Research and Reports in Tropical Medicine 2022:13 25–40.
Chagas disease (CD) is caused by the parasite Trypanosoma cruzi, and it is endemic in Central, South America, Mexico and the South of the United States. It is an important cause of early mortality and morbidity, and it is associated with po...verty and stigma. A third of the cases evolve into chronic cardiomyopathy and gastrointestinal disease. This review proposes strategies to address challenges faced by non-endemic countries
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Countries, partners, and donors are committed to the global elimination of blinding trachoma by 2020.
Achieving this public health milestone requires more than funding; it requires health personnel with the
right mix of skills, and well supported and managed health systems. Mass drug administratio...n (MDA)
with Zithromax®, the Pfizer, Inc. donated antibiotic, is a key component of the SAFE strategy, endorsed
by the World Health Organization. There is growing
recognition that improving all aspects of MDA, from
planning to training, recording to reporting, and
receipt of drug to distribution (the supply chain), will
be necessary if MDA programmes are going to reduce
the community burden of Chlamydia trachomatis, and
eliminate trachoma as a cause of blindness by 2020.
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Research to develop point-of-care tests is in progress. Treatment of Buruli ulcer comprises 8 weeks of combined antibiotics (rifampicin and clarithromycin). Complementary therapies such as wound care, skin graft and prevention of disability are needed in some cases to ensure full recovery.
The targ...et set by the World Health Organization (WHO) for control of Buruli ulcer is for countries to achieve a rate of case confirmation by PCR of at least 70%. All endemic countries have at least one PCR facility to support confirmation of cases. However, most countries in the WHO African Region have not been able to reach the target, and the rate of case confirmation has been declining
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PLoS Med. 2009 Oct;6(10):e1000159. doi: 10.1371/journal.pmed.1000159. Epub 2009 Oct 6.
PLoS Medicine Vol. 6 no. 10 (2009) e1000165
The purpose of this TPP is to communicate the minimum and ideal characteristics desired to meet the need for discriminating low levels of risk for transmission, i.e. targeted prevalence thresholds in the surveyed areas. An in vitro diagnostic test is needed for the detection of analyte(s) specific t...o Wuchereria bancrofti, Brugia malayi, and Brugia timori to aid in the surveillance of defined geographic areas as to whether infection and/or transmission potential has increased (recrudescence) or decreased (elimination of transmission).
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In 2009, WHO’s Second International Conference on Buruli Ulcer Control and Research resolved to strengthen the capacity of national laboratories to confirm cases of the disease, but advised that “efforts are still needed to develop simple diagnostic tools usable in the field as well as disabilit...y prevention methods”.
In 2013, WHO and the Foundation for Innovative New Diagnostics convened a meeting of Buruli ulcer experts in Geneva, Switzerland (9) at which two priority unmet needs in diagnosis were identified:
a diagnostic test for early detection of Buruli ulcer in symptomatic patients with sufficient positive predictive value to put patients on appropriate treatment; and
a screening test at the primary health care or community level for symptomatic patients with ulcer
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PLoS Negl TropDis14(10): e0008837. https://doi.org/ 10.1371/journal.pntd.0008837.
We conducted alandscape analysis on parasitic and vector-borne disease elimination approaches with the aim toidentify evidence-based strategies, core components and key concepts for achieving and sustaining schistosom...iasis control and for progressing elimination efforts towards interruption oftransmission insubSaharan Africa.
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PLoS Negl Trop Dis 18(7): e0012282.
This review highlights common diagnostic
approaches for detecting schistosomiasis in field and clinical settings, major challenges,
and provides new and novel opportunities and diagnosis pathways that will be critical in sup-
porting elimination of schistosomi...asis.
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The development of this target product profile (TPP) was led by the WHO Department of Control of Ne-
glected Tropical Diseases (NTD) following standard WHO guidance for TPP development. In order to
identify and prioritize diagnostic needs, a WHO NTD Diagnostics Technical Advisory Group (DTAG)
was... formed, and different subgroups were created to advise on specific NTDs, including a subgroup
working on the human African trypanosomiasis (HAT) diagnostic innovation needs. This group of in-
dependent experts included leading scientists, public health officials and endemic-country end-user rep-
resentatives. Standard WHO Declaration of Interest procedures were followed. A landscape analysis of
the available products and of the development pipeline was conducted, and the salient areas with unmet
needs were identified
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PLoS Negl Trop Dis 16(11): e0010908. https://doi.org/10.1371/journal.pntd.0010908
HAT diagnosis relies on laboratory techniques because clinical signs and symptoms are unspecific. Serodiagnostic tests exist only for Tbg and are based on the detection of specific antibodies, thus they are not confirmatory of infection. With the current low disease prevalence, the positive predicti...ve value of serological tests is particularly low. Field-applicable tools include the card agglutination test for trypanosomiasis (CATT) used mainly in active screening by specialized mobile teams, and the rapid diagnostic tests that are more suitable for individual testing at point-of-care. Confirmation of Tbg infection requires microscopic examination of body fluids necessitating specific training. The best performing methods are laborious and reach 85–95% diagnostic sensitivity when performed by skilled personnel.
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HAT diagnosis relies on laboratory techniques because clinical signs and symptoms are unspecific. Serodiagnostic tests exist only for Tbg and are based on the detection of specific antibodies, thus they are not confirmatory of infection. With the current low disease prevalence, the positive predicti...ve value of serological tests is particularly low. Field-applicable tools include the card agglutination test for trypanosomiasis (CATT) used mainly in active screening by specialized mobile teams, and the rapid diagnostic tests that are more suitable for individual testing at point-of-care.
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PLoS Negl Trop Dis 16(11): e0010885. https://doi.org/10.1371/journal.pntd.0010885
HAT diagnosis in non-endemic countries is rare and can be challenging, but alertness and
surveillance must be maintained to contribute to WHO’s elimination goals. Early detection is
particularly important as it co...nsiderably improves the prognosis.
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