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The leishmaniases are a group of diseases caused by Leishmania spp., which occur in cutaneous, mucocutaneous and visceral forms. They are neglected tropical diseases (NTDs), which disproportionately affect marginalized populations who have limited access to health care. HIV co-infected patients with
...
Leishmania infection are highly infectious to sandflies, and an increase in the coinfection rate in an endemic area is likely to increase the effective infective reservoir.
more
Interim rapid response guidance, 10 June 2022.
It includes considerations for certain populations such as patients with mild disease with considerations for community care, patients with moderate to severe disease, sexually active persons, pregnant or breastfeeding women, children and young persons
...
. The guidance also addresses considerations for clinical management such as the use of therapeutics, nutritional support, mental health services, and post-infection follow-up.
The document provides guidance for clinicians, health facility managers, health workers and infection prevention and control practitioners including but not limited to those working in primary care clinics, sexual health clinics, emergency departments, infectious diseases clinics, genitourinary clinics, dermatology clinics, maternity services, paediatrics, obstetrics and gynaecology and acute care facilities that provide care for patients with suspected or confirmed monkeypox
more
Covid-19 Test to Treat Guidelines
recommended
n response to the outbreak, the Africa Centres for Disease Control and Prevention (Africa CDC) has been supporting African Union Member States in responding to the COVID-19 pandemic through a variety of interventions such as non-pharmaceutical interventions, quarantine, testing, isolation, contact t
...
racing, and clinical management. The Test to Treat guideline aims to increase continental testing efforts and reduce COVID-19 transmission in Africa and put-up response measures to control the impact of the virus, both to limit spread and to reduce substantially the risks of severe health outcomes related to COVID-19 infection. These countermeasures include highly effective vaccines and boosters, rapid testing options for monitoring exposure, and effective therapeutic options for both pre-exposure prevention and treatment of mild-to-moderate disease, oxygen therapy for moderate-severe disease, all of which can potentially be updated efficiently as new variants emerge that may affect the effectiveness of the available tools.
more
Buruli ulcer : management of Mycobacterium ulcerans disease : a manual for health care providers
recommended
This manual is addressed to health care providers dealing with Mycobacterium ulcerans disease (Buruli ulcer). The manual aims to achieve a better understanding of the disease, its clinical presentation and its surgical management. The manual is aimed particularly at district health care providers. A
...
comprehensive protocol, adapted to each form and stage of the disease, is presented together with comments on the levels of resources and capabilities necessary
to shorten the length of treatment, to prevent complications and to minimize undesired sequelae and thus to obtain the best possible outcome for each patient. Some sections include advice relevant to surgeons (e.g. relating to bone infection). However, the level to which particular comments are intended to apply should be clear from the context.
more
This video "Buruli Ulcer Disease: Intro to the Module" is part of a multimedia-based module by Richard Phillips, Stephen Sarfo, Emmanuel Adu, Veronica Owusu-Afriyie, and Cary Engleberg (University of Michigan). The Buruli ulcer disease is due to infection
...
by Mycobacterium ulcerans. This programme describes the basic pathophysiology of the disease, the typical clinical presentations, and the management of cases with complicated features. The program should be informative for both medical students and practitioners who wish to increase their knowledge about this serious tropical disease.
more
Nat Commun 9, 5370 (2018). https://doi.org/10.1038/s41467-018-07804-8. Mycobacterium ulcerans is the causative agent of Buruli ulcer, a neglected tropical skin disease that is most commonly found in children from West and Central Africa. Despite the severity of the
...
infection, therapeutic options are limited to antibiotics with severe side effects. Here, we show that M. ulcerans is susceptible to the anti-tubercular drug Q203 and related compounds targeting the respiratory cytochrome bc1:aa3. While the cytochrome bc1:aa3 is the primary terminal oxidase in Mycobacterium tuberculosis, the presence of an alternate bd-type terminal oxidase limits the bactericidal and sterilizing potency of Q203 against this bacterium. M. ulcerans strains found in Buruli ulcer patients from Africa and Australia lost all alternate terminal electron acceptors and rely exclusively on the cytochrome bc1:aa3 to respire. As a result, Q203 is bactericidal at low dose against M. ulcerans replicating in vitro and in mice, making the drug a promising candidate for Buruli ulcer treatment.
more
Evidence-based guidelines are one of the most useful tools for improving public health and clinical practice. Their purpose is to formulate interventions based on strong evidence of efficacy, avoid unnecessary risks, use resources efficiently, reduce clinical variability and, in essence, improve hea
...
lth and ensure quality care, which is the purpose of health systems and services. These guidelines were developed following the GRADE methodology, with the support of a panel of clinical experts from different countries, all convened by the Pan American Health Organization. By responding to twelve key questions about the clinical diagnosis and treatment of dengue, chikungunya, and Zika, evidence-based recommendations were formulated for pediatric, youth, adult, older adult, and pregnant patients who are exposed to these diseases or have a suspected or confirmed diagnosis of infection. The purpose of the guidelines is to prevent progression to severe forms of these diseases and the fatal events they may cause. The recommendations are intended for health professionals, including general, resident, and specialist physicians, nursing professionals, and medical and nursing students, who participate in caring for patients with suspected dengue, chikungunya, or Zika. They are also intended for health unit managers and the executive teams of national arboviral disease prevention and control programs, who are responsible for facilitating the process of implementing these guidelines.
more
Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA) of antihelmintics is recommended by WHO to elimina
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te lymphatic filariasis as a public health problem. This study aims to produce the first geospatial estimates of the global prevalence of lymphatic filariasis infection over time, to quantify progress towards elimination, and to identify geographical variation in distribution of infection.
more
Personne ne va dans un établissement de soins de santé pour tomber malade. On s’y rend pour se faire soigner, pour accoucher
ou pour se faire vacciner. Cependant, des centaines de millions de personnes s’exposent à un risque accru d’infection
...
en cherchant à obtenir des soins dans des établissements de santé dépourvus de produits de première nécessité, notamment de services d’approvisionnement en eau, d’assainissement et d’hygiène, de gestion des déchets biomédicaux et de nettoyage (services WASH). L’absence de services WASH dans les établissements de santé compromet la sécurité et la dignité des patients, tout en menaçant d’exacerber la propagation d’infections résistantes aux agents antimicrobiens et en fragilisant les efforts déployés pour améliorer la santé des enfants et des mères.
more
Carlos Chagas discovered American trypanosomiasis, also named Chagas disease (CD) in his honor, just over a century ago. He described the clinical aspects of the disease, characterized by its etiological agent (Trypanosoma cruzi) and identified its insect vector. Initially, CD occurred only in Latin
...
America and was considered a silent and poorly visible disease. More recently, CD became a neglected worldwide disease with a high morbimortality rate and substantial social impact, emerging as a significant public health threat. In this context, it is crucial to better understand better the epidemiological scenarios of CD and its transmission dynamics, involving people infected and at risk of infection, diversity of the parasite, vector species, and T. cruzi reservoirs. Although efforts have been made by endemic and non-endemic countries to control, treat, and interrupt disease transmission, the cure or complete eradication of CD are still topics of great concern and require global attention. Considering the current scenario of CD, also affecting non-endemic places such as Canada, USA, Europe, Australia, and Japan, in this review we aim to describe the spread of CD cases worldwide since its discovery until it has become a global public health concern.
more
Pathogens . 2021 Nov 16;10(11):1493.doi: 10.3390/pathogens10111493
.Chronic manifestations of Chagas disease present as disabling and life-threatening condi-tions affecting mainly the cardiovascular and gastrointestinal systems. Although meaningful research has outlined the different molecular mech
...
anisms underlying Trypanosoma cruzi’s infection and the host-parasite interactions that follow, prompt diagnosis and treatment remain a challenge, particu-larly in developing countries and also in those where the disease is considered non-endemic. This review intends to present an up-to-date review of the parasite’s life cycle, genetic diversity, virulence factors, and infective mechanisms, as well as the epidemiology, clinical presentation, diagnosis, and treatment options of the main chronic complications of Chagas disease.
more
Rev. Panam Salud Publica. 2017;41:e153. doi: 10.26633/RPSP.2017.153
Worldwide, over 6 million people are infected with Trypanosoma cruzi, the pathogen that causes Chagas disease (CD). In the Americas, CD creates the greatest burden in disability-adjusted life years of any parasitic
...
infection. In Colombia, 437 000 people are infected with T. cruzi, of whom 131 000 suffer from cardiomyopathy. Colombia’s annual costs for treating patients with advanced CD reach US$ 175 016 000. Although timely etiological treatment can significantly delay or prevent development of cardiomyopathy—and costs just US$ 30 per patient—fewer than 1% of people with CD in Colombia and elsewhere receive it.
more
Microorganisms . 2022 Jul 14;10(7):1427.
Chagas disease (CD) is endemic in about 21 countries of the Americas. The disease has spread to recently Chagas-free regions, mainly due to migration, and can now also be diagnosed in countries such as the USA, Canada, many European and some African, eastern
...
Mediterranean and western Pacific countries. About 6 million people are infected and 70 million live with a daily risk of infection. Although many efforts have been made to control the disease, and some improvements were achieved, still, less than about 1% of the infected have access to diagnosis and treatment. This causes high morbidity and mortality rates with more than 12,000 deaths per year
more
Research and Reports in Tropical Medicine 2022:13 25–40
Chagas disease (CD) or American trypanosomiasis is a neglected parasitic disease associated with significant mortality and morbidity that includes long-term disability, social stigma and a mental health toll. Perceived as a disease of the ve
...
ry poor, this infection, once limited to rural areas of Latin America (LA), has now spread via migration to non-endemic areas and countries, where transmission is maintained via non-vectorial routes.
more
Front. Public Health, 02 July 2019 Sec. Infectious Diseases: Epidemiology and Prevention
Volume 7 - 2019 | https://doi.org/10.3389/fpubh.2019.00166
Chagas disease (CD) is an anthropozoonosis caused by the protozoan parasite Trypanosoma cruzi, that affects about 6–8 million people worldwide (1) a
...
nd causes approximately 50,000 deaths per year. Another 65–100 million people are living in areas at risk for infection worldwide (2–4). Even though over a century has passed since its discovery, CD remains one of the leading public health problems for most Latin American countries
more
Chagas disease is named after the Brazilian physician Carlos Chagas, who discovered the disease in 1909. It is caused by the parasite Trypanosoma cruzi, which is transmitted to animals and people by insect vectors and is found only in the Americas (mainly, in rural areas of Latin America where pover
...
ty is widespread). Chagas disease (T. cruzi infection) is also referred to as American trypanosomiasis
more
After 100 years of chemotherapy with impractical and toxic drugs, an oral cure for human African trypanosomiasis (HAT) is available: Fexinidazole. In this case, we review the history of drug discovery for HAT with special emphasis on the discovery, pre-clinical development, and operational challenge
...
s of the clinical trials of fexinidazole. The screening of the Drugs for Neglected Diseases initiative (DNDi) HAT-library by the Swiss TPH had singled out fexinidazole, originally developed by Hoechst (now Sanofi), as the most promising of a series of over 800 nitroimidazoles and related molecules. In cell culture, fexinidazole has an IC50 of around 1 µM against Trypanosoma brucei and is more than 100-fold less toxic to mammalian cells. In the mouse model, fexinidazole cures both the first, haemolymphatic, and the second, meningoencephalitic stage of the infection, the latter at 100 mg/kg twice daily for 5 days. In patients, the clinical trials managed by DNDi and supported by Swiss TPH mainly conducted in the Democratic Republic of the Congo demonstrated that oral fexinidazole is safe and effective for use against first- and early second-stage sleeping sickness. Based on the positive opinion issued by the European Medicines Agency in 2018, the WHO has released new interim guidelines for the treatment of HAT including fexinidazole as the new therapy for first-stage and non-severe second-stage sleeping sickness caused by Trypanosoma brucei gambiense (gHAT). This greatly facilitates the diagnosis and treatment algorithm for gHAT, increasing the attainable coverage and paving the way towards the envisaged goal of zero transmission by 2030.
more
Schistosomiasis is a public health problem in tropical and subtropical regions of Africa, Asia, the Caribbean and South America. It is one of the neglected tropical diseases (NTDs) - a group of diseases and conditions that affect particularly low-income populations, worldwide.
Last year, WHO laun
...
ched a new road map for 2021-2030 that aims to end the suffering from NTDs by 2030, in line with the Sustainable Development Goals. The road map specifically targets the elimination of schistosomiasis as a public health problem, globally.
This guideline provides evidence-based recommendations in the following areas: prevalence thresholds, target age groups and frequency of PC, establishment of WASH and snail control activities to support control and elimination of schistosomiasis, diagnostic tests for the assessment of schistosomiasis infection in animal reservoirs, in snail hosts, and in humans.
more
Progress Toward Global Eradication of Dracunculiasis
Hopkins, D.; Weiss, A.; Roy, S.
Morbidity and Mortality Weekly Report MMWR; National Libary of Medicine
(2020)
CC
Dracunculiasis (Guinea worm disease), caused by the parasite Dracunculus medinensis, is traditionally acquired by drinking water containing copepods (water fleas) infected with D. medinensis larvae, but in recent years also appears increasingly to be transmitted by eating fish or other aquatic anima
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ls. The worm typically emerges through the skin on a lower limb of the host 1 year after infection, causing pain and disability.
more
BMJ Open 2021;11:e042279. doi:10.1136/bmjopen-2020-042279. Neglected tropical diseases tend to cluster in the same poor populations, and to make progress with their control, they will have to be dealt with in an integrated manner. Peptide microarrays may be a solution to tese problems, where diagnos
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is for co-infection can be detected simultaneously using the one tool.
more