Control of Neglected Tropical Diseases

Hotez, Peter J.; Molyneux, David; Fenwick, Alan; Kumaresan, Jacob; Sachs, Sonia Ehrlich; Sachs, Jeffrey D.; Savioli, Lorenzo

doi:10.1056/nejmra064142

Cited by 1,345 publications

(1,214 citation statements)

References 56 publications

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“…The neglected tropical diseases (NTD) are a group of disabling, chronic diseases that prevail in tropical and subtropical, resource-constrained areas with poor sanitation [1]. A majority of these diseases are caused by parasitic worms, of which the most common species affect more than 500 million people in sub-Saharan Africa [2,3].…”

Section: Introductionmentioning

confidence: 99%

Point-of-care mobile digital microscopy and deep learning for the detection of soil-transmitted helminths and Schistosoma haematobium

Holmström

Linder

Ngasala

et al. 2017

Global Health Action

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Background: Microscopy remains the gold standard in the diagnosis of neglected tropical diseases. As resource limited, rural areas often lack laboratory equipment and trained personnel, new diagnostic techniques are needed. Low-cost, point-of-care imaging devices show potential in the diagnosis of these diseases. Novel, digital image analysis algorithms can be utilized to automate sample analysis. Objective: Evaluation of the imaging performance of a miniature digital microscopy scanner for the diagnosis of soil-transmitted helminths and Schistosoma haematobium, and training of a deep learning-based image analysis algorithm for automated detection of soil-transmitted helminths in the captured images. Methods: A total of 13 iodine-stained stool samples containing Ascaris lumbricoides, Trichuris trichiura and hookworm eggs and 4 urine samples containing Schistosoma haematobium were digitized using a reference whole slide-scanner and the mobile microscopy scanner. Parasites in the images were identified by visual examination and by analysis with a deep learning-based image analysis algorithm in the stool samples. Results were compared between the digital and visual analysis of the images showing helminth eggs. Results: Parasite identification by visual analysis of digital slides captured with the mobile microscope was feasible for all analyzed parasites. Although the spatial resolution of the reference slide-scanner is higher, the resolution of the mobile microscope is sufficient for reliable identification and classification of all parasites studied. Digital image analysis of stool sample images captured with the mobile microscope showed high sensitivity for detection of all helminths studied (range of sensitivity = 83.3–100%) in the test set (n = 217) of manually labeled helminth eggs. Conclusions: In this proof-of-concept study, the imaging performance of a mobile, digital microscope was sufficient for visual detection of soil-transmitted helminths and Schistosoma haematobium. Furthermore, we show that deep learning-based image analysis can be utilized for the automated detection and classification of helminths in the captured images.

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Section: Introductionmentioning

confidence: 99%

Point-of-care mobile digital microscopy and deep learning for the detection of soil-transmitted helminths and Schistosoma haematobium

Holmström

Linder

Ngasala

et al. 2017

Global Health Action

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“…Soil-transmitted helminth infections affect more than a quarter of the human population, mostly in low-income countries in tropical and subtropical regions of the world (Bethony et al 2006;Chan, 1997;Hotez et al 2007). It is difficult to estimate the amount of morbidity and mortality caused by intestinal nematodes.…”

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confidence: 99%

Efficacy of the cyclooctadepsipeptide PF1022A againstHeligmosomoides bakeri in vitroandin vivo

et al. 2011

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The cyclooctadepsipeptide PF1022A derived from the fungus, Mycelia sterilia, is characterized by a broad spectrum of activity against different parasitic gastrointestinal nematodes of livestock. In the present work the anthelmintic activity of PF1022A against Heligmosomoides bakeri, a widely used laboratory model was studied. Albendazole, ivermectin and levamisole served as reference. In vitro, PF1022A showed low activity on embryonation but significantly inhibited egg hatch (10 and 100 μg/ml), whereas albendazole (10 and 100 μg/ml) revealed statistically significant inhibitions of both embryonation and egg hatch. PF1022A (1-100 μg/ml) completely inhibited larval movement at most examination points. Comparable significant anthelmintic activity on the larval stages of H. bakeri was observed with levamisole (48-100%), while slightly lower activities were observed with ivermectin (20-92%) and albendazole (0-87%) at 1-100 μg/ml. PF1022A and levamisole significantly inhibited motility and egg release of adult worms, while albendazole and ivermectin failed to demonstrate activity. Significant worm burden reductions were achieved with PF1022A, levamisole and ivermectin in vivo. For example, at 0·125 mg/kg PF1022A a worm burden reduction of 91·8% was observed. The use of drug combinations did not further enhance the in vitro and in vivo activity of PF1022A. In conclusion, further investigations are warranted with PF1022A, as the drug is characterized by significant larvicidal and nematocidal activity in vitro and in vivo.

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“…Hotez et al [80,81] has written compellingly about the need to bring research capacity to bear on conditions such as leishmaniasis, helminthic diseases, trypanosomiasis, schistosomiasis, and sickle cell anemia. While these conditions cause or contribute untold morbidity and mortality, they tend to be ignored by usual research sponsors, including both international agencies and the private sector.…”

Section: Conclusion and Actionsmentioning

confidence: 99%

Better Drug Therapy for the Children of Africa: Current Impediments to Success and Potential Strategies for Improvement

et al. 2013

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A commentary is presented on the urgent need for a comprehensive effort to improve the practice of pediatric therapeutics in Africa. A call for action is addressed to a variety of practitioners internationally, many of whom possess skills that could be fruitfully applied to the improvement of health outcomes for African children. Successful engagement with the many challenges requires the complementary effort of researchers in basic and clinical pharmacology and toxicology, nurses, pharmacists, physicians, clinical pharmacologists, clinical pharmacists, and political leaders and civil servants. While a comprehensive or systematic review of the relevant literature has not been attempted, the authors have highlighted promising initiatives driven by international agencies and academic networks. Two African perspectives are presented to reinforce the prospect of child health gains that can be achieved through consistent pursuit of optimal therapy for conditions such as respiratory infection, diarrhea, malaria, and HIV/AIDS. There is an imperative for development of north-south and south-south partnerships that will amplify current research efforts and mobilize existing knowledge concerning pediatric drugs. The overall goal is a multidisciplinary commitment to making essential medicines available at the right time, the right place, and in the right formulation for African children from infancy to adolescence.

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Control of Neglected Tropical Diseases

Cited by 1,345 publications

References 56 publications

Point-of-care mobile digital microscopy and deep learning for the detection of soil-transmitted helminths and Schistosoma haematobium

Point-of-care mobile digital microscopy and deep learning for the detection of soil-transmitted helminths and Schistosoma haematobium

Efficacy of the cyclooctadepsipeptide PF1022A againstHeligmosomoides bakeri in vitroandin vivo

Better Drug Therapy for the Children of Africa: Current Impediments to Success and Potential Strategies for Improvement

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