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Buruli ulcer is a disease of skin and soft tissue with the potential to leave sufferers scarred and disabled. It is caused by an environmental pathogen, Mycobacterium
ulcerans, that produces a des
...
tructive toxin. The exact mode of transmission is unclear. The main burden of disease falls on children living in sub-Saharan Africa, but healthy people of all ages, races, and socioeconomic classes are susceptible.
more
Leprosy/Hansen disease is a chronic infectious disease primarily impacting the skin and peripheral nerves. If left untreated, leprosy can have long
...
-term consequences, including deformities and disabilities, which are associated with stigma. Leprosy is one of the 21 neglected tropical diseases (NTDs), a group of conditions prevalent in tropical regions. In the “WHO Roadmap for Neglected Tropical Diseases 2021–2030”, leprosy, human African trypanosomiasis (HAT) and onchocerciasis are targeted for interruption of transmission. Acknowledging the growing necessity for establishing a process to verify the absence of new autochthonous leprosy cases, a technical guidance has been developed outlining a clear pathway, demarcating phases with
indicators and milestones leading towards the elimination of leprosy disease.
more
Buruli ulcer is a chronic, progressive skin disease caused by infection with Mycobacterium ulcerans. It is currently considered to be one of the neglected tropical diseases; less common than tubercu
...
losis but more common than leprosy. The initial lesion is a painless subcutaneous nodule, usually less than 5 cm diameter and adherent to skin. The nodule typically breaks down centrally after days to weeks forming an ulcer with undermined edges. Thus, the external appearance of the ulcer underestimates the true size of the affected area. The patient remains well and there is no pain unless secondary bacterial infection occurs. Other forms of M. ulcerans disease include a firm plaque lesions that behaves in the same way as the nodule or an oedematous lesion that is more aggressive and extends rapidly resulting in a very large ulcer.
Any age group can be affected by Buruli ulcer diseases, but the incidence peaks at 5 to 15 years. Ulcers are most frequently on the limbs but can be on the trunk or head, sometimes with catastrophic consequences such as loss of sight or loss of breast or genital tissue. Healing close to a joint can result in contracture, and sometimes there is so much tissue destruction on a limb that amputation is unavoidable. Occasionally osteomyelitis occurs in bone adjacent to a skin lesion but involvement of other organs is rare. Disseminated disease with HIV has been reported.
more
Chromoblastomycosis (CMB) is a chronic fungal infection of the skin and the subcutaneous tissue caused by a transcutaneous traumatic inoculation of a specific group of dematiaceous fungi occurring mainly in tropical and subtropical zones worldwide.
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If not diagnosed at early stages, patients with CBM require long term therapy with systemic antifungals, sometimes associated with physical methods. Unlike other neglected endemic mycoses, comparative clinical trials have not been performed for this disease. Nowadays, therapy is based on a few open trials and on expert opinion. Itraconazole either as monotherapy or associated with other drugs, or with physical methods, is widely used. Recently, photodynamic therapy has been successfully employed in combination with antifungals in patients presenting with CBM. In the present revision the most used therapeutic options against CBM are reviewed as well as the several factors that may have impact on the patient's outcome.
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Skin prick reactivity among asthmatics in East Africa
Kwizera, R.; Wadda, V.; Mugenyi, L.; et al.
World Allergy Organization Jornal Volume 13, Issue 6100130June 2020
(2020)
CC2
The burden of asthma in Africa is high, and yet the disease is not universally prioritised. Data on allergic asthma and its impact on asthma morbidity are limited in Africa. Our aim was to describe the distribution of
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skin prick positivity among asthmatics in Eastern Africa.
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Noma (cancrum oris) is a serious gangrenous disease of the mouth and face, mainly affecting children aged 2 to 6 years in sub-Saharan Africa.
Despite substantial knowledge gaps, it is reported to be linked with malnutrition, poor oral hygiene, im
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munosuppression, and living in extreme poverty situations.
This course addresses epidemiology, pathogenesis, clinical features, diagnosis, treatment, and public health considerations, including the human rights perspective of noma.
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Chagas disease is a zoonosis caused by the protozoa Trypanosoma cruzi. It is transmitted to humans by contact of triatomine bug faeces with a break in the skin (often caused by a bite from the triat
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omine bug), or with mucous membranes. Transmission by contaminated blood transfusion, accidental exposure to blood, mother-to-child (during pregnancy or childbirth) or consumption of contaminated food and water is also possible.
Chagas disease has two phases: an acute phase, which lasts approximately 4 to 6 weeks, and a chronic phase, which is lifelong if left untreated.
The disease is primarily found on the American continent. It is significantly underdiagnosed.
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The skin of a patient is the first and most visible structure of the body that any health-care worker encounters during the course of an examination. To the patient, it is also highly visible, and any dise
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ase that affects it is noticeable and will have an impact on personal and social well-being. The skin is therefore an important entry point for both diagnosis and management. Many diseases of humans are associated with changes to the skin, ranging from symptoms such as itching to changes in colour, feel and appearance.
This training guide explains how to identify the signs and symptoms of neglected tropical diseases of the skin through their visible characteristics. It also contains information on how to diagnose and manage common skin problems that front-line health workers may encounter.
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Chagas disease is found mainly in endemic areas of 21 continental Latin American countries. The most common way people are infected with Chagas is through the blood-sucking triatomine bugs, also known as ‘kissing bugs’ (or vinchuca, barbeiro, pi
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to, chinche, chipo in different Latin American countries). The bugs typically live in wall or roof cracks of poorly constructed homes made of materials such as mud, straw and palm thatch. They come out at night to feed on people’s blood while they’re sleeping, then defecate close to the bite. Their faeces contain the parasite, which can then enter the person’s body when they inadvertently smear the bug’s waste into the bite or another skin break, the eyes or the mouth.
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Skin NTDs App
recommended
Recognizing neglected tropical diseseases through changes on the skin.
App for Android and IOS, free of charge. The App is available in English and French, with plans to explore translations into other languages, such as Portuguese and Spanish, to
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better serve diverse communities.
A patient's skin is the first and most visible structure of the body that a healthcare worker encounters during an examination. It is also highly visible to the patient, and any disease that affects it can be felt and has an impact on personal and social wellbeing. The skin is therefore an important entry point for diagnosis and management. Many human diseases are associated with changes in the skin, ranging from symptoms such as itching to changes in colour, feel and appearance.
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Mycetoma is a chronic, progressively destructive infectious disease of the subcutaneous tissues, affecting skin, muscle and bone. Mycetoma occurs in tropical and subtropical environments characteriz
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ed by short rainy seasons and prolonged dry seasons that favour the growth of thorny bushes. Global burden is not known, but the disease is endemic; it has been reported from countries in Africa, Asia, Europe and Latin America. This course addresses the epidemiology of mycetoma, clinical features, diagnosis, treatment, and public health interventions.
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Considered a neglected tropical disease, Guinea worm disease (dracunculiasis) is a parasitic infection caused by the nematode roundworm parasite Dracunculus medinensis. It is contracted when people
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consume water from stagnant sources contaminated with Guinea worm larvae. Inside a human's abdomen, Guinea worm larvae mate and female worms mature and grow. After about a year of incubation, the female Guinea worm, one meter long, creates an agonizingly painful lesion on the skin and slowly emerges from the body. Guinea worm sufferers may try to seek relief from the burning sensation caused by the emerging worm and immerse their limbs in water sources, but this contact with water stimulates the emerging worm to release its larvae into the water and begin the cycle of infection all over again.
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Buruli ulcer (BU), the second most common mycobacterial disease in West Africa, is a necrotizing skin disease that can lead to high morbidity in af
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fected patients. The disease is caused by Mycobacterium ulcerans (MU), whose major virulence factor is mycolactone. Although early infection can be treated with antibiotics, an effective preventative strategy is challenging due to unknown reservoir(s) and unresolved mode(s) of transmission.
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Female Genital Schistosomiasis (FGS) is a gynaecological disease caused by Schistosoma haematobium, a parasitic worm that is acquired by skin contact with freshwater contaminated by schistosome cerc
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eriae. Communities in which the infection is most endemic have limited access to clean water and healthcare services. Up to 150 million adolescent girls and women are estimated to be at risk of FGS and about 16–56 milion womens are living with FGS, with the majority of these in sub-Saharan Africa. The variability of these estimates points to the fact that this neglected tropical disease is not well studied and frequently not prioritized by local, regional, and global health policy makers.
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Course information
Yaws is targeted for eradication by WHO in the 2021-2030 NTD Roadmap. It is therefore crucial to know how to identify cases, design and implement activities to eradicate the disease at the community level.
In the context of inte
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gration of skin NTDs it is vital to learn to recognize a disease targeted for eradication. At the individual level yaws lesions may mimic other skin diseases. At the community level, it is key to know how to design and implement the total community treatment strategy and monitor its impact. This course aims at providing health workers with the basic knowledge to understand the epidemiology, diagnosis, treatment, impact, eradication strategy and reporting of yaws.
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Onchocerca volvulus transmitted by repeated bites of infected blackflies (Simulium spp.). These blackflies breed along fast-flowing rivers and streams, close to remote villages located near fertile land where people rely on agriculture.
There is a need to reinforce skills of national and district
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health workers to know and identify the disease, understand the risk factors according to the context and living conditions of the affected communities, and promote the implementation of public health interventions. With the shift from control to elimination, large areas in Africa require mapping to assess whether transmission is active, and treatment required. A sampling strategy named Onchocerciasis elimination mapping has been developed to help countries conduct those assessments and start treatment where needed.
This course examines the epidemiology of Onchocerciasis, clinical aspects, impact, diagnosis, treatment and control, elimination, public health interventions and role of community health workers
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Injury to the skin and underlying tissues from acute exposure to
a large external dose of radiation is referred to as cutaneous
radiation injury (CRI). Acute radiation syndrome (ARS) 1 will
usually be accompani
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ed by some skin damage; however, CRI
can occur without symptoms of ARS. This is especially true with
acute exposures to beta radiation or low-energy x-rays, because
beta radiation and low-energy x-rays are less penetrating and less
likely to damage internal organs than gamma radiation is. CRI can
occur with radiation doses as low as 2 Gray (Gy) or 200 rads 2 and
the severity of CRI symptoms will increase with increasing doses.
Most cases of CRI have occurred when people inadvertently came
in contact with unsecured radiation sources from food irradiators,
radiotherapy equipment, or well depth gauges. In addition, cases of
CRI have occurred in people who were overexposed to x-radiation
from fluoroscopy units.
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Scabies is an infestation of the skin by the human itch mite (Sarcoptes scabiei var. hominis). The microscopic scabies mite burrows into the upper layer of the skin where it lives and lays its eggs.
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The most common symptoms of scabies are intense itching and a pimple-like skin rash. The scabies mite usually is spread by direct, prolonged, skin-to-skin contact with a person who has scabies.
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Onchocerciasis, or river blindness, is a neglected tropical disease (NTD) caused by the parasitic worm Onchocerca volvulus. It is transmitted through repeated bites by blackflies of the genus Simulium. The
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disease is called river blindness because the blackfly that transmits the infection lives and breeds near fast-flowing streams and rivers, mostly near remote rural villages. The infection can result in visual impairment and sometimes blindness. Additionally, onchocerciasis can cause skin disease, including intense itching, rashes, or nodules under the skin. Worldwide onchocerciasis is second only to trachoma as an infectious cause of blindness.
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