Saturday, August 24, 2019

FW: (LML) Epidemiology of Hansen's Disease for interruption of transmission


Leprosy Mailing List – August 24,  2019

Ref.:    (LML) Epidemiology of Hansen's Disease for interruption of transmission

From:  Joel Almeida, London and Mumbai


Dear Pieter & colleagues, 


At the recent symposium of the Indian Association of Leprologists, I was invited to talk about "Burning Issues" in Hansen's Disease (HD). Following the talk, there were probing questions and thoughtful discussion. Based on that, I have modified some of the slides from the talk. A small selection of slides is displayed below. 



Figure 1. The thick red arrow at upper right shows how transmission continues despite MDT and all our other current efforts and innovations. Neglected LL patients with recurrent disease can shed up to a billion bacilli per day, including tens of millions of viable bacilli (1). No other sources apart from armadillos show such a high concentration of viable bacilli. In two Indian towns, 17% of previously treated patients experiencing destitution were found to show positive skin smears (2). Shandong ensured prolonged anti-microbial protection for LL patients after the recommended duration of MDT. This led to near-zero transmission. That's because one protected LL patient could no longer be replaced by a new LL patient. In epidemiological terms, the reproductive ratio of LL patients fell below one. That's what it takes to interrupt transmission. We can match Shandong's success by adding monthly post-MDT chemoprophylaxis for all known LL patients, as part of competent case management. 3 bactericidal drugs (e.g. rifampicin+moxifloxacin+minocycline or similar) given monthly are likely to exceed the efficacy of the prolonged MDT that was demonstrated to be so highly effective in Shandong.



Figure 2. Researchers in India have reported findings strongly suggesting that viable M. leprae are implicated in type 1 reactions (4) and ENL (5). Viable M. leprae can turn neural cells into stem cells, macrophages into slaves, and can evade digestion by lysosomes in LL patients. Given this remarkable range of powerful effects, viable M. leprae could well play a role in reactions too. Therefore, post-MDT chemoprophylaxis for all LL patients, together with other interventions, is likely to help avert further nerve damage caused by recurrent disease. Patients with signs of type 1 reaction or ENL need not be denied anti-microbial treatment, alongside other appropriate treatment. 




Figure 3. Our neglect of LL patients not only maintains transmission but also allows new visible deformities to develop despite MDT. These deformities tend to increase fear and stigma in the community. A pilot survey in two rural communities in India revealed that 15% to 33% of persons who previously received MDT showed visible deformity (6). This happens even in areas with active case-finding where fewer than 5% of newly diagnosed patients show visible deformity. Despite MDT, over 2300 persons per million of the general population in a rural area of Maharashtra state (India) showed visible deformity caused by HD (7). By now, that figure is probably higher. 


The solution lies in competent case management. Competent case management includes quarterly nerve function assessment for all MB patients during 2 years after the start of MDT (with prednisolone used as necessary), and monthly post-MDT chemoprophylaxis for all LL patients. Rehabilitation and inclusion services too are part of competent case management. 




Figure 4. 85% of nerve function impairment in South Asia occurs without any signs or symptoms of reaction ("silent neuritis / silent neuropathy / quiet nerve damage") (8).


Asymptomatic patients rarely can afford to lose wages just to travel to a clinic for nerve function assessment. Trained, mobile personnel can transform the situation. One trained paramedical worker equipped with transport can serve all the MB patients in a large population, as is being done in Dadra Nagar Haveli (India). However, in some states of India, it is not easy for the government to attract and train sufficient skilled staff. NGOs can play a particularly important role in such areas, training and sponsoring staff who can take competent services to the patient's doorstep. Some NGOs are already starting such effective action. 





Figure 5. The use of single drugs accelerates the selection of multiple-drug resistant (MDR) bacilli. Combined with a high recurrence rate among neglected LLp patients, that could cause the equivalent of an epidemiological tsunami of HD, setting us back decades. Drug resistance is, in mathematical terms, a discontinuity. Like a cliff rather than a slope. In one former HD colony in Brazil, MDR bacilli and recurrent disease interacted despite even MDT (9). This is a foretaste of what could happen elsewhere. 


Therefore, it is prudent and ethical to use only combinations of drugs, of roughly equivalent bactericidal potency, and to give them for an adequate duration. This is true even for prophylaxis among contacts. If attempting prophylaxis among contacts, PGL-1 Ig antibody (10) can help identify those contacts who require further investigation and, if their skin smears are positive, require full MB-MDT. In the remaining PGL-1 Ig positive contacts, with negative skin smears, full PB-MDT could suffice. If contacts with sub-clinical disease and anergy are under-treated, recurrence and drug resistance are highly likely.





Neglect of LL patients after MDT explains why transmission has continued during the past two decades. This has happened even in Cuba (10) where nearly all our promising interventions have been implemented for nearly 20 years (including serological tests, MDT, contact tracing, BCG and chemoprophylaxis among contacts). Competent case management for MB patients during and after MDT is the missing key to zero transmission, zero new disability and zero stigma. It can unlock the efficacy of all our other interventions. Neglect of LL patients after MDT may be expedient in the short run, because patients are generally quite trusting. But such expedient neglect has allowed the bacilli to continue spreading and damaging patients, during the past two decades. We can change that. Shandong demonstrated how.


Epidemiological impact at the front lines is the ultimate test of effectiveness for an intervention. That was what Shandong provided, demonstrating near-zero transmission by protecting LL patients after the usual duration of MDT. That's what we all can strive to achieve. By adding post-MDT chemoprophylaxis and competent case management, we can create zones of near-zero transmission and near-zero new disability in our own areas. These measurable successes will be like candles in the darkness. This light can keep expanding from endemic area to endemic area until it encircles the globe with competent, compassionate, impactful practice. 


Congratulations to the Indian Association of Leprologists for organising this symposium, and for the inspiring work of its members. They keep spotting subtle clues, questioning shaky assumptions and predictions, improving interventions at the front lines, while educating and inspiring a new generation of experts and supplying expertise to the national programme. India's national motto is "satyameva jayate" (truth alone triumphs). We can keep improving the quality of our scientific analysis so that our errors are all short-lived and our interventions become steadily more impactful. Shandong's local experts deviated from global fashions, but that was necessary for their world-leading success. The frontlines are where the battle is ultimately won or lost. We cannot afford to sideline the insights of patients and experts in endemic countries and endemic areas, lest we lose touch with reality. Together with them, we all can succeed.


Joel Almeida





1. Davey TF, Rees RJ. The nasal dicharge in leprosy: clinical and bacteriological aspects. Lepr Rev. 1974 Jun;45(2):121-34.


2. Rao PS, Mozhi NM, Thomas MV. Leprosy affected beggars as a hidden source for transmission of leprosy. Indian J Med Res. 2000 Aug;112:52-5.


3. Katoch K, Aggarwal A, Yadav VS, Pandey. A National sample survey to assess the new case disease burden of leprosy in India. Indian Journal of Medical Research, 2017; 146(5): 585-605.  


4. Save MP, Dighe AR, Natrajan M & Shetty VP. Association of viable Mycobacterium leprae with Type 1 reaction in leprosy. Lepr Rev (2016) 87, 78–92


5. Arora P, Sardana K, Agarwal A, Lavania M. Resistance as a cause for chronic steroid dependent ENL - a novel paradigm with potential implications in management. Lepr Rev (2019) 90, 201– 205


6. Aggarwal A, Pandey A. Inverse sampling to study disease burden of leprosy. Indian J Med Res 132, October 2010, 438-441.


7. Ganapati R, Pai VV, Tripathi A. Can primary health centres offer care to the leprosy disabled after integration with general health services? - a study in rural India. Lepr Rev 2008, 79:340–341


8. Croft RP, Nicholls PG, Richardus JH, Smith WC. Incidence rates of acute nerve function impairment in leprosy: a prospective cohort analysis after 24 months (The Bangladesh Acute Nerve Damage Study). Lepr Rev. 2000 Mar;71(1):18-33


9. Rosa PS, D'Espindula HRS, Melo ACL et al. Emergence and transmission of drug/multidrug-resistant Mycobacterium leprae in a former leprosy colony in the Brazilian Amazon. Clinical Infectious Diseases. 1 July 2019, ciz570,


10. Nagao-Dias AT, de Macedo AC, Rodrigues RO et al. Serum Anti-PGL-1 IgG, IgM, and IgA in a 3-Year Follow-up Study of 4–15-Year-old Leprosy Contacts. The Pediatric Infectious Disease Journal: September 2019 - Volume 38 - Issue 9 - p e193–e198  doi: 10.1097/INF.0000000000002337


11. Beldarraín-Chaple E. Historical Overview of Leprosy Control in Cuba. MEDICC Rev. 2017 Jan;19(1):23-30.

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

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Contact: Dr Pieter Schreuder <<


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Friday, August 23, 2019

(LML) New publications on cross-cutting issues in NTDs. August, 2019

Leprosy Mailing List – August 23,  2019

Ref.:   (LML) New publications on cross-cutting issues in NTDs. August, 2019

From:  Roos Geutjes, Amsterdam, the Netherlands

Dear colleagues,

Next month, the Neglected Tropical Disease NGO Network annual conference will be held in Liverpool. InfoNTD will be hosting a stand at the conference. We would be happy to meet you in person, discuss opportunities and receive feedback on our platform. Should you be interested in scheduling an appointment, please don't hesitate to contact us.

We look forward to seeing you there!

Warm regards,
Roos Geutjes

InfoNTD Coordinator

New publications

WHO Alliance for the Global Elimination of Trachoma by 2020: progress report on elimination of trachoma, 2018
World Health Organization; 2019.
Read more

Surgical Approaches to the Urogenital Manifestations of Lymphatic Filiriasis
World Health Organization; 2019.
Read more

Using mobile technologies to support the training of community health workers in low-income and middle-income countries: mapping the evidence
Winters N, Langer L, Nduku P, et al.. BMJ Global Health. 2019; 4(4).
Abstract This paper maps the evidence published between 2000 and 2018 on the use of mobile technologies to train community health workers (CHWs) in low- and middle-income countries (LMICs) across nine areas of global healthcare, including the neglected areas of disability and mental health.
Read more

Advancing a standardised approach to onchocerciasis elimination mapping.
Hamill L, Hill B, Pavluck A, Downs P. Community eye health. 2019; 32(105):24.  
Read more

Evidence of high endemicity of leprosy and yaws in the municipality of Balé-Loko in the Central African Republic.
Um Boock A, Ntozo'o JP, Boua B, Vander Plaetse B. Medecine et sante tropicales. 2019; 29(2):155-158.
Abstract The incidence of neglected tropical diseases (NTD) can serve as an indicator for assessing the quality of healthcare systems because these diseases affect the poorest populations, living in areas where healthcare access is most difficult. The Central African Republic Ministry of Health, in collaboration with FAIRMED, decided to conduct the survey reported here in a village named/owned by the Central African Society of Agriculture and Wood Peeling (SCAD).
Read more

Information systems for mental health in six low and middle income countries: cross country situation analysis.
Upadhaya N, Jordans MJ, Abdulmalik J, et al.. International journal of mental health systems. 2016; 1060.
Abstract Our study indicates the need for greater technical and resources input to strengthen routine HMIS and develop standardized HMIS indicators for mental health, focusing in particular on indicators of coverage and quality to facilitate the implementation of the WHO mental health action plan 2013-2020.
Read more

From river blindness to river epilepsy: Implications for onchocerciasis elimination programmes.
Colebunders R, Siewe Fodjo J, Hopkins A, et al.. PLoS neglected tropical diseases. 2019; 13(7):e0007407.
Read more

Kankanet: An artificial neural network-based object detection smartphone application and mobile microscope as a point-of-care diagnostic aid for soil-transmitted helminthiases.
Yang A, Bakhtari N, Langdon-Embry L, et al.. PLoS neglected tropical diseases. 2019; 13(8):e0007577.
Abstract Endemic areas for soil-transmitted helminthiases often lack the tools and trained personnel necessary for point-of-care diagnosis. This study pilots the use of smartphone microscopy and an artificial neural network-based object detection application named Kankanet to address those two needs.
Read more

Rehabilitation in health systems: guide for action.
Geneva: World Health Organization; 2019.
Read more

Setia Sampai Terbukti: A Triadic Intervention in Persons With Leprosy to Improve Wellbeing and Reduce Stigma
Wutun RP, Wijaya RP. Journal of Health and Behavioral Science. 2019; 1(2):106-111.
Abstract Persons with leprosy suffer physically, psychologically and socially. They feel punished, condemned, discarded and ostracized as the result of their stigma. We argued that leprosy management and complete healing better be done simultanously on physiological, psychological, sociological and religious faith-spiritual levels, using triadic approach intervention.
Read more

Mapping evidence of the concomitant management of schistosomiasis by traditional health practitioners and health care professionals in communities with high prevalent infections: a systematic scoping review protocol.
Mushebenge G-, Mashamba-Thompson T, Nlooto M. Systematic reviews. 2019; 8(1):175.
Abstract This review will map the evidence in the literature of the concomitant management of schistosomiasis by THPs and HCPs in communities with a high prevalent infection in LMICs. The review findings will be important for policy makers across the healthcare continuum and be used to inform stakeholders' consensus process to explore the development of a generic set of patient-centered quality indicators that are applicable to multiple care settings. It will also identify research gaps in schistosomiasis management in LMICs and provide direction for future research.
Read more

Public Perception on Gender Issues and Women's HealthCare Concerns Related to Leprosy: Implications for Leprosy Control Program in Southeast Nigeria
Nwankwo I. Emerald Publishing Limited; 2019.
Abstract The study fills the knowledge gap with respect to gender issues and women's healthcare concerns related to leprosy and their implications for leprosy control program in Southeast Nigeria.
Read more

Cutaneous leishmaniasis: A neglected disfiguring disease for women.
Bilgic-Temel A, Murrell DF, Uzun S. International journal of women's dermatology. 2019; 5(3):158-165.
Abstract Leishmaniasis is one of eight neglected tropical diseases currently endemic in 102 countries/areas around the world. In recent years, cutaneous leishmaniasis (CL) has been increasingly observed among migrants, travelers, ecotourists, and military personnel. Because of its great capacity to mimic other dermatoses, CL is one of the great imitators and can mislead practitioners, which can result in untreated lesions that cause scars.
Read more

The Elimination of Neglected Tropical Diseases (NTDs): A Case Study Exemplifying How Foreign Assistance Funding Can Be Catalytic in Reducing the Burden of Major Global Health Conditions.
Wainwright E, Evans D, Rotondo L, et al.. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2019.
Abstract In 2006, following direct advocacy and published rationale, the U.S. Agency for International Development (USAID) established a neglected tropical disease (NTD) program to support the scale-up of integrated platforms targeting the elimination and control of five NTDs-lymphatic filariasis, trachoma, onchocerciasis, schistosomiasis and soil-transmitted helminthiasis. As a result, most of the supported countries are on track to achieve their elimination goals (for lymphatic filariasis and trachoma) by 2020 or 2021 and their control goals soon thereafter.
Read more

Epidemiology, ecology and human perceptions of snakebites in a savanna community of northern Ghana.
Musah Y, Ameade EP, Attuquayefio DK, Holbech LH. PLoS neglected tropical diseases. 2019; 13(8):e0007221.
Abstract Due to poverty as well as limited infrastructure and public health facilities, people in rural Africa, including Ghana, often have no other choice than to seek treatment from traditional medical practitioners (TMPs). The African 'snakebite crisis' is highlighted here using regionally representative complementary data from a community-based epidemiological and ecological study in the savanna zone of northern Ghana
Read more

Functional Outcome Following Lower Extremity Amputation: A Review of Contextual Factors Influencing Function in Low- to Middle-Income Group Countries
Mullerpatan R, Sonkhia M, Thomas B, Mishra S, Gupta A, Agarwal B. Critical Reviews in Physical and Rehabilitation Medicine. 2019; 31(2).
Abstract Our review highlights a strong need to build greater awareness on rehabilitation measures following amputation and need for disability inclusive environment to promote community participation in low- to middle-income countries.
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Estimating the cost of illness and burden of disease associated with the 2014-2015 chikungunya outbreak in the U.S. Virgin Islands.
Feldstein LR, Ellis EM, Rowhani-Rahbar A, et al.. PLoS neglected tropical diseases. 2019; 13(7):e0007563.
Abstract These findings highlight the significant economic burden of the recent CHIKV outbreak in the USVI and will aid policy-makers in making informed decisions about prevention and control measures for inevitable, future CHIKV outbreaks.
Read more

Schistosomiasis in Sub-Sahara Africa: Causes, Consequences and Control Measures for a Leading Neglected Tropical Disease
Doowuese Y, N. Chigor V, A. Eze E, D. Akosu D, U. Onwuka A, N. Okorie C. International Journal of Sciences. 2019; 8(07).
Abstract Access to safe water, improved sanitation, hygiene education, and snail control are possible control measures reported so far in literatures. The future control measure of schistosomiasis is likely to be based on the discovery and adoption of cheap novel drugs, schistosomicides and vaccines to combat the worrisome infection in the sub Saharan Africa and other places in the Tropics.
Read more

Hepatitis E should be considered a neglected tropical disease.
Azman AS, Ciglenecki I, Wamala JF, Lynch J, Aggarwal R, Rahman M, et al.. PLoS neglected tropical diseases. 2019; 13(7):e0007453.
Read more

Strengthening national health research systems in the WHO African Region - progress towards universal health coverage.
Rusakaniko S, Makanga M, Ota MO, Bockarie M, Banda G, Okeibunor J, et al.. Globalization and health. 2019; 15(1):50.
Abstract Health challenges and health systems set-ups differ, warranting contextualised healthcare interventions to move towards universal health coverage. WHO African Region (WHO AFR) facilitated the adoption of a regional strategy for strengthening national health research systems (NHRS) in 2015. We assessed the progress in strengthening NHRS among the 47 member states of the WHO AFR.
Read more

Responsive mental health systems to address the poverty, homelessness and mental illness nexus: The Banyan experience from India.
Narasimhan L, Gopikumar V, Jayakumar V, Bunders J, Regeer B. International journal of mental health systems. 2019; 1354.
Abstract The case study serves as an example of how responsive mental health systems may be constructed with both a user centred and a service integration focus.
Read more

Soil-transmitted helminth and its associated risk factors among school-aged children
Darlan DM, Winna M, Simorangkir HA, Rozi MF, Arrasyid NK, Panggabean M. IOP Conference Series: Earth and Environmental Science. 2019; 305.
Abstract Our study aimed to determine any significance among purposed risk factor of STH infection. This study was an analytical survey with cross sectional design. The number of samples is 39 student of 101747 Public Elementary School located in Klumpang Kebun Street, Klumpang Kebun Village, Hamparan Perak District, Deli Serdang who are determined based on inclusion and exclusion criteria. The data of personal hygiene, environmental sanitation and socio-economic was obtained by filling in the questionnaire.
Read more

Gambian human African trypanosomiasis in North West Uganda. Are we on course for the 2020 target?
Selby R, Wamboga C, Erphas O, et al.. PLoS neglected tropical diseases. 2019; 13(8):e0007550.
Abstract Results confirm gHAT prevalence in the study area of West Nile is below the elimination threshold (1 new case / 10,000 population), making elimination on course across this study area if status is maintained.
Read more

Dilemma in the Brazilian Tropical Medicine: 'Is speed more important than direction?'
Lacerda MV, Val FF, Monteiro WM. Anais da Academia Brasileira de Ciências. 2019.
Abstract With the recent changes in the epidemiology of infectious diseases in Brazil, research funding has been changing in a manner that does not properly consider biodiversity and poverty-related diseases. The burden of disease and the affected neglected populations need to be part of the equation in developing countries with limited funding.
Read more

High snakebite underreporting rate in the Centre Region of Cameroon: an observational study.
Tchoffo D, Kamgno J, Kekeunou S, Yadufashije C, Nana Djeunga HC, Nkwescheu A. BMC public health. 2019; 19(1):1040.
Abstract Snakebite is an endemic condition in the Centre Region of Cameroon. Because of the high rate of non-reporting of cases, the collection of information from the registers of the health facilities only appears not enough to assess the real importance of envenomation in this Region.
Read more

Developing the first national database and map of lymphatic filariasis clinical cases in Bangladesh: Another step closer to the elimination goals.
Karim MJ, Haq R, Mableson HE, et al.. PLoS neglected tropical diseases. 2019; 13(7):e0007542.
Abstract The Bangladesh LF Programme has developed one of the largest, most comprehensive country databases on LF clinical conditions in the world. It provides an essential database for health workers to identify local morbidity hotspots, deliver the minimum package of care, and address the dossier elimination requirements.
Read more

Large scale detailed mapping of dengue vector breeding sites using street view images
Haddawy P, Wettayakorn P, Nonthaleerak B, Su Yin M, Wiratsudakul A, öning J, et al.. PLOS Neglected Tropical Diseases. 2019; (7Suppl 1).
Abstract In this paper we present the design and implementation of a pipeline to detect outdoor open containers which constitute potential dengue vector breeding sites from geotagged images and to create highly detailed container density maps at unprecedented scale. We implement the approach using Google Street View images which have the advantage of broad coverage and of often being two to three years old which allows correlation analyses of container counts against historical data from manual surveys.
Read more

Progress towards lymphatic filariasis elimination in Ghana from 2000-2016: Analysis of microfilaria prevalence data from 430 communities.
Biritwum N, Frempong KK, Verver S, et al.. PLoS neglected tropical diseases. 2019; 13(8):e0007115.
Abstract Ghana started its national programme to eliminate lymphatic filariasis (LF) in 2000, with mass drug administration (MDA) with ivermectin and albendazole as main strategy. We review the progress towards elimination that was made by 2016 for all endemic districts of Ghana and analyze microfilaria (mf) prevalence from sentinel and spot-check sites in endemic districts.
Read more

Concurrent Schistosoma mansoni and Schistosoma haematobium infections in a peri-urban community along the Weija dam in Ghana:- A Wake up call for effective National Control Programme.
Anyan WK, Abonie SD, Aboagye-Antwi F, Tettey MD, Nartey LK, Hanington PC, et al.. Acta tropica. 2019; 105116.
Abstract Globally over 200 million people are infected with schistosomiasis, and approximately 80% are caused by just two of five species, Schistosoma haematobium and Schitosoma mansoni that are broadly distributed. Surprisingly, little attention has been given to co-infection with these two species. We have studied co-infection with S. mansoni and S. haematobium in a peri-urban community in Ghana, one of the most highly endemic countries for schistosomiasis.
Read more

The catalytic role of a research university and international partnerships in building research capacity in Peru: A bibliometric analysis.
Belter CW, Garcia PJ, Livinski AA, Leon-Velarde F, Weymouth KH, Glass RI. PLoS neglected tropical diseases. 2019; 13(7):e0007483.
Abstract This analysis suggests that international training of Peruvian physician-scientists who built and sustained longstanding international partnerships with funding accelerated quality research on diseases of local importance. Middle-income countries might consider the Peruvian experience where long-term research and training partnerships yielded impressive advances to address key health priorities of the country.
Read more

The health and economic burden of lymphatic filariasis prior to mass drug administration programmes.
Mathew CG, Bettis AA, Chu BK, et al.. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2019.
Abstract The Global Programme to Eliminate Lymphatic Filariasis (GPELF) was launched in 2000 with the goal of eliminating LF as a public health problem by 2020. Despite considerable progress, around 60% is remaining with the deadline looming a year away. Consequently, there is a continued need for investment in both the mass drug administration (MDA) and morbidity management programmes, which this paper aims to demonstrate by estimating the health and economic burden of LF prior to MDA programmes starting in GPELF areas.
Read more

Risk Factors for Physical Disability in Patients With Leprosy: A Systematic Review and Meta-analysis.
de Paula HL, de Souza CD, Silva SR, Martins-Filho PR, Barreto JG, Gurgel RQ, et al.. JAMA dermatology. 2019.
Abstract This systematic review and meta-analysis confirms the association between the presence of physical disabilities and male sex, multibacillary leprosy, leprosy reactions, and lepromatous presentation.
Read more

Community-level epidemiology of soil-transmitted helminths in the context of school-based deworming: Baseline results of a cluster randomised trial on the coast of Kenya.
Halliday KE, Oswald WE, Mcharo C, et al.. PLoS neglected tropical diseases. 2019; 13(8):e0007427.
Abstract Overall, results show that despite several years of school-based deworming, hookworm infection remains common among untreated adults in this population, suggesting that this strategy alone is insufficient to reduce community-wide hookworm infection and in the longer term to eliminate transmission.
Read more

Risk profiling of soil-transmitted helminth infection and estimated number of infected people in South Asia: A systematic review and Bayesian geostatistical Analysis.
Lai Y-, Biedermann P, Shrestha A, Chammartin F, À Porta N, Montresor A, et al.. PLoS neglected tropical diseases. 2019; 13(8):e0007580.
Abstract Our risk maps provide an overview of the geographic distribution of soil-transmitted helminth infection in four mainland countries of South Asia and highlight the need for up-to-date surveys to accurately evaluate the disease burden in the region.
Read more

The prevalence of schistosomiasis in Uganda: A nationally representative population estimate to inform control programs and water and sanitation interventions.
xum NG, Kibira SP, Ssenyonga R, Nobili J, Shannon AK, Ssempebwa JC, et al.. PLoS neglected tropical diseases. 2019; 13(8):e0007617.
Abstract Our results highlight the importance of incorporating monitoring and evaluation data into control programs in Uganda to understand the geographic distribution of schistosomiasis prevalence outside of communities where endemicity is known to be high. Water and sanitation interventions should be considered an essential investment for elimination alongside drug treatment.
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Integration of schistosomiasis control activities within the primary health care system: a critical review.
Bizimana P, Ortu G, Van Geertruyden J-, Nsabiyumva F, Nkeshimana A, Muhimpundu E, et al.. Parasites & vectors. 2019; 12(1):393.
Abstract The results of this review suggest a positive impact of integration of schistosomiasis control within the primary health care system. However, more robust studies are needed, especially in resource-limited regions, for conclusive evidence on the effectiveness and the sustainability of this strategy.
Read more

HIV and Chagas Disease Coinfection, a Tractable Disease?
Guidetto B, Tatta M, Latini V, Gonzales M, Riarte A, Tavella S, et al.. Open forum infectious diseases. 2019; 6(7).
Abstract We present 2 patients born in Argentina who were newly diagnosed with advanced HIV disease and Chagas disease reactivation with central nervous system involvement. The patients received concurrent benznidazole treatment and antiretroviral therapy, showing good response. Improvement in morbidity and mortality due to early treatment makes this treatment appropriate for coinfected patients.
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Lessons from lymphatic filariasis elimination and the challenges of post-elimination surveillance in China.
Fang Y, Zhang Y. Infectious diseases of poverty. 2019; 8(1):66.
Abstract Sophisticated diagnostic criteria, systematic surveillance regimes, the Direct Network Report system, and regular trainings can effectively prevent the recrudescence of LF during surveillance phases.
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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 <<