even more NGT Flashcards by Emily Southall

describe the progress in Ethiopia for schisto

for schisto in 2014 10million school children needed treatment
2.9million received treatment
2015 - 6.4 million targeted for treatment
2016 >10million children targeted for treatment
now 10 million treated every year

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describe the progress in Ethiopia for soil transmitted helminths

2014 26.9million school aged children require treatment
8.8millionrecieved treatment
2015 - 22.3 million targeted for treatment
2016 26.9million children targeted for treatment
program ongoing

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the sandfly and dermal leishmania

bite skin, infection stay in skin - self cures after 6 months
can become mucocutaneous from causing gross mutilation by destroying soft tissues in nose, mouth and throat
Afghanistan, Algeria, Iraq, Saudi arabia, Syria, brazil and peru

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visceral leishmania

fever, weight loss, enlarged spleen and liver. have low red cell count, low white cell count and low platelet count
die if not treated
india, Bangladesh, Nepal, sudan, and brazil
AmBisome 1st line treatment

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Trypanosomiasis

tsetse fly - limited distribution

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trypanosomiasis brucei gambiense

west and central Africa
>90% of reported sleeping sickness cases are this form
infected for years without symptoms
when symptoms appear already in advanced disease state when symptoms appear

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trypanosoma brucei rhodesiense

eastern and southern Africa
<10% cases
first symptoms from few weeks after bite
develop rapidly - invades nervous system and kills

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control of sleeping sickness

dependant on diagnosis - can treat people if found quick
Sanofi and Bayer donate the drugs
tsetse control - traps and systematic insecticide on cattle - flies bite cattle and die

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data on sleeping sickness

11000 people infected
2015 - 3500 deaths
1990 34000 deaths
>80% cases in demographic republic of Congo

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Chaga’s disease

south American form of trypanosomiasis
trypanosoma cruzi
10 million infected
major heart problems
bed bugs
confined to people with bad quality housing
outbreak in Spain - immegrants in Brazil sold blood

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acute phase of Chaga’s disease

weeks/months
can be symptom free
symptoms mild - swelling, fever, fatigue, rash, body aches, nausea, headache, diarrhea or vomiting, swollen glands, enlargement of liver or spleen
if left untreated infection persists and advances to chronic phase

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chronic phase of chaga’s disease

symptoms 10-20yrs after infection or never
irregular heartbeat, congestive heart failure, sudden cardiac arrest, difficulty swallowing due to enlarged oesophagus, abdominal pain/constipation due to enlarged colon

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Americal trypanosomiasis

Louisiana and texas
costs $1000 per year
diagnosis and access to care - major issues
vector control for breaking transmission
recently spread into Europe via immigrants who sell blood

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DNDi and new drugs

business plan to develop treatment for African sleeping sickness, leishmaniasis, and Chagas disease as well as filarial diseases and paediatric HIV

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Buruli ulcer

chronic skin disease 
mycobacterium ulcerans 
5000 cases per year 
poor knowledge and reporting hide true prevalence 
don't kill but you wish they did

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buruli control strategy

train health workers
early detection
AB - donated drugs for other conditions reduced this
case management - surgery if needed

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Leprosy

chronic 
bacillus - mycobacterium leprae 
multiply slowly 
incubation period 5 years 
>85% pop natural immunity 
multidrug therapy - 3 drugs 
donated by Novartis
250000 new infections 
SE asia region achieved elimination in 2005
leprosy should die out but goes undiagnosed so transmission may increase

where were more than half the leprosy cases in 2014

india

leprosy prevention and control

early detection and MDT 
reduce new cases by 50% by 2020 
capacity building to sustain control 
reduce stigma and discrimination 
intensify research

Podoconiosis

‘dust in the feet’ swelling of feet and legs - silicon into people with bare feet
Africa, central, S America, Indonesia and lowlands irrigated by rivers from highlands
we give control by giving people shoes

less common NGT

viral: dengue, rabies
helminths: echinococcus, taeniasis - cysticercosis, loa loa

dengue virus

mosquito born
Aedes aegypti 
tropical distribution 
>100 countries 
4 known serotypes 
and dengue haemorrhagic fever is the serious consequence 
dengue is increasing

dengue stats

40% people live where risk
endemic in Asia, pacific, the Americas and the Caribbean
WHO estimate that 50-100million infections occur yearly

control of dengue

diagnosis and case management 
integrated surveillance and outbreak response 
sustainable vector control 
possible vaccine in the future 
operational research 
diagnosis is difficult

Hepatitis

71 million chornicallu infected hep C 257 million with hep B 2016 WHO target of 90% reduction in chronic infection and 65% reduction in mortality by 2030 from 2015 levels need more people to be tested

hep c

schisto treatment blamed for Egypt's high prevalence of Hep C - share needles lead to liver cancer 1st treatment interferon - others now Harvoni and olysio and sovaldi

Rabies

``` viral Asia and Africa death rate 100% effective vaccine shortly (5 days) after infection bats and dogs ```

rabies stats

17400 deaths 2015 >95% in Africa/Asia 40% <15 old

control successes for rabies

canine vaccination humane management of dogs vaccination elimination targets

treponematoses

treponema (a spirochete bacterium) infection | causes Pinta, yaws, and syphilis

pinta

human skin disease endemic to mexico, central America, S America infection by spirochete, Treonema carateum

Yaws

children 2-14 target eradication - 2020 azithromycin treatment

yaws cases

``` campaign reduced infections to <2.5million not to elimination Ghana most cases Cote D'lvoire PNG and Solomon islands ```

new developments for yaws

effective treatment - azithromycin for active and latent yaws and H ducrevi ulcers comprehensive diagnostic framework - Trep-RDT, DPP and PCR - strategy to reduce costs knowledge management - completion of: a program managers guide, an eradication vaerification guide, supportive IEC materials and an integrated skin NTDs guide

next steps for yews

scale up mapping - operational research on optimal mapping strategies for a disease targeted for eradication scaling up MDA with donation - determine optimal number of rounds of MDA, social and health system research to achieve high coverage and integrate surveillance with other skin disease

Syphilis

STD treponema pallidum transmitted by direct contact with syphilitic chancre occur on external genitals, vagina or anus, rctum lips or mouth in sex transmit from placenta tio foetus no symptoms for years but are at risk of late complications if not treated

Loa Loa

west and central Africa a filarial worm transmitted by Tabanids - horse flies mass treatment of LF and Oncho with albendazole and ivermectin = serious side effects in people with Loa Loa need more specific diagnostic tests for Loa Loa in high risk areas

cysticercosis (Taenia solium)

leading cause of epilepsy in Hispanic americans 41400-169000 cases responsible for 10% seizures in ED in LA

Taenia solium

pork tapeworm live in human gut and infects between 4 and 8 million people eggs of worm ejected in stool in pig cysts form - if eaten undercooked develop into new tapeworm poor hygiene result in development of worm and so epilepsy susceptible to treatment with praziquantel kill cyst which may make it symptomatic treating pigs available better hygiene ultimate power

Echinococcus granulosis

dog tapeworm adult worm lives in the dog and eggs are passed on to the faeces eggs consumed by sheep - cysts in sheep brain and cavity when sheep slaughtered - offal thrown to dogs - new infections humans involved when in close to dogs and eggs get into mouth -- cysts in liver

what is the drug to treat trachoma and who donated it

Zithromax (azithromycin) | Pfizer

company that donate albendazole until LF is eradicated

GFK