[EQ] The Neglected Tropical Diseases of Latin America and the Caribbean

The Neglected Tropical Diseases of Latin America and the Caribbean:
A Review of Disease Burden and Distribution and a Roadmap for Control and Elimination

 

Peter J. Hotez1*, Maria Elena Bottazzi1, Carlos Franco-Paredes2,3, Steven K. Ault4*, Mirta Roses Periago4

1 Department of Microbiology, Immunology, and Tropical Medicine, The George Washington University and Sabin Vaccine Institute, Washington, D.C., USA
2 Hospital Infantil de México, Federico Gómez, México, D.F., México,
3 Department of Medicine, Emory University, Atlanta, Georgia, United States of America,
4 Pan American Health Organization/World Health Organization (PAHO/WHO), Washington, D.C., United States of America
PLoS Negl Trop Dis 2(9): e300. doi:10.1371/journal.pntd.0000300

 

Available online at: http://www.plosntds.org/article/info%3Adoi%2F10.1371%2Fjournal.pntd.0000300

 

“….The neglected tropical diseases (NTDs) represent some of the most common infections of the poorest people living in the Latin American and Caribbean region (LAC). Because they primarily afflict the disenfranchised poor as well as selected indigenous populations and people of African descent, the NTDs in LAC are largely forgotten diseases even though their collective disease burden may exceed better known conditions such as of HIV/AIDS, tuberculosis, or malaria. Based on their prevalence and healthy life years lost from disability, hookworm infection, other soil-transmitted helminth infections, and Chagas disease are the most important NTDs in LAC, followed by dengue, schistosomiasis, leishmaniasis, trachoma, leprosy, and lymphatic filariasis.

 

On the other hand, for some important NTDs, such as leptospirosis and cysticercosis, complete disease burden estimates are not available. The NTDs in LAC geographically concentrate in 11 different sub-regions, each with a distinctive human and environmental ecology. In the coming years, schistosomiasis could be eliminated in the Caribbean and transmission of lymphatic filariasis and onchocerciasis could be eliminated in Latin America.

 

However, the highest disease burden NTDs, such as Chagas disease, soil-transmitted helminth infections, and hookworm and schistosomiasis co-infections, may first require scale-up of existing resources or the development of new control tools in order to achieve control or elimination. Ultimately, the roadmap for the control and elimination of the more widespread NTDs will require an inter-sectoral approach that bridges public health, social services, and environmental interventions….”

“……Rather than a strictly disease-centered approach [4],[9],[72],[82], comprehensive public policies aimed at community development and poverty reduction will be adopted. These policies will be then implemented at the local level through the mobilization and involvement of various agencies [9],[72] under the responsibility of different government sectors (inter-sectoral action) so that they can come together in a synergistic and synchronic manner. Together with strong social participation and appropriate technologies, the inter-sectoral action completes the three pillars advocated in a primary health care strategy and will contribute towards health systems strengthening. Examples of such inter-sectoral partnering were recently reviewed [72],[82]….”

 

 

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