NTDs 2 Flashcards
Describe the coverage of schistosomiasis in Ethiopia
For schistosomiasis
Over 10 Million School-aged children requiring treatment - 2014
2.9 million school-aged children received treatment (29% coverage)-2014
6.4 million school-aged children targeted for treatment (64% coverage)-2015
Over 10 million school-aged children targeted for treatment (100% coverage)
-2016
Describe the coverage of STHs in Ethiopia
- 9 million school-aged children and pre-SAC require treatment- 2014
- 8 million school-aged children and pre-SAC received treatment (33%)- 2014
- 3 million school-aged children and pre-SAC targeted for treatment (83%)- 2015
- 9 million school-aged children and pre-SAC targeted for treatment (100%)- 2016
How many NTDs are there
Core Group of 13 – MDA for 7
Describe Leishmaniasis
Dermal – nasty superating wound at the site of the bite which self heals in 6 months – it can become “mucocutaneous” form causing gross mutilation by destroying soft tissues in nose mouth and throat
Visceral – leads to fever, weight loss, and an enlarged spleen and liver. P will have low red blood cell count (anemia), low white blood cell count, and low platelet count.
Transmitted by sandflies – small enough to go through a mosquito net – pin prick bite
Describe the prevalence of Leishmaniasis around the world
Over 90 percent of the cases of cutaneous leishmaniasis occur in parts of Afghanistan, Algeria, Iran, Iraq, Saudi Arabia, and Syria (in the Old World) and in Brazil and Peru (in the New World);
Over 90 percent of the cases of visceral leishmaniasis occur in parts of India, Bangladesh, Nepal, Sudan, and Brazil.
AmBisome as first line of treatment against VL
What is the vector for Trypanosomiasis (Sleeping sickness)
Transmitted by the Tsetse fly which has a sharp bite but fortunately a very limited distribution
Describe the two forms of Trypanosomiasis
Trypanosoma brucei gambiense (T.b.g.) is found in west and central Africa. This form represents more than 90% of reported cases of sleeping sickness and causes a chronic infection. A person can be infected for years without symptoms of the disease. When symptoms do emerge, the patient is often already in an advanced disease stage when the central nervous system is affected.
Trypanosoma brucei rhodesiense (T.b.r.) is found in eastern and southern Africa. This form represents less than 10% of reported cases but that is because it causes an acute infection.
First signs and symptoms are observed a few months or weeks after an infected Tsetse fly bite.
The disease develops rapidly and invades the central nervous system and kills !
Describe the status of sleeping sickness control
Control is dependent on early diagnosis (with only 2,500 new cases diagnosed in 2015) Delivery of donated therapy to infected persons (Sanofi and Bayer donate the drugs) Tsetse control (baited traps) New tsetse control using systemic insecticides in cattle in Uganda to prevent the two forms mixing geographically
Describe the most recent data associated with sleeping sickness
An estimated 11,000 people are currently infected with 2,800 new infections in 2015.
In 2015 it caused around 3,500 deaths, down from 34,000 in 1990.
More than 80% of these cases are in the Democratic Republic of the Congo.[1
What is Chagas disease and what is it transmitted by
Chaga’s Disease – the South American form of Trypanosomiasis
Trypanosoma cruzi is found in parts of South America, with an estimated 10 million infected, and can cause major heart problems in up to 30% of these
It is transmitted by bed bugs and therefore is confined to people with poor quality housing
Describe the acute phase of Chagas
The acute phase of Chagas disease, which lasts for weeks or months, can be symptom-free. When signs and symptoms do occur, they are usually mild and may include:
Swelling at the infection site, Fever, Fatigue, Rash
Body aches, Headache, Nausea, diarrhea or vomiting, Swollen glands
Enlargement of your liver or spleen
If left untreated, the infection persists and advances to the chronic phase.
Describe the chronic phase of Chagas
Signs and symptoms of the chronic phase of Chagas disease may occur 10 to 20 years after initial infection, or they may never occur. In severe cases, however, Chagas disease signs and symptoms may include:
Irregular heartbeat
Congestive heart failure and sudden cardiac arrest
Difficulty swallowing due to enlarged esophagus
Abdominal pain or constipation due to enlarged colon
Describe Chagas disease (American Trypanosomiasis
Transmission documented in Louisiana and Texas
Treatment cost up to $1,000 per year
Diagnosis and access to care are major constraints
Vector control for breaking transmission.
Recently it has spread into Europe via immigrants who sell blood
Describe DNDi and new drugs
In the Business Plan for the period 2015-2023, DNDi maintains its commitment to develop treatments for African sleeping sickness, leishmaniasis, and Chagas disease as well as filarial diseases and paediatric HIV
Describe Buruli Ulcer
A chronic skin disease caused by Mycobacterium ulcerans endemic in 33 countries but highest in Ghana, Gabon and Australia
About 5,000 cases per year are reported from half of the 33 countries
Poor knowledge and reporting may hide the true prevalence
Describe Buruli control strategy
Training of health workers
early case detection
treatment with antibiotics
Case management – surgery if necessary
What is Leprosy also known as
Hansen Disease
Describe Leprosy
Leprosy is a chronic disease caused by a bacillus, Mycobacterium leprae
M. leprae multiplies very slowly and the incubation period of the disease is considered to be about five years.
Can you believe that over 95% of the population have natural immunity
Since 1981, WHO Study Group recommended multi-drug therapy (MDT), a combination of three drugs which effectively kills the pathogen and cures the patient. This is donated by Novartis
Describe the elimination goals associated with leprosy
In 1991 World Health Assembly passed a resolution to eliminate leprosy as a public health problem by the year 2000 - defined as a prevalence rate of less than one case per 10,000 population.
The global disease burden was reduced from 5.2 million in 1985 to 805,000 in 1995 to 753,000 by 1999 to 220,000 cases by 2005.
Now about 150 to 250 people in the United States and 250,000 around the world are estimated to get new infections
The South-East Asia Region, including India, achieved the elimination goal in December 2005.
The last six major countries to achieve the target were:
DR Congo, Madagascar, Mozambique, Nepal, Tanzania and the last to do so was BRAZIL
Describe the Leprosy new cases trends
The most recent World Health Organisation figures state that in 2014 there were 213,899 new cases of leprosy diagnosed. More than half of these were found in India.
Describe the leprosy strategy for prevention and control
Target 1 Implementation of early detection and MDT
Target 2 Reduce new cases by 50% by 2020
Target 3 Capacity building to sustain control
Target 4 Reduce stigma and discrimination
Target 5 Intensify research
Describe Podoconiosis (non LF elephantiasis)
Podoconiosis (‘‘dust in the feet’) presents as a horrible swelling of the feet and lower legs. It is seen in susceptible families of bare-footed farmers in well-defined fertile volcanic highland zones of Africa, Central and South America, and Indonesia, and also in the lowlands irrigated by rivers from these highlands.
It is due to the absorption of silica particles from the soil, through the feet of someone from a susceptible family.
This causes the the legs and feet swell, and progress
through stages which are described as
‘‘water bag’, ‘‘rubbery’, and ‘‘wooden’.
Treatment – choose another occupation !!!
Describe viral and helminth NTDs
Viral Dengue Rabies Helminths Echinococcus Taeniasis – cysticercosis Loa loa
Describe Dengue
A mosquito borne (Aedes aegypti) viral disease with a global tropical distribution.
It is spreading – in 1955 there were 3 and in 1959 there were 9 countries reported having Dengue
Today over 100 countries have Dengue
There are 4 known viral serotypes
And dengue hemorraghic fever (DHF) is the serious consequence
