Sunday, May 19, 2019

(LML) InfoNTD monthly e-newsletter on NTDs and cross-cutting issues - May 2019

Leprosy Mailing List – May 19,  2019

Ref.:  (LML) InfoNTD monthly e-newsletter on NTDs and cross-cutting issues - May 2019

From:  Roos Geutjes, Amsterdam, the Netherlands

Dear colleagues,

Digital health interventions play an important role in todays' health systems strengthening. Even in the most remote areas, people often have access to mobile phones. Numerous applications are being developed worldwide to support governments, organisations, programmes, communities and individuals with the aim to improve health outcomes. Working with, or building an application is one thing, scaling up or ensuring long-term success can be challenging, especially when programmes end and funding stops. Let's learn from each other to increase success and sustainability in mobile health interventions. Therefore, in this newsletter you will find no less than five publications on mobile health as cross cutting theme. 

Congratulations to our partner Sightsavers who has won a bronze accoloade in the Brand Film Festival Awards this month with their "What We Do brand film". This is the second film award for Sightsavers in recent weeks. On 27 April the organisation collected another bronze award at the 2019 Charity Film Awards for a film entitled 'One billion treatments for neglected tropical diseases'. The film highlights their work of providing combined treatment for river blindness and lymphatic filariasis as part of the UNITED programme. Well done, Sightsavers! 

Should you be missing any information on cross-cutting NTD issues on the portal and in this newsletter, please don't hesitate to contact me. Suggestions are always welcome. 

Warm regards,
Roos Geutjes

InfoNTD Coordinator

New publications

The gendered impact of Buruli ulcer on the household production of health and social support networks: Why decentralization favors women.
Agbo I, Johnson R, Sopoh G, Nichter M. PLoS neglected tropical diseases. 2019; 13(4):e0007317.
Abstract The treatment of moderate to severe BU affects the well-being of entire households and places a strain on both gender relations within households and social relations with kin asked for various types of support. In this paper, we employ the conceptual lenses provided by the Household Production of Health approach to understanding the impact of illness on the household as a unit of analysis, gender studies, and social support related research to better understand BU health care decision making and the psychosocial experience of BU hospitalization.
Read more

Collateral Benefits of Preventive Chemotherapy - Expanding the War on Neglected Tropical Diseases.
Hotez PJ, Fenwick A, Molyneux DH. The New England journal of medicine. 2019.
Read more

Female genital schistosomiasis and HIV/AIDS: Reversing the neglect of girls and women.
Hotez PJ, Harrison W, Fenwick A, et al.. PLoS neglected tropical diseases. 2019; 13(4):e0007025.
Read more

Navigating the Structure of Research on Sustainable Development Goals
Nakamura M. P. 3rd Institute for Scientific Information; 2019.
Read more

Maladies tropicales négligées (MTN) : les chercheurs-lutteurs francophones plaident pour une approche intégrée du diagnostic
Neglected tropical diseases (NTD): French-speaking researchers-fighters call for an integrated approach to diagnosis.
Boutin J-. Médecine et Santé Tropicales. 2019; 29(1):23-25.
Abstract Le réseau francophone sur les maladies tropicales négligées (RFMTN) créé sous l'égide d'Aviesan en avril 2016 a, parmi ses 5 objectifs, ceux de favoriser les interactions entre les institutions francophones membres, de développer des programmes collaboratifs permettant de répondre à des appels d'offres et de mener un plaidoyer efficace auprès des instances politiques et des bailleurs. Pour faire un point d'étape de ses deux premières années d'existence il a tenu à Montpellier (France) un colloque plénier les 22 et 23 octobre 2018 auquel ont très activement participé des experts venus de nombreuses institutions scientifiques africaines, françaises et internationales. Cet article présente l'essentiel des débat.
Read more

Inequalities in the social determinants of health and Chagas disease transmission risk in indigenous and creole households in the Argentine Chaco.
Fernández M, Gaspe M, Gürtler RE. Parasites & vectors. 2019; 12(1):184.
Abstract The social determinants of health (SDHs) condition disease distribution and the ways they are handled. Socio-economic inequalities are closely linked to the occurrence of neglected tropical diseases, but empirical support is limited in the case of Chagas disease, caused by the protozoan Trypanosoma cruzi. Herein we assessed the relationship between key structural SDHs and the risk of T. cruzi vector-borne transmission in rural communities of the Argentine Chaco occupied by creoles and an indigenous group (Qom)
Read more

Uniting to Combat Neglected Tropical Diseases 2018 Action Framework Report
Uniting to Combat NTDs. Uniting to Combat NTDs; 2019.
Read more

Influence of Donor Aid Policy on Disability Inclusion in Myanmar
Soe SK. University of Sydney Faculty of Health Sciences Occupational Therapy. 2019.
Abstract Article 32 of the UNCRPD requires that international aid programs are inclusive and accessible to people with disabilities. Myanmar is both a signatory to the UNCRPD and is also a major recipient of aid from signatory countries. This study aimed to identify if the requirements of Article 32. 1 (a) are reflected in donor-funded aid programmes in Myanmar. The primary purpose was to analyse compliance along 'the aid delivery chain' understood to encompass policy commitment by donor agencies and in-country partners, identifying influencing factors on disability-inclusive development practices.
Read more

Achieving Sustainability and Scale-Up of Mobile Health Noncommunicable Disease Interventions in Sub-Saharan Africa: Views of Policy Makers in Ghana
Opoku D, Busse R, Quentin W. JMIR mHealth and uHealth. 2019; 7461636(52 Suppl21).
Abstract A growing body of evidence shows that mobile health (mHealth) interventions may improve treatment and care for the rapidly rising number of patients with noncommunicable diseases (NCDs) in sub-Saharan Africa (SSA). A recent realist review developed a framework highlighting the influence of context factors, including predisposing characteristics, needs, and enabling resources (PNE), for the long-term success of mHealth interventions. The views of policy makers will ultimately determine implementation and scale-up of mHealth interventions in SSA. However, their views about necessary conditions for sustainability and scale-up remain unexplored.
Read more

Pediatric tropical medicine: The neglected diseases of children.
Hotez PJ, Odom John AR, LaBeaud DA. PLoS neglected tropical diseases. 2019; 13(5):e0007008.
Abstract Our objective is to highlight several ominous trends, including our findings that (1) the pediatric tropical disease burdens are huge and do not appear to be declining and (2) fewer trainees are entering the field. Included here are are some key suggestions to address these concerns.
Read more

Economic evaluations of onchocerciasis interventions: a systematic review and research needs.
Turner HC, Walker M, Pion SD, McFarland DA, Bundy DA, Basáñez M-. Tropical medicine & international health : TM & IH. 2019.
Abstract To provide a systematic review of economic evaluations that has been conducted for onchocerciasis interventions, to summarise current key knowledge and to identify research gaps.
Read more

Is the elimination of 'sleeping sickness' affordable? Who will pay the price? Assessing the financial burden for the elimination of human African trypanosomiasis in sub-Saharan Africa
Sutherland SC, Tediosi F. BMJ Global Health. 2019; 4(2).
Abstract Programme to eliminate neglected tropical diseases (NTDs) have gained global recognition, and may allow for improvements to universal health coverage and poverty alleviation. The objective of this analysis was to forecast the financial burden of direct costs of HAT Tbg to funders and society.
Read more

An Ecological Framework for Modeling the Geography of Disease Transmission.
Johnson EE, Escobar LE, Zambrana-Torrelio C. Trends in ecology & evolution. 2019.
Abstract Ecological niche modeling (ENM) is widely employed in ecology to predict species' potential geographic distributions in relation to their environmental constraints and is rapidly becoming the gold-standard method for disease risk mapping. However, given the biological complexity of disease systems, the traditional ENM framework requires reevaluation. We propose a theoretical framework based on the biological properties of both hosts and parasites to produce reliable outputs resembling disease system distributions. This new framework will help the field of disease ecology and applications of biogeography in the epidemiology of infectious diseases.
Read more

Chapter 11 - m-Health in Public Health Practice: A Constellation of Current Evidence
Abdulrahman S, Ganasegeran K. 2019.
Abstract This chapter examines historical and current literature evidence of m-Health application in public health practice, its impact on global population health and future prospects.
Read abstract

Models for enhancing the development of experiential learning approaches within mobile health technologies.
Broussard JD, Teng EJ. Professional Psychology: Research and Practice. 2019.
Abstract Benefits of mHealth apps are numerous, but potential limitations include poorer understanding of material due to the lack of real-time support from providers, limited scope and depth of interventions, and absence of theoretical grounding and/or empirical support. A potential reason for these limitations is that treatment experts and app developers lack a common theory-based conceptual model to inform the objectives of mHealth interventions. We discuss how clinicians and app developers can use models of learning processes, such as Experiential Learning Theory (ELT) and Bloom's Taxonomy, to facilitate collaboration among professionals and to increase experiential learning within mHealth interventions.
Read more

Effects of water, sanitation, handwashing and nutritional interventions on soil-transmitted helminth infections in young children: A cluster-randomized controlled trial in rural Bangladesh.
Ercumen A, Benjamin-Chung J, Arnold BF, Lin A, Hubbard AE, Stewart C, et al.. : the preprint server for biology. 2019.
Abstract Soil transmitted helminths (STH) infect >1.5 billion people. Mass drug administration (MDA) effectively reduces infection; however, there is evidence for rapid reinfection and risk of potential drug resistance. We conducted a randomized controlled trial in Bangladesh (WASH Benefits, NCT01590095) to assess whether water, sanitation, hygiene and nutrition interventions, alone and combined, reduce STH in a setting with ongoing MDA.
Read more

Knowledge, attitudes and practices related to schistosomiasis transmission and control in Leyte, Philippines.
Francisco I, Jiz M, Rosenbaum M, Baltazar P, Steele JA. PLoS neglected tropical diseases. 2019; 13(5):e0007358.
Abstract In the Philippines, 860,000 people are afflicted with Schistosoma japonicum annually, and another 6.7 million live in endemic areas. The disease's complex epidemiology as well as the influence of poverty in endemic areas demand an integrated, multi-sectoral approach to disease control. Results from behavioral or sociocultural studies on schistosomiasis could improve the content and impact of schistosomiasis control in rural villages in the Philippines. We investigated knowledge, attitudes and practices related to schistosomiasis transmission and control in an endemic village in Leyte Province, Philippines.
Read more

Mobile health ethics and the expanding role of autonomy.
Schmietow B, Marckmann G. Medicine, health care, and philosophy. 2019.
Abstract Mhealth technology is mushrooming world-wide and, in a variety of forms, reaches increasing numbers of users in ever-widening contexts and virtually independent from standard medical evidence assessment. Yet, debate on the broader societal impact including in particular mapping and classification of ethical issues raised has been limited. This article, as part of an ongoing empirically informed ethical research project, provides an overview of ethical issues of mhealth applications with a specific focus on implications on autonomy as a key notion in the debate
Read more

Health-related Quality of Life and Wound Care Practices Among Patients With Chronic Wounds in a Southwestern Nigerian Community.
Oladele H, Fajemilehin R, Oladele A, Babalola E. Wounds : a compendium of clinical research and practice. 2019.
Abstract Chronic wounds (CWs) are a common problem around the world. Although known to affect quality of life, patients' perception may vary among cultures. The purpose of this article is to determine the effects of CWs on health-related quality of life (HRQoL) and identify wound care practices among a select population in southwestern Nigeria.
Read more

Chagas disease as example of a reemerging parasite.
Guarner J. Seminars in diagnostic pathology. 2019.
Read more

Helminth infections in light of an ongoing intervention in endemic areas of Guragae zone, Southern Ethiopia: an implication for neglected tropical diseases elimination in Ethiopia by 2020
Shumbej T, Girum T. Tropical Diseases, Travel Medicine and Vaccines. 2019.
Abstract Helminth infections are among the major public health problems in developing countries. Considerable efforts have been made towards the control of morbidity caused by infection with helminths in Ethiopia. The national control program is designed to achieve the elimination of helminth infections as a major public health problem by 2020.
Read more

Evaluating mHealth Apps Using Affordances: Case of CommCare Versus DHIS2 Tracker
Chhetri A, Iversen M, øll J, Kanjo C. 2019.
Abstract CommCare and DHIS2 Tracker are two software packages which were configured for community health workers (CHW) in Malawi and evaluated and compared.
Read more

Guidance on stakeholder engagement practices to inform the development of area-wide vector control methods.
Thizy D, Emerson C, Gibbs J, et al.. PLoS neglected tropical diseases. 2019; 13(4):e0007286.
Read more

Trends in dengue research in the Philippines: A systematic review.
Agrupis K, Ylade M, Aldaba J, Lopez A, Deen J. PLoS neglected tropical diseases. 2019; 13(4):e0007280.
Abstract Dengue is an important public health problem in the Philippines. We sought to describe the trends in dengue research in the country. We searched four databases and identified published studies on dengue research in the Philippines during the past 60 years. We reviewed 135 eligible studies, of which 33% were descriptive epidemiologic studies or case series, 16% were entomologic or vector control studies, 12% were studies on dengue virology and serologic response, 10% were socio-behavioral and economics studies, 8% were clinical trials, 7% were on burden of disease, 7% were investigations on markers of disease severity, 5% were on dengue diagnostics, and 2% were modeling studies.
Read more

A high-intensity cluster of infection around Mbita causeway, western Kenya: a confirmatory cross-sectional survey.
Chadeka E, Nagi S, Cheruiyot NB, et al.. Tropical medicine and health. 2019; 4726.
Abstract In Kenya, communities residing along the shores and islands of Lake Victoria bear a substantial burden of schistosomiasis. Although there is a school-based deworming program in place, the transmission of varies even at a fine scale. Given the focal nature of schistosomes' transmission, we aim to identify areas with high intensity of infection in Mbita, Homabay County, western Kenya, for prioritized integrated control measures.
Read more

Effects, equity, and cost of school-based and community-wide treatment strategies for soil-transmitted helminths in Kenya: a cluster-randomised controlled trial.
Pullan RL, Halliday KE, Oswald WE, et al.. Lancet (London, England). 2019.
Abstract School-based deworming programmes can reduce morbidity attributable to soil-transmitted helminths in children but do not interrupt transmission in the wider community. We assessed the effects of alternative mass treatment strategies on community soil-transmitted helminth infection.
Read more

Healthcare equity analysis: applying the Tanahashi model of health service coverage to community health systems following devolution in Kenya.
McCollum R, Taegtmeyer M, Otiso L, Mireku M, Muturi N, Martineau T, et al.. International journal for equity in health. 2019; 18(1):65.
Abstract Universal health coverage (UHC) is growing as a national political priority, within the context of recently devolved decision-making processes in Kenya. Our study applied Tanahashi's equity model (according to availability, accessibility, acceptability, contact with and quality) to review perceived equity of health services by actors across the health system and at community level, following changes to the priority-setting process at sub-national levels post devolution in Kenya.
Read more

Community-wide soil-transmitted helminth treatment is equity-effective.
Keiser J, Utzinger J. Lancet (London, England). 2019.
Read more

Sustainable innovation in vector control requires strong partnerships with communities.
Bartumeus F, Costa GB, Eritja R, et al.. PLoS neglected tropical diseases. 2019; 13(4):e0007204.
Read more

Soil-transmitted helminthiases in Nepal: transmission boundaries and implications for local communities and international travelers.
Baldovin T, Amoruso I, Zangrando D, Cocchio S, et al.. Acta tropica. 2019.
Abstract Soil transmitted helminthiasis (STHs) are endemic in Nepal but since the country territory is extremely heterogeneous, a multidisciplinary assessment is required to evaluate the risk of infection in different areas.
Read more

GDPR & the InfoNTD newsletter

New EU data protection regulations came into force on 25 May 2018. We have been reviewing our practices with regards to the GDPR, including our privacy statement and mailing list. InfoNTD sends out monthly e-mails to its subscribers with an overview of recent publications on NTDs and cross-cutting issues. The purpose of this activity is to keep subscribers up to date. InfoNTD will only process the data we have (names, email addresses) for the purpose of sending you the newsletter. We take your security seriously and will never share your contact details with anyone else. You can update your preferences or unsubscribe from this list at any time.

LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link:

Contact: Dr Pieter Schreuder <<

(LML) Brazil: UN expert on leprosy


Leprosy Mailing List – May 19,  2019

Ref.:  (LML)  Brazil: UN expert on leprosy

From:  Alice Cruz, Quito, Equador

Dear colleagues,

Leprosy: Expert calls on Brazil to redouble efforts to end discrimination

·         First official visit by UN leprosy expert since creation of mandate

·         Nearly 27,000 new cases reported in Brazil in 2017, up from previous year

·         Health care, employment and education concerns for those affected

BRASILIA (14 May 2019) – A UN human rights expert expressed serious concerns about the number of children affected by leprosy in Brazil, many of whom are denied access to schooling, and urged the Government to take urgent steps to ensure the rights of those affected with the disease are protected.

In the first official country visit since the creation of the mandate, Special Rapporteur Alice Cruz assessed the situation in Brazil, which has the second highest rate of new cases worldwide. Latest data from the World Health Organization shows there were 26,875 leprosy cases in 2017.

"I welcome the commitment of the Brazilian Government to become a global leader on the elimination of discrimination against persons affected by leprosy (Hansen's disease) and their family members and on the full protection of their rights, but the Government should take vigorous steps towards this objective," Cruz said in a statement at the end of her eight-day visit.

The UN expert expressed serious concerns about the prevailing stigma associated with the disease, and the lack of understanding about transmission and treatment. "Contrary to popular conception, leprosy is a curable disease, it is difficult to transmit and after the first doses of treatment there is no risk of transmission," Cruz said.

"I acknowledge the efforts of the Brazilian Government to fight discrimination against this vulnerable group, but I still find significant gaps that need to be addressed. Persons affected by leprosy continue to experience prejudice, structural and interpersonal discrimination and have limited access to fundamental rights and substantive equality.

"They still struggle to receive appropriate and comprehensive health care, obtain education and employment, and some are still searching for their children who were forcibly taken in the past," said Cruz.

She expressed her serious concern that the rate of children diagnosed with physical impairments was still very high and that many were denied access to schooling on the grounds of leprosy.

"More must be done to ensure early detection, prompt treatment, rehabilitation and reconstructive surgery," the UN expert said. "An adequate standard of living must be ensured by poverty reduction policies, as well as accessibility and reasonable accommodation at schools and work settings. Many people who are affected have asked the authorities to take decisive steps to protect their rights, including affirmative policies to tackle inequality and reparation measures for physical and psychosocial impairments and disabilities caused as a result of past policies," she added.

During her visit, the expert met federal and local government representatives in Brasilia, Rio de Janeiro and Belem, as well as representatives of civil society organizations, academics and health professionals. She also met people affected by leprosy and their family members in Curupaiti, Rocinha, Marituba and Combu island.

Her final report, including findings and key recommendations, will be presented to the UN Human Rights Council in June 2020. 



Hanseníase: Relatora apela ao Brasil para redobrar esforços no combate à discriminação

·         Primeira visita oficial da Relatora em hanseníase da ONU desde a criação do mandato

·         Aproximadamente 27.000 casos novos foram registrados no Brasil em 2017, número acima do ano anterior

·         Cuidados de saúde, emprego e educação para as pessoas afetadas

BRASÍLIA (14 de maio de 2019) - Especialista em direitos humanos da ONU expressou sérias preocupações com o número de crianças afetadas pela Hanseníase no Brasil, muitas das quais tem o acesso à escola denegado, e instou o governo a tomar medidas urgentes para garantir que os direitos das pessoas afetadas com a doença estejam protegidos.

Em sua primeira visita oficial desde a criação do mandato, a Relatora Especial Alice Cruz avaliou a situação no Brasil, que tem a segunda maior taxa de casos novos em Hanseníase no mundo. Os dados mais recentes da Organização Mundial da Saúde apontam para 26.875 novos casos de Hanseníase em 2017.

"Congratulo o compromisso do governo brasileiro de se tornar um líder global na eliminação da discriminação contra pessoas afetadas pela Hanseníase e seus familiares, bem como na proteção total de seus direitos, mas o Governo deve tomar medidas vigorosas para alcançar esse objetivo", afirmou Alice Cruz em comunicado no final de sua visita de oito dias.

A especialista da ONU expressou sérias preocupações com a questão do estigma predominantemente associado à doença e a falta de conhecimento sobre transmissão e tratamento. "Ao contrário da concepção popular, a Hanseníase é uma doença curável e de difícil transmissão, após as primeiras doses de tratamento, não há risco de transmissão", disse Alice Cruz.

"Reconheço os esforços do governo brasileiro para combater a discriminação contra esse grupo vulnerável, mas ainda encontro lacunas significativas que precisam ser resolvidas. As pessoas afetadas pela Hanseníase continuam sofrendo preconceito, discriminação estrutural e interpessoal e têm acesso limitado a direitos fundamentais e igualdade substantiva.

"Elas e eles ainda lutam, tanto para receber cuidados de saúde adequados e abrangentes, quanto para obter educação e emprego; alguns ainda procuram por seus filhos dos quais foram separados de maneira forçada no passado", disse Alice Cruz.

A Relatora expressou séria preocupação com o fato de a taxa de crianças diagnosticadas com deficiências físicas ser ainda muito alta e muitas dessas crianças terem o acesso à escola denegado em razão da Hanseníase.

"Mais deve ser feito para garantir a detecção precoce, o tratamento imediato, a reabilitação e a cirurgia reconstrutiva", disse a especialista da ONU. "Um padrão de vida adequado deve ser assegurado por políticas de redução da pobreza, bem como através da garantia da acessibilidade e da acomodação razoável nas escolas e nos ambientes de trabalho. Muitas das pessoas afetadas pediram às autoridades que tomassem medidas decisivas para proteger seus direitos, incluindo políticas afirmativas para combater desigualdades e medidas de reparação tendo em vista deficiências físicas, psicossociais e situações de violação de direitos resultante de políticas passadas", acrescentou.

Durante sua visita ao Brasil, além de representantes de organizações da sociedade civil, da academia e dos serviços de saúde, a Relatora encontrou com autoridades do governo federal, estadual e municipal em Brasília, Rio de Janeiro e Belém. A visita também permitiu encontrar com pessoas afetadas pela Hanseníase e seus familiares em Curupaiti, na Rocinha, em Marituba e na ilha do Combu.

O relatório final da visita, incluindo as informações levantadas e as principais recomendações, será apresentado ao Conselho de Direitos Humanos da ONU em junho de 2020.


Ms Alice Cruz is the first UN Special Rapporteur on the elimination of discrimination against persons affected by leprosy and their family members, appointed in November 2017 by the Human Rights Council. Ms. Cruz worked as External Professor at the Law School of University Andina Simón Bolívar – Ecuador and in several Portuguese universities as researcher on health and human rights, in particular leprosy. She participated in the elaboration of WHO Guidelines for Strengthening Participation of Persons Affected by Leprosy in Leprosy Services. She has researched and written on the subject of eliminating leprosy and the stigma attached to it and has interacted with various stakeholders, including persons affected by leprosy.

The Special Rapporteurs are part of what is known as the Special Procedures of the Human Rights Council. Special Procedures, the largest body of independent experts in the UN Human Rights system, is the general name of the Council's independent fact-finding and monitoring mechanisms that address either specific country situations or thematic issues in all parts of the world. Special Procedures experts work on a voluntary basis; they are not UN staff and do not receive a salary for their work. They are independent from any government or organization and serve in their individual capacity.

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link:

Contact: Dr Pieter Schreuder <<