Emerging and Reemerging Neglected Tropical Diseases: a Review of Key Characteristics, Risk Factors, and the Policy and Innovation Environment

Abstract

SUMMARY In global health, critical challenges have arisen from infectious diseases, including the emergence and reemergence of old and new infectious diseases. Emergence and reemergence are accelerated by rapid human development, including numerous changes in demographics, populations, and the environment. This has also led to zoonoses in the changing human-animal ecosystem, which are impacted by a growing globalized society where pathogens do not recognize geopolitical borders. Within this context, neglected tropical infectious diseases have historically lacked adequate attention in international public health efforts, leading to insufficient prevention and treatment options. This subset of 17 infectious tropical diseases disproportionately impacts the world's poorest, represents a significant and underappreciated global disease burden, and is a major barrier to development efforts to alleviate poverty and improve human health. Neglected tropical diseases that are also categorized as emerging or reemerging infectious diseases are an even more serious threat and have not been adequately examined or discussed in terms of their unique risk characteristics. This review sets out to identify emerging and reemerging neglected tropical diseases and explore the policy and innovation environment that could hamper or enable control efforts. Through this examination, we hope to raise awareness and guide potential approaches to addressing this global health concern.

The neglected zoonoses—the case for integrated control and advocacy

“…Policy-makers need to know the current cost and burden of the disease, the best method of controlling it, the full economic cost of control, and the impacts on their communities. However, in many poorer countries, putting resources into the surveillance and treatment of animal populations rarely meets with much support, despite that fact that improved human and animal health can play a major role in promoting food security and eradicating poverty [77,78]. Given the institutional limitations in the veterinary and human public health sectors in Africa, interventions for NZDs could benefit from adopting a One Health approach that supports intersector working practices [78,79].…”

“…Provider and/or commercial interest add a political dimension to disease prioritization or neglect, and there is now concern about the public health threat of new, re-emerging and neglected zoonoses in the industrialized world [76,77]. Identification of gaps can help in targeting funds to the areas of greatest need.…”

Interventions for vector-borne diseases focused on housing and hygiene in urban areas: a scoping review

“…aegypti pupae.Healy et al (2014) [62]USANot VBD specific ( Ae. albopictus )• Quanti non-randomized• Around 800 households• 3 months• Recruitment of volunteers from AmeriCorps and training (mosquito biology and role-playing techniques)• Community education included: [1] door-to-door active education (actively walking around the front and back yard with the resident, describing current and potential mosquito habitats + distributing educational material), [2] tire pick-up days, [3] trash can drilling days, and [4] media releases.In both counties:• ↓ in unmanaged containers/home after intervention not sustained in following months but stayed under levels of control• spatial analysis: treatment sites = ↑ source reduction behavior vs continued ↑ in container habitats in control area• No clear effect on infestation levelsRecommended that an active education campaign could better promote source reduction behavior in the community to prevent peridomestic mosquitoes, rather than of passive education measure (distribution of pamphlets).Bodner et al (2016) [61]USANot VBD specific ( Culex pipiens )• Quanti RCT• 40 houses in 6 areas ( n =  240 households)• 2 years• Distribution of educational print materials included a calendar, a notepad, a flyer, and a magnet with pictorial and written mosquito education information• ↓ concern for mosquito-borne illnesses• No effect on water-source and mosquito-infested containersPrint educational materials may have unintended negative effects on resident attitudes and household management of mosquito production.Ensink et al (2007) [67]PakistanNot VBD specific ( Ae. aegypti )• Quanti descriptive• 6 ponds in intervention and 6 ponds in control• 6 months• Sanitization of waste ponds: reducing amount of floating matter + eliminating emergent vegetation + repairing cracks in the cement structure•↓ 0% positive sample water for Anopheles and almost 0 for Culex in intervention ponds vs 19.2% and 34.0% respectively in control pondsRecommended that vegetation management and maintenance of the concrete structures and waste inflow to waste stabilization ponds be improved in areas with a risk of mosquito-borne diseases.Traps disposal ( n =  4)Ratovonjato et al (2003) [40]MadagascarPlague• Quanti RCT• 212 treated boxes in intervention area and 214 empty boxes in control area (=426 boxes)• 8 months• Kartman boxes (wooden tunnel-like boxes having biscuits like baits containing a rodenticide and insecticide for fleas) placed• ↑ Rats found dead: 968 in treated area vs 3 in control• Between J120–180: ↓ Prevalence of rats with fleas: 0% in treated area vs 60% in control area• Between J120–180: ↓ Cheopis index at 0 in treated area and 5.0 in control areaKartman bait-boxes reached the rat borne and the vectors of plague found in urban area.…”

Can the Cure for Chagas’ Disease be Found in Nature?

“…NTDs include the three major protozoan diseases: human African trypanosomiasis (HAT or "sleeping sickness"), Chagas' disease, and leishmaniasis [5]. Dengue, foodborne trematodiases, leprosy, lymphatic filariasis, schistosomiasis, soil transmitted helminthiasis, and trachoma [6] are also classified as NTDs.…”