary approaches diminishing the health gap in a globalized world. In this short review, we summarize the actual scenario concerning the main helminths in Southeast Asia and how an environmental DNA approach and the use of GIS could contribute to surveillance and control programs.

Trachoma

Serological and PCR-based markers of ocular Chlamydia trachomatis transmission in northern Ghana after elimination of trachoma

Laura G. Senyonjo et al.
PLOS Neglected Tropical Diseases
Trachoma is a disease caused by Chlamydia trachomatis (Ct). Validation of elimination of trachoma as a public health problem is based on clinical indicators. Antibody and infection data may provide a better understanding of transmission dynamics in elimination settings. . . Infection and serological data provide useful insights into transmission dynamics. Even if an [evaluation unit, or] EU meets trachoma elimination targets, this may not reflect complete interruption of transmission of ocular Ct infection.

19th Trachoma Expert Committee Meeting in Muscat, Oman

International Trachoma Initiative
The 19th meeting of the Trachoma Expert Committee (TEC) was held on November 12–14, 2018 at The Grand Hyatt in Muscat, Oman. Former senior vice president and chief medical officer of Pfizer Inc. Joseph Feczko chaired the meeting for the last time before rotating off the chair. Meeting observers included colleagues from WHO, Pfizer, USAID, and implementing partners. . . In calendar year 2017, ITI shipped over 81.4 million treatments of Zithromax®, and provided Zithromax® to 140 new districts with a population of 19.3 million. Two hundred nine districts with a population of 26.7 million reached the [follicular trachoma, or] TF elimination target and no longer warrant [mass drug administration, or] MDA.

Cross-cutting

Braving the odds to combat NTDs in Democratic Republic of Congo

Ndellejong Cosmas Ejong
Sightsavers
Without community acceptance, participation and ownership, eliminating these diseases is impossible. Programme uptake has improved, especially in Ituri North, because resources are being allocated annually to make sure trained community volunteers are available for drug distribution. Investments have also been made in social mobilisation and sensitisation to raise awareness of the NTD treatment programmes and their importance. This work has meant more people are treated each year within endemic communities, and the number of people refusing treatment is gradually declining each year. This indicates that the project is on the right path to elimination.

Health, financial, and education gains of investing in preventive chemotherapy for schistosomiasis, STH, and LF. . .

Jan-Walter De Neve et al.
PLOS Neglected Tropical Diseases
This analysis incorporates financial and education gains into the economic evaluation of health interventions, and therefore provides information about the efficiency of attainment of three Sustainable Development Goals (SDGs). Our findings reveal how the national scale-up of NTD control in Madagascar can help address health (SDG3), economic (SDG1), and education (SDG4) goals. This study further highlights the potentially large societal benefits of investing in NTD control in low-resource settings.

Neglected Tropical Diseases and Mental Health: Progress, Partnerships, and Integration

Freddie Bailey et al.
Trends in Parasitology
Neglected tropical diseases (NTDs) are increasingly recognised as major drivers of psychosocial morbidity in affected individuals and their caregivers. Nevertheless, there has remained a lack of prioritisation at the policy level of some of the most stigmatising and chronic NTDs, with subsequent under-representation within NTD programmes. In response, the Neglected Tropical Disease/Non-Governmental Organization/Network (NNN) has established a Mental Wellbeing and Stigma Task Group (MWS) to address these issues through a comprehensive research agenda. In our article, we highlight the progress in understanding the scope of the mental health impact of NTDs and the innovative practice emerging in this area. Finally, we examine opportunities for integration of mental and physical health for individuals with NTDs.

Health Roche Diagnostics, World Bank Chart Efficient Universal Health Coverage Delivery

Modupe Gbadeyanka
Business Post (Nigeria)
Health experts, policymakers, leading diagnostics equipment manufacturer – Roche Diagnostics and other stakeholders in the health sector recently came together to deliberate on achieving Universal Health Coverage, improving access to healthcare for people and the importance of quality systems. . . Speaking during the session, Senior Health Specialist IFC, World Bank Dr. Olumide Okunola, emphasized that Universal Health Care is not an aspiration but a requirement that all African countries must work towards.

[AUDIO] Neglected Tropical Diseases: Chagas disease and schistosomiasis

Robert Herriman
Outbreak News Today
According to the World Health Organization (WHO), Neglected tropical diseases (NTDs)– a diverse group of communicable diseases that prevail in tropical and subtropical conditions in 149 countries – affect more than one billion people and cost developing economies billions of dollars every year. . . Hutchinson Distinguished Professor of Biological Sciences at Loyola University New Orleans, Patricia Dorn, PhD talks about Chagas disease in this Mar. 2017 interview. In the second half, Parasitology teacher and author of the book, Parasites: Tales of Humanity’s Most Unwelcome Guests, Rosemary Drisdelle discusses schistosomiasis in this interview earlier this year.

Other

Speed up public health decisions on scabies by skipping full-body exams, study says

Michael Marks
EurekAlert!
For years, the diagnosis of scabies has relied on time-consuming and intrusive full-body examinations. Now, researchers reporting in PLOS Neglected Tropical Diseases have found that an exam of just a patient's hands, feet and lower legs may have the potential to catch more than 90 percent of all scabies cases, regardless of severity. These speedier exams may be useful in public health assessments on the prevalence of scabies.

Sleeping sickness parasite uses multiple metabolic pathways

Science Daily
Parasitic protozoa called trypanosomes synthesize sugars using an unexpected metabolic pathway called gluconeogenesis, according to a new study. The authors note that this metabolic flexibility may be essential for adaptation to environmental conditions and survival in mammalian host tissues.

Oxazolidinones Can Replace Clarithromycin in Combination with Rifampin in a Mouse Model of Buruli Ulcer

Deepak V. Almeida et al.
Antimicrobial Agents and Chemotherapy
Rifampin (RIF) plus clarithromycin (CLR) for 8 weeks is now the standard of care for Buruli ulcer (BU) treatment, but CLR may not be an ideal companion for rifamycins due to bidirectional drug-drug interactions. The oxazolidinone linezolid (LZD) was previously shown to be active against Mycobacterium ulcerans infection in mice but has dose- and duration-dependent toxicity in humans. Sutezolid (SZD) and tedizolid (TZD) may be safer than LZD. Here, we evaluated the efficacy of these oxazolidinones in combination with rifampin in a murine BU model.

Mass drug administration for malaria elimination: do we understand the settings well enough?

Manuel W. Hetzel and Blaise Genton
BMC Medicine
Mass drug administration (MDA) of antimalarials has re-emerged as a recommended tool for interrupting malaria transmission, but evidence from low endemicity settings is scarce. A trial in Zanzibar found that two rounds of MDA made no significant impact on malaria incidence, and many questions on the optimal mode and setting for implementing MDA remain unanswered. A more thorough understanding of local sources and drivers of transmission, and a better toolbox for evaluating interventions in near-elimination settings are essential.

A Simple Model to Predict the Potential Abundance of Aedes aegypti Mosquitoes One Month in Advance

Andrew J. Monaghan
The American Journal of Tropical Medicine and Hygiene
We developed a simple, intuitive empirical model that uses readily available temperature and humidity variables to predict environmental suitability for low, medium, or high potential abundance of adult Ae. aegypti in a given city 1 month in advance. Potential abundance was correctly predicted in 73% of months in arid Phoenix, AZ (over a 10-year period), and 63% of months in humid Miami, FL (over a 2-year period). The monthly model predictions can be updated daily, weekly, or monthly and thus may be applied to forecast suitable conditions for Ae. aegypti to inform vector-control activities and guide household-level actions to reduce mosquito habitat and human exposure.

Innovative data spurs healthcare delivery in Africa

Samuel Hinneh
SciDevNet
Application of innovative data is helping four countries in Sub-Saharan Africa to improve primary healthcare delivery, a new report has revealed. . . The report which was launched by the Primary Health Care Performance Initiative at a panel event at in the United States this month (12 December) shows that using local, regional, and national-level data for priority setting can ensure that policies are sustainable and scalable while remaining relevant at the community level.

Upcoming Events 

Control and combat visceral leishmaniasis (kala-azar)
January 7-February 4, 2019, Webinar
Visceral leishmaniasis (VL) - also known as kala-azar - is endemic in parts of South Asia, East Africa, Southern Europe and South America. It is fatal if untreated, but the tools do exist to control and even eliminate VL transmission in some of these areas. This online course will you give you an understanding of the biology and epidemiology of VL, then explain practical control and elimination tools that you can use to combat it.

Women Deliver 2019 Conference 
June 3-6, 2019, 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.

6th International Symposium on One Health Research
September 18-19, 2019, Ulaanbaatar, Mongolia
An opportunity for foreign scientists to interact closely with high-ranking Mongolian leaders who specialize in human and animal research leading to numerous research collaborations and discoveries.

IAPB Council of Members 2019
October 5-8, 2019, Nairobi, Kenya
The next Council of Members will be held 5-8 October 2019 in Nairobi, alongside local partners Sightsavers.