even more NGT Flashcards
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
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
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
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
Trypanosomiasis
tsetse fly - limited distribution
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
trypanosoma brucei rhodesiense
eastern and southern Africa
<10% cases
first symptoms from few weeks after bite
develop rapidly - invades nervous system and kills
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
data on sleeping sickness
11000 people infected
2015 - 3500 deaths
1990 34000 deaths
>80% cases in demographic republic of Congo
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
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
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
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
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
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
buruli control strategy
train health workers
early detection
AB - donated drugs for other conditions reduced this
case management - surgery if needed
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
