scholarly journals African regional progress and status of the programme to eliminate lymphatic filariasis: 2000–2020

2020 ◽  
Vol 13 (Supplement_1) ◽  
pp. S22-S27
Author(s):  
Kebede Deribe ◽  
Didier K Bakajika ◽  
Honorat Marie-Gustave Zoure ◽  
John O Gyapong ◽  
David H Molyneux ◽  
...  
Keyword(s):  
Vector Control ◽  
Lymphatic Filariasis ◽  
Neglected Tropical Diseases ◽  
Public Health Problem ◽  
World Health ◽  
Malaria Vector Control ◽  
Tropical Diseases ◽  
Significant Progress ◽  
African Region ◽  
Preventive Chemotherapy

Abstract To eliminate lymphatic filariasis (LF) by 2020, the World Health Organization (WHO) has launched a campaign against the disease. Since the launch in 2000, significant progress has been made to achieve this ambitious goal. In this article we review the progress and status of the LF programme in Africa through the WHO neglected tropical diseases preventive chemotherapy databank, the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) portal and other publications. In the African Region there are 35 countries endemic for LF. The Gambia was reclassified as not requiring preventive chemotherapy in 2015, while Togo and Malawi eliminated LF as a public health problem in 2017 and 2020, respectively. Cameroon discontinued mass drug administration (MDA) and transitioned to post-MDA surveillance to validate elimination. The trajectory of coverage continues to accelerate; treatment coverage increased from 0.1% in 2000 to 62.1% in 2018. Geographical coverage has also significantly increased, from 62.7% in 2015 to 78.5% in 2018. In 2019, 23 of 31 countries requiring MDA achieved 100% geographic coverage. Although much remains to be done, morbidity management and disability prevention services have steadily increased in recent years. Vector control interventions conducted by other programmes, particularly malaria vector control, have had a profound effect in stopping transmission in some endemic countries in the region. In conclusion, significant progress has been made in the LF programme in the region while we identify the key remaining challenges in achieving an Africa free of LF.

scholarly journals Supporting drug development for neglected tropical diseases using mathematical modelling

2021 ◽  
Author(s):  
Martin Walker ◽  
Jonathan I D Hamley ◽  
Philip Milton ◽  
Frédéric Monnot ◽  
Sally Kinrade ◽  
...  
Keyword(s):  
Drug Development ◽  
Mathematical Modelling ◽  
Neglected Tropical Diseases ◽  
Public Health Problem ◽  
World Health ◽  
Tropical Diseases ◽  
Resource Saving ◽  
Preventive Chemotherapy ◽  
Health Organization ◽  
Chemotherapy Strategy

Abstract Drug-based interventions are at the heart of global efforts to reach elimination as a public health problem (trachoma, soil-transmitted helminthiases, schistosomiasis, lymphatic filariasis) or elimination of transmission (onchocerciasis) for five of the most prevalent neglected tropical diseases tackled via the World Health Organization preventive chemotherapy strategy. While for some of these diseases there is optimism that currently available drugs will be sufficient to achieve the proposed elimination goals, for others—particularly onchocerciasis—there is a growing consensus that novel therapeutic options will be needed. Since in this area no high return of investment is possible, minimizing wasted money and resources is essential. Here, we use illustrative results to show how mathematical modelling can guide the drug development pathway, yielding resource-saving and efficiency payoffs, from the refinement of target product profiles and intended context of use, to the design of clinical trials.

The Epitome of Novel Techniques and Targeting Approaches in Drug Delivery for Treating Lymphatic Filariasis

2020 ◽  
Vol 21 (12) ◽  
pp. 1250-1263
Author(s):  
Saurabh Shrivastava ◽  
Anshita Gupta ◽  
Chanchal Deep Kaur
Keyword(s):  
Lymphatic Filariasis ◽  
Neglected Tropical Diseases ◽  
Therapeutic Interventions ◽  
Tropical Diseases ◽  
Human Beings ◽  
Therapeutic Approaches ◽  
Preventive Chemotherapy ◽  
Bioactive Substances ◽  
Lymphatic Diseases ◽  
Life Threatening

Background: Lymphatic filariasis is a pervasive and life-threatening disease for human beings. Currently, 893 million people in 49 countries worldwide affected by lymphatic filariasis as per WHO statistics. The concealed aspects of lymphatic diseases such as delayed disease detection, inappropriate disease imaging, the geographical outbreak of infection, and lack of preventive chemotherapy have brought this epidemic to the edge of Neglected Tropical Diseases. Many medications and natural bioactive substances have seen to promote filaricidal activity against the target parasitic species. However, the majority of failures have occurred in pharmaceutical and pharmacokinetic issues. Objective: The purpose of the study is to focus on the challenges and therapeutic issues in the treatment of filariasis. The review brings novel techniques and therapeutic approaches for combating lymphatic filariasis. It also offers significant developments and opportunities for such therapeutic interventions. Conclusion: Through this review, an attempt has made to critically evaluate the avenues of innovative pharmaceuticals and molecular targeting approaches to bring an integrated solution to combat lymphatic filariasis.

scholarly journals Are current preventive chemotherapy strategies for controlling and eliminating neglected tropical diseases cost-effective?

2021 ◽  
Vol 6 (8) ◽  
pp. e005456
Author(s):  
Hugo C Turner ◽  
Wilma A Stolk ◽  
Anthony W Solomon ◽  
Jonathan D King ◽  
Antonio Montresor ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Low Income ◽  
Neglected Tropical Diseases ◽  
Cost Effective ◽  
Healthcare Spending ◽  
Tropical Diseases ◽  
Preventive Chemotherapy ◽  
Middle Income ◽  
Disability Adjusted Life ◽  
The Cost

Neglected tropical diseases (NTDs) remain a significant cause of morbidity and mortality in many low-income and middle-income countries. Several NTDs, namely lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases (STH) and trachoma, are predominantly controlled by preventive chemotherapy (or mass drug administration), following recommendations set by the WHO. Over one billion people are now treated for NTDs with this strategy per year. However, further investment and increased domestic healthcare spending are urgently needed to continue these programmes. Consequently, it is vital that the cost-effectiveness of preventive chemotherapy is understood. We analyse the current estimates on the cost per disability-adjusted life year (DALY) of the preventive chemotherapy strategies predominantly used for these diseases and identify key evidence gaps that require further research. Overall, the reported estimates show that preventive chemotherapy is generally cost-effective, supporting WHO recommendations. More specifically, the cost per DALY averted estimates relating to community-wide preventive chemotherapy for lymphatic filariasis and onchocerciasis were particularly favourable when compared with other public health interventions. Cost per DALY averted estimates of school-based preventive chemotherapy for schistosomiasis and STH were also generally favourable but more variable. Notably, the broader socioeconomic benefits are likely not being fully captured by the DALYs averted metric. No estimates of cost per DALY averted relating to community-wide mass antibiotic treatment for trachoma were found, highlighting the need for further research. These findings are important for informing global health policy and support the need for continuing NTD control and elimination efforts.

scholarly journals Baseline Mapping of Neglected Tropical Diseases in Africa: The Accelerated WHO/AFRO Mapping Project

2021 ◽  
Author(s):  
Maria P. Rebollo ◽  
Adiele Nkasiobi Onyeze ◽  
Alexandre Tiendrebeogo ◽  
Mutale Nsakashalo Senkwe ◽  
Benido Impouma ◽  
...  
Keyword(s):  
Program Implementation ◽  
Ad Hoc ◽  
Neglected Tropical Diseases ◽  
Tropical Diseases ◽  
African Region ◽  
African Countries ◽  
Preventive Chemotherapy ◽  
Data Portal ◽  
The Impact ◽  
Technical Framework

Mapping is a prerequisite for effective implementation of interventions against neglected tropical diseases (NTDs). Before the accelerated WHO/AFRO NTD Mapping Project was initiated in 2014, mapping efforts in many countries were frequently carried out in an ad hoc and nonstandardized fashion. In 2013, there were at least 2,200 different districts (of the 4,851 districts in the WHO African region) that still required mapping, and in many of these districts, more than one disease needed to be mapped. During its 3-year duration from January 2014 through the end of 2016, the project carried out mapping surveys for one or more NTDs in at least 2,500 districts in 37 African countries. At the end of 2016, most (90%) of the 4,851 districts had completed the WHO-required mapping surveys for the five targeted Preventive Chemotherapy (PC)-NTDs, and the impact of this accelerated WHO/AFRO NTD Mapping Project proved to be much greater than just the detailed mapping results themselves. Indeed, the AFRO Mapping Project dramatically energized and empowered national NTD programs, attracted donor support for expanding these programs, and developed both a robust NTD mapping database and data portal. By clarifying the prevalence and burden of NTDs, the project provided not only the metrics and technical framework for guiding and tracking program implementation and success but also the research opportunities for developing improved diagnostic and epidemiologic sampling tools for all 5 PC-NTDs—lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiasis, and trachoma.

scholarly journals Model-based Geostatistical Methods Enable Efficient Design and Analysis of Prevalence Surveys for Soil-Transmitted Helminth Infection and Other Neglected Tropical Diseases

2021 ◽  
Author(s):  
Olatunji Johnson ◽  
Claudio Fronterre ◽  
Benjamin Amoah ◽  
Antonio Montresor ◽  
Emanuele Giorgi ◽  
...  
Keyword(s):  
Large Scale ◽  
Neglected Tropical Diseases ◽  
Public Health Problem ◽  
Predictive Performance ◽  
World Health ◽  
Sampling Effort ◽  
Tropical Diseases ◽  
Efficient Design ◽  
Post Intervention ◽  
Model Based

Abstract Maps of the geographical variation in prevalence play an important role in large-scale programmes for the control of Neglected Tropical Diseases. Pre-control mapping is needed to establish the appropriate control intervention in each area of the country in question. Mapping is also needed post-intervention to measure the success of control efforts. In the absence of comprehensive disease registries, mapping efforts can be informed by two kinds of data: empirical estimates of local prevalence obtained by testing individuals from a sample of communities within the geographical region of interest; digital images of environmental factors that are predictive of local prevalence. In this paper, we focus on the design and analysis of impact surveys, i.e. prevalence surveys that are conducted post-intervention with the aim of informing decisions on what further intervention, if any, is needed to achieve elimination of the disease as a public health problem. We show that geospatial statistical methods enable prevalence surveys to be designed and analysed as efficiently as possible so as to make best use of hard-won field data. We use three case-studies based on data from soil-transmitted helminth impact surveys in Kenya, Sierra Leone and Zimbabwe to compare the predictive performance of model-based geostatistics with methods described in current World Health Organisation guidelines. In all three cases, we find that model-based geostatistics substantially outperforms the current WHO guidelines, delivering improved precision for reduced field-sampling effort. We argue from experience that similar improvements will hold for prevalence mapping of other Neglected Tropical Diseases.

Lymphatic filariasis in the Southeast Asian region; status and control options.

2020 ◽  
Vol 15 (059) ◽  
Author(s):  
Nilmini T. G. A. Chandrasena
Keyword(s):  
Sri Lanka ◽  
Lymphatic Filariasis ◽  
Disease Burden ◽  
Public Health Problem ◽  
Southeast Asian ◽  
World Health ◽  
Selective Treatment ◽  
Preventive Chemotherapy ◽  
Asian Region ◽  
Health Organization

Abstract The Global Program to Eliminate Lymphatic Filariasis (GPELF) was launched in year 2000 by the World Health Organization (WHO) with the goal set for elimination by 2020. Over half the global disease burden lies in the Southeast Asian region (SEAR). The preventive chemotherapy (PC) programme has been initiated in all the WHO SEAR member states with varying levels of progress. Maldives, Sri Lanka and Thailand have achieved the goal of elimination as a public health problem (EPHP) within the stipulated period with Bangladesh working towards validation in 2021. Both Sri Lanka and Thailand are continuing with post-validation surveillance combined with selective treatment, striving for zero transmission in-parallel with the morbidity management and disability prevention program (MMDP). Timor-Leste appears close to reaching critical transmission thresholds with 100% coverage and triple therapy in the last round of PC. Data on MMDP activities are insufficient to comment on reaching EPHP status. PC coverage and country reports indicate ongoing transmission in Nepal, Myanmar, Indonesia and India requiring further rounds of PC. The PELF has made considerable progress in the SEAR towards elimination but there still remain significant transmission and disease burden in the highly populated countries in SEAR.

scholarly journals Diagnostics to support elimination of lymphatic filariasis—Development of two target product profiles

2021 ◽  
Vol 15 (11) ◽  
pp. e0009968
Author(s):  
Kimberly Y. Won ◽  
Katherine Gass ◽  
Marco Biamonte ◽  
Daniel Argaw Dagne ◽  
Camilla Ducker ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Neglected Tropical Diseases ◽  
Public Health Problem ◽  
Use Cases ◽  
World Health ◽  
Product Configuration ◽  
Diagnostic Tools ◽  
Advisory Group ◽  
Use Case ◽  
Target Product

As lymphatic filariasis (LF) programs move closer to established targets for validation elimination of LF as a public health problem, diagnostic tools capable of supporting the needs of the programs are critical for success. Known limitations of existing diagnostic tools make it challenging to have confidence that program endpoints have been achieved. In 2019, the World Health Organization (WHO) established a Diagnostic Technical Advisory Group (DTAG) for Neglected Tropical Diseases tasked with prioritizing diagnostic needs including defining use-cases and target product profiles (TPPs) for needed tools. Subsequently, disease-specific DTAG subgroups, including one focused on LF, were established to develop TPPs and use-case analyses to be used by product developers. Here, we describe the development of two priority TPPs for LF diagnostics needed for making decisions for stopping mass drug administration (MDA) of a triple drug regimen and surveillance. Utilizing the WHO core TPP development process as the framework, the LF subgroup convened to discuss and determine attributes required for each use case. TPPs considered the following parameters: product use, design, performance, product configuration and cost, and access and equity. Version 1.0 TPPs for two use cases were published by WHO on 12 March 2021 within the WHO Global Observatory on Health Research and Development. A common TPP characteristic that emerged in both use cases was the need to identify new biomarkers that would allow for greater precision in program delivery. As LF diagnostic tests are rarely used for individual clinical diagnosis, it became apparent that reliance on population-based surveys for decision making requires consideration of test performance in the context of such surveys. In low prevalence settings, the number of false positive test results may lead to unnecessary continuation or resumption of MDA, thus wasting valuable resources and time. Therefore, highly specific diagnostic tools are paramount when used to measure low thresholds. The TPP process brought to the forefront the importance of linking use case, program platform and diagnostic performance characteristics when defining required criteria for diagnostic tools.

scholarly journals The roadmap towards elimination of lymphatic filariasis by 2030: insights from quantitative and mathematical modelling

2019 ◽  
Vol 3 ◽  
pp. 1538 ◽  
Author(s):  
Keyword(s):  
Public Health ◽  
Lymphatic Filariasis ◽  
Health Problem ◽  
Neglected Tropical Diseases ◽  
Public Health Problem ◽  
World Health ◽  
Basic Care ◽  
The World ◽  
Health Organization ◽  
Initial Target

The Global Programme to Eliminate Lymphatic Filariasis was launched in 2000 to eliminate lymphatic filariasis (LF) as a public health problem by 1) interrupting transmission through mass drug administration (MDA) and 2) offering basic care to those suffering from lymphoedema or hydrocele due to the infection. Although impressive progress has been made, the initial target year of 2020 will not be met everywhere. The World Health Organization recently proposed 2030 as the new target year for elimination of lymphatic filariasis (LF) as a public health problem. In this letter, LF modelers of the Neglected Tropical Diseases (NTDs) Modelling Consortium reflect on the proposed targets for 2030 from a quantitative perspective. While elimination as a public health problem seems technically and operationally feasible, it is uncertain whether this will eventually also lead to complete elimination of transmission. The risk of resurgence needs to be mitigated by strong surveillance after stopping interventions and sometimes perhaps additional interventions.

Heterocycles in the Treatment of Neglected Tropical Diseases

2020 ◽  
Vol 27 ◽  
Author(s):  
Kush K. Maheshwari ◽  
Debasish Bandyopadhyay
Keyword(s):  
Developing Countries ◽  
Heterocyclic Compounds ◽  
Neglected Tropical Diseases ◽  
World Health ◽  
Current Status ◽  
Poor People ◽  
Tropical Diseases ◽  
Concise Review ◽  
The World ◽  
Health Organization

Background: Neglected tropical diseases (NTDs) affect a huge population of the world and majority of the victims belong to the poor community of the developing countries. Until now, the World Health Organization (WHO) has identified 20 tropical diseases as NTDs that must be addressed with high priority. However, many heterocyclic scaffolds have demonstrated potent therapeutic activity against several NTDs. Objective: There are three major objectives: (1) To discuss the causes, symptoms, and current status of all the 20 NTDs; (2) To explore the available heterocyclic drugs, and their mechanism of actions (if known) that are being used to treat NTDs; (3) To develop general awareness on NTDs among the medicinal/health research community and beyond. Methods: The 20 NTDs have been discussed according to their alphabetic orders along with the possible heterocyclic remedies. Current status of treatment with an emphasis on the heterocyclic drugs (commercially available and investigational) has been outlined. In addition, brief discussion of the impacts of NTDs on socio-economic condition is included. Results: NTDs are often difficult to diagnose and the problem is worsened by the unhealthy hygiene, improper awareness, and inadequate healthcare in the developing countries where these diseases primarily affect poor people. The statistics include duration of suffering, numbers affected, and access to healthcare and medication. The mechanism of actions of various heterocyclic drugs, if reported, have been briefly summarized. Conclusion: Scientists and pharmaceutical corporations should allocate more resources to reveal the in-depth mechanism of actions of many heterocyclic drugs that are currently being used for the treatment of NTDs. Analysis of current heterocyclic compounds and development of new medications can help in the fight to reduce/remove the devastating effects of NTDs. An opinion-based concise review has been presented. Based on available literature, this is the first effect to present all the 20 NTDs and related heterocyclic compounds under the same umbrella.

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