Professor Peter Hotez told some shocking truths in his talk about neglected tropical diseases at the APHA conference in San Diego this week. Some of these diseases are taking hold in the southern USA.
There are 14 neglected tropical diseases according to the Global network for neglected diseases. But PLoS Neglected Diseases lists 37. These chronic, disfiguring, disabling diseases affect 1.2 billion poor people worldwide, according to Hotez. Ascariasis, trichuriasis, hookworm, schistosomiasis, lymphatic filariasis, onchocerciasis and the bacterial disease trachoma are the 7 major neglected diseases. They are part of a vicious circle with poverty, they cause poverty and poverty promotes them. Many of the world’s poor have mutiple infections with these diseases, and the result can be growth failure, loss of IQ, memory, and reduced school performance. These diseases sap earning power. As an example, Hotez quoted one study that found hookworm reduced earning capacity by 40%. Poverty causes these diseases too when it goes hand in hand with poor housing, poor sanitation and agricultural work.
Hotez and co-workers have developed a one stop treatment which could be administered annually at a cost of only 50 US cents per head and treat many of these diseases in one go. The rapid impact package deals with all 7 listed above.
It is bad enough that the diseases exist in the developing world but the shocking thing for me was that neglected tropical diseases are on the up in one of the most ‘developed’ countries - the USA, in Appalachia, the cotton belt, the Mississippi region and the Texas/Mexican border.
Hotez quoted some examples of the neglected diseases now emerging in the Southern States:
Cycstercercosis is the leading cause of epilepsy in Hispanics in the south west USA
Chagas’ disease (American trypanosomiasis) could be affecting up to a million people in the USA and causes heart disease.
Toxacariasis, has recently been suggested to cause asthma in children and developmental delays.
African Americans in the south are disproportionately affected. How can the USA overlook this? US doctors go overseas to help those developing countries, there is an invisible developing country right at home.
Something Hotez didn’t touch on was preventive measures. A shot of drugs only solves the problem for a while, the benefit is dependent on the continuing supply of drugs. To prevent these diseases should we be looking at sanitation, hygiene, bednets? Ascariasis, trichuriasis, hookworm are organisms that live in the soil and are spread by faecal contamination of food and water so improved sanitation would prevent the spread of these parasites.
Is it a case of drug treatments being more glamorous, easier to get funding for?
Peter Hotez is chairman of the Department of Microbiology, Immunology, and Tropical Diseases at George Washington University Washington D.C., and is the editor in chief of the scientific journal, PLoS Neglected Tropical Diseases and a prime mover in the Global network for neglected tropical diseases.
For more about the neglected tropical diseases see the Global network for neglected diseases
Global Health also has many records on these diseases.
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