Neglected Tropical Diseases?

Picture this, you were finally able to save up for that amazing trip to the Caribbean and you’re there. Sipping on a pina colada, laying on a hammock on your last day, and of course, scratching the bites of those pesky mosquitoes that seem to be everywhere. You had an amazing time, and you are ready to go back home. 

You fly back, and everything seems normal, but a couple of days later, you start feeling sick. It’s like the flu, and you think it’s the flu…but only a bit harsher. A few more days pass, and you are now experiencing strong fevers, excruciating headaches, body rashes, and crippling bone pains. You start to think that this particular flu is getting out of hand, and you decide to go to the doctor. After days of running different tests for all the common diseases, they still don’t know what’s going on.  

After a few more specific blood tests, many calls to the CDC, and a thorough review of your recent travel history they got it. You contracted dengue fever. “Den-what fever?!” you may surprisingly ask. And for a good reason you do. This is one of the many Neglected Tropical Diseases. Let’s check what on earth they are. 

 NTDs 

Neglected Tropical Diseases (NTDs) are a group of parasitic, viral, fungal, and bacterial diseases that affect more than one billion people in tropical and subtropical regions of the world, particularly in Africa, Asia, and the Americas. These diseases are often overlooked and receive little attention by developed countries and local governments, despite causing significant morbidity, mortality, and economic burden in the affected populations, which more often than not are already struggling socially and financially.  

The World Health Organization (WHO) identifies 20 NTDs, including African trypanosomiasis (sleeping sickness), Chagas disease, dengue fever, leprosy, lymphatic filariasis, river blindness, schistosomiasis, and trachoma to name a few. These NTDs primarily affect poor and marginalized communities that often lack access to clean water, sanitation, and healthcare. However, according to the Global Report on neglected tropical diseases 2023, there have been significant advances, even if they were hindered by COVID, after the most vulnerable countries to these diseases started to follow the 2021 WHO’s neglected disease roadmap. This roadmap sets global targets and milestones to prevent, control, eliminate or eradicate NTDs and better aligned its own cross-cutting NTD targets with the Sustainable Development Goals.  

 Impacts on human health. 

 Given that NTDs induce systemic infections and can also be transmitted from mother to children during pregnancy, they have the potential of causing malnutrition and stunted growth in children, leading to cognitive and physical developmental delays. Maternal health is affected as well, as NTDs can cause complications during pregnancy and childbirth. Disability is another major consequence of NTDs, with many individuals experiencing lifelong impairments from the infection. This can lead to exclusion from society, reduced productivity, and increased dependence on caregivers. In addition to the human cost, NTDs have a significant economic burden. Some estimates suggest losses of billions of dollars annually in terms of healthcare costs and productivity losses in the countries affected by them. Addressing NTDs through prevention, treatment, and research is essential to improving health and subsequently reducing poverty in these communities. 

One Health? 

Neglected tropical diseases (NTDs) are also a perfect example of how the One Health approach can be applied to? real-life situations and that it is actually being used to manage them now. Many of the NTDs are zoonotic diseases, which (as you probably already know) means they can be transmitted from animals to humans. For example, let’s take a look at Leishmaniasis, a parasitic disease that affects more than a million people every year and that is transmitted by sandflies that live in animal burrows.  

By understanding the connection, between humans, the flies, the disease, and the environment, the One Health approach aims to control the disease not only by treating human patients with antiparasitic drugs, but also, by targeting animal reservoirs and reducing exposure to (and controlling the populations of) sandflies.  

Additionally, many NTDs are linked to environmental factors such as poor sanitation and hygiene. For example, Soil-Transmitted Helminths (STHs) are parasitic worms that live in soil contaminated with human feces. One Health approach to controlling STHs involves treating infected people and improving access to clean water and sanitation to prevent reinfection. By taking a One Health approach to control NTDs, we can address the complex and interconnected factors that contribute to their persistence and ultimately work towards eliminating these devastating diseases. 

Conclusion 

Recently, we shared a Twitter thread about the recently discovered presence of the parasite Trypanosoma cruzi (which causes the NTD known as Chagas disease) in Florida’s native kissing bugs.  

This research was what motivated us to write this blog post. As the conjunction of climate change, human-driven ecosystem transformation, and land degradation becomes more and more intense, many previously unknown health risks start to become more evident. Here in Florida, we have many of the conditions that these diseases need to thrive, and it is time to start paying more attention to them, creating holistic and inclusive solutions based on a One Health approach to avoid worse consequences for us, and for the people that live with them every day. 

By: Alejandro Sanchez MDP | Communications and Engagement Specialist

by One Health Center of Excellence