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1.
PLoS Negl Trop Dis ; 15(12): e0009904, 2021 12.
Article in English | MEDLINE | ID: covidwho-1724768

ABSTRACT

Since its early spread in early 2020, the disease caused by the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Coronavirus Disease 2019 (COVID-19) has caused mass disruptions to health services. These have included interruptions to programs that aimed to prevent, control, and eliminate neglected tropical diseases (NTDs). In March 2020, the World Health Organization (WHO) released interim guidelines recommending the temporary cessation of mass drug administration (MDA), community-based surveys, and case detection, while encouraging continuation of morbidity management and vector control where possible. Over the course of the following months, national programs and implementing partners contributed to COVID-19 response efforts, while also beginning to plan for resumption of NTD control activities. To understand the challenges, opportunities, and recommendations for maximizing continuity of disease control during public health emergencies, we sought perspectives from Nigeria and Guinea on the process of restarting NTD control efforts during the COVID-19 pandemic. Through semistructured interviews with individuals involved with NTD control at the local and national levels, we identified key themes and common perspectives between the 2 countries, as well as observations that were specific to each. Overall, interviewees stressed the challenges posed by COVID-19 interruptions, particularly with respect to delays to activities and related knock-on impacts, such as drug expiry and prolonged elimination timelines, as well as concerns related to funding. However, respondents in both countries also highlighted the benefits of a formal risk assessment approach, particularly in terms of encouraging information sharing and increasing coordination and advocacy. Recommendations included ensuring greater availability of historical data to allow better monitoring of how future emergencies affect NTD control progress; continuing to use risk assessment approaches in the future; and identifying mechanisms for sharing lessons learned and innovations between countries as a means of advancing postpandemic health systems and disease control capacity strengthening.


Subject(s)
COVID-19 , Communicable Disease Control/organization & administration , Neglected Diseases/prevention & control , Communicable Disease Control/economics , Government Programs/economics , Government Programs/organization & administration , Guinea , Humans , Mass Drug Administration , Nigeria , SARS-CoV-2 , Tropical Medicine/methods
2.
Bull World Health Organ ; 100(2): 96-97, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1686366

ABSTRACT

Uche Amazigo talks to Andreia Azevedo Soares about the impact of the pandemic on NTD-related activities and the prospects for regaining momentum on the global NTD agenda.


Subject(s)
Pandemics , Tropical Medicine , Humans , Neglected Diseases/epidemiology , Pandemics/prevention & control
3.
Nature ; 587(7834): 331, 2020 11.
Article in English | MEDLINE | ID: covidwho-1671516
5.
PLoS Negl Trop Dis ; 15(11): e0009523, 2021 11.
Article in English | MEDLINE | ID: covidwho-1593078

ABSTRACT

BACKGROUND: Billions of doses of medicines are donated for mass drug administrations in support of the World Health Organization's "Roadmap to Implementation," which aims to control, eliminate, and eradicate Neglected Tropical Diseases (NTDs). The supply chain to deliver these medicines is complex, with fragmented data systems and limited visibility on performance. This study empirically evaluates the impact of an online supply chain performance measurement system, "NTDeliver," providing understanding of the value of information sharing towards the success of global health programs. METHODS: Retrospective secondary data were extracted from NTDeliver, which included 1,484 shipments for four critical medicines ordered by over 100 countries between February 28, 2006 and December 31, 2018. We applied statistical regression models to analyze the impact on key performance metrics, comparing data before and after the system was implemented. FINDINGS: The results suggest information sharing has a positive association with improvement for two key performance indicators: purchase order timeliness (ß = 0.941, p = 0.003) and-most importantly-delivery timeliness (ß = 0.828, p = 0.027). There is a positive association with improvement for three variables when the data are publicly shared: shipment timeliness (ß = 2.57, p = 0.001), arrival timeliness (ß = 2.88, p = 0.003), and delivery timeliness (ß = 2.82, p = 0.011). CONCLUSIONS: Our findings suggest that information sharing between the NTD program partners via the NTDeliver system has a positive association with supply chain performance improvements, especially when data are shared publicly. Given the large volume of medicine and the significant number of people requiring these medicines, information sharing has the potential to provide improvements to global health programs affecting the health of tens to hundreds of millions of people.


Subject(s)
Neglected Diseases/prevention & control , Tropical Medicine , Chemoprevention , Humans , Information Dissemination , Retrospective Studies
6.
PLoS Negl Trop Dis ; 15(12): e0010064, 2021 12.
Article in English | MEDLINE | ID: covidwho-1581898

ABSTRACT

BACKGROUND: Among the many collaterals of the COVID-19 pandemic is the disruption of health services and vital clinical research. COVID-19 has magnified the challenges faced in research and threatens to slow research for urgently needed therapeutics for Neglected Tropical Diseases (NTDs) and diseases affecting the most vulnerable populations. Here we explore the impact of the pandemic on a clinical trial for plague therapeutics and strategies that have been considered to ensure research efforts continue. METHODS: To understand the impact of the COVID-19 pandemic on the trial accrual rate, we documented changes in patterns of all-cause consultations that took place before and during the pandemic at health centres in two districts of the Amoron'I Mania region of Madagascar where the trial is underway. We also considered trends in plague reporting and other external factors that may have contributed to slow recruitment. RESULTS: During the pandemic, we found a 27% decrease in consultations at the referral hospital, compared to an 11% increase at peripheral health centres, as well as an overall drop during the months of lockdown. We also found a nation-wide trend towards reduced number of reported plague cases. DISCUSSION: COVID-19 outbreaks are unlikely to dissipate in the near future. Declining NTD case numbers recorded during the pandemic period should not be viewed in isolation or taken as a marker of things to come. It is vitally important that researchers are prepared for a rebound in cases and, most importantly, that research continues to avoid NTDs becoming even more neglected.


Subject(s)
COVID-19 , Health Impact Assessment , Neglected Diseases/drug therapy , Plague/drug therapy , Randomized Controlled Trials as Topic , Research , Tropical Medicine/trends , Disease Notification , Epidemiological Monitoring , Humans , Madagascar/epidemiology , Pandemics , Patient Acceptance of Health Care , Patient Selection , Plague/epidemiology , Referral and Consultation/trends
7.
Adv Parasitol ; 114: 1-26, 2021.
Article in English | MEDLINE | ID: covidwho-1458847

ABSTRACT

Human parasitic infections-including malaria, and many neglected tropical diseases (NTDs)-have long represented a Gordian knot in global public health: ancient, persistent, and exceedingly difficult to control. With the coronavirus disease (Covid-19) pandemic substantially interrupting control programmes worldwide, there are now mounting fears that decades of progress in controlling global parasitic infections will be undone. With Covid-19 moreover exposing deep vulnerabilities in the global health system, the current moment presents a watershed opportunity to plan future efforts to reduce the global morbidity and mortality associated with human parasitic infections. In this chapter, we first provide a brief epidemiologic overview of the progress that has been made towards the control of parasitic diseases between 1990 and 2019, contrasting these fragile gains with the anticipated losses as a result of Covid-19. We then argue that the complementary aspirations of the United Nations Sustainable Development Goals (SDGs) and the World Health Organization (WHO)'s 2030 targets for parasitic disease control may be achieved by aligning programme objectives within the One Health paradigm, recognizing the interdependence between humans, animals, and the environment. In so doing, we note that while the WHO remains the preeminent international institution to address some of these transdisciplinary concerns, its underlying challenges with funding, authority, and capacity are likely to reverberate if left unaddressed. To this end, we conclude by reimagining how models of multisectoral global health governance-combining the WHO's normative and technical leadership with greater support in allied policy-making areas-can help sustain future malaria and NTD elimination efforts.


Subject(s)
COVID-19 , One Health , Parasitic Diseases , Tropical Medicine , Animals , Global Health , Humans , Neglected Diseases/epidemiology , Neglected Diseases/prevention & control , Parasitic Diseases/epidemiology , Parasitic Diseases/prevention & control , SARS-CoV-2
9.
J Travel Med ; 27(8)2020 12 23.
Article in English | MEDLINE | ID: covidwho-1387946

ABSTRACT

BACKGROUND: Numerous publications focus on fever in returning travellers, but there is no known systematic review considering all diseases, or all tropical diseases causing fever. Such a review is necessary in order to develop appropriate practice guidelines. OBJECTIVES: Primary objectives of this review were (i) to determine the aetiology of fever in travellers/migrants returning from (sub) tropical countries as well as the proportion of patients with specific diagnoses, and (ii) to assess the predictors for specific tropical diseases. METHOD: Embase, MEDLINE and Cochrane Library were searched with terms combining fever and travel/migrants. All studies focusing on causes of fever in returning travellers and/or clinical and laboratory predictors of tropical diseases were included. Meta-analyses were performed on frequencies of etiological diagnoses. RESULTS: 10 064 studies were identified; 541 underwent full-text review; 30 met criteria for data extraction. Tropical infections accounted for 33% of fever diagnoses, with malaria causing 22%, dengue 5% and enteric fever 2%. Non-tropical infections accounted for 36% of febrile cases, with acute gastroenteritis causing 14% and respiratory tract infections 13%. Positive likelihood ratios demonstrated that splenomegaly, thrombocytopenia and hyperbilirubinemia were respectively 5-14, 3-11 and 5-7 times more likely in malaria than non-malaria patients. High variability of results between studies reflects heterogeneity in study design, regions visited, participants' characteristics, setting, laboratory investigations performed and diseases included. CONCLUSION: Malaria accounted for one-fifth of febrile cases, highlighting the importance of rapid malaria testing in febrile returning travellers, followed by other rapid tests for common tropical diseases. High variability between studies highlights the need to harmonize study designs and to promote multi-centre studies investigating predictors of diseases, including of lower incidence, which may help to develop evidence-based guidelines. The use of clinical decision support algorithms by health workers which incorporate clinical predictors, could help standardize studies as well as improve quality of recommendations.


Subject(s)
COVID-19 , Communicable Disease Control/standards , Fever , Travel Medicine/methods , Tropical Medicine/methods , COVID-19/diagnosis , COVID-19/epidemiology , Diagnosis, Differential , Fever/diagnosis , Fever/etiology , Humans , Practice Guidelines as Topic , Transients and Migrants/statistics & numerical data
10.
PLoS Negl Trop Dis ; 15(8): e0009626, 2021 08.
Article in English | MEDLINE | ID: covidwho-1365416

ABSTRACT

"Fit-for-purpose" diagnostic tests have emerged as a prerequisite to achieving global targets for the prevention, control, elimination, and eradication of neglected tropical diseases (NTDs), as highlighted by the World Health Organization's (WHO) new roadmap. There is an urgent need for the development of new tools for those diseases for which no diagnostics currently exist and for improvement of existing diagnostics for the remaining diseases. Yet, efforts to achieve this, and other crosscutting ambitions, are fragmented, and the burden of these 20 debilitating diseases immense. Compounded by the Coronavirus Disease 2019 (COVID-19) pandemic, programmatic interruptions, systemic weaknesses, limited investment, and poor commercial viability undermine global efforts-with a lack of coordination between partners, leading to the duplication and potential waste of scant resources. Recognizing the pivotal role of diagnostic testing and the ambition of WHO, to move forward, we must create an ecosystem that prioritizes country-level action, collaboration, creativity, and commitment to new levels of visibility. Only then can we start to accelerate progress and make new gains that move the world closer to the end of NTDs.


Subject(s)
Neglected Diseases/prevention & control , Tropical Medicine , COVID-19/diagnosis , Disease Eradication , Humans , Neglected Diseases/diagnosis , SARS-CoV-2 , World Health Organization
12.
Trans R Soc Trop Med Hyg ; 115(2): 182-184, 2021 01 28.
Article in English | MEDLINE | ID: covidwho-1307557

ABSTRACT

The forthcoming World Health Organization road map for neglected tropical diseases (NTDs) 2021-2030 recognises the complexity surrounding control and elimination of these 20 diseases of poverty. It emphasises the need for a paradigm shift from disease-specific interventions to holistic cross-cutting approaches coordinating with adjacent disciplines. The One Health approach exemplifies this shift, extending beyond a conventional model of zoonotic disease control to consider the interactions of human and animal health systems within their shared environment and the wider social and economic context. This approach can also promote sustainability and resilience within these systems. To achieve the global ambition on NTD elimination and control, political will, along with contextualised innovative scientific strategies, is required.


Subject(s)
One Health , Tropical Medicine , Animals , Global Health , Humans , Neglected Diseases/prevention & control , World Health Organization
14.
PLoS Pathog ; 17(4): e1009384, 2021 04.
Article in English | MEDLINE | ID: covidwho-1231263

ABSTRACT

It is estimated that more than 1 billion people across the world are affected by a neglected tropical disease (NTD) that requires medical intervention. These diseases tend to afflict people in areas with high rates of poverty and cost economies billions of dollars every year. Collaborative drug discovery efforts are required to reduce the burden of these diseases in endemic regions. The release of "Open Access Boxes" is an initiative launched by Medicines for Malaria Venture (MMV) in collaboration with its partners to catalyze new drug discovery in neglected diseases. These boxes are mainly requested by biology researchers across the globe who may not otherwise have access to compounds to screen nor knowledge of the workflow that needs to be followed after identification of actives from their screening campaigns. Here, we present guidelines on how to move such actives beyond the hit identification stage, to help in capacity strengthening and enable a greater impact of the initiative.


Subject(s)
Drug Discovery , Malaria/drug therapy , Neglected Diseases/drug therapy , Validation Studies as Topic , Access to Information , Humans , Tropical Medicine/methods
15.
Trans R Soc Trop Med Hyg ; 115(8): 841-846, 2021 08 02.
Article in English | MEDLINE | ID: covidwho-1228539

ABSTRACT

The Ascend West and Central Africa programme, funded by the UK Foreign, Commonwealth and Development Office (FCDO) is supporting integrated preventative chemotherapy for up to five neglected tropical diseases (NTDs), including intestinal worms, lymphatic filariasis, river blindness, trachoma and schistosomiasis. The programme is implemented across 13 countries by a consortium of four leading international development partners: Sightsavers, Liverpool School of Tropical Medicine, Schistosomiasis Control Initiative Foundation and Mott Macdonald. This paper presents messages learnt from country assessments that took place prior to the global outbreak of coronavirus disease 2019 (COVID-19). These messages remain relevant post-COVID-19, with greater priority being given to the challenges for national NTD programmes in continuing to deliver mass drug administration (MDA) during the pandemic. Stakeholder coordination from the earliest stages of the pandemic has occurred at two levels: in the first mile with global partners of the NTD Supply Chain Forum and in the last mile with implementing partners in each country. This has been instrumental to manage delayed MDA, including the impact delays have on the shipment of NTD donated drugs and the distribution of stock held in country. The Ascend West and Central Africa programme is supporting countries with the resumption of MDA through a risk assessment and mitigation action (RAMA) process.


Subject(s)
COVID-19 , Pharmaceutical Preparations , Tropical Medicine , Africa, Central/epidemiology , Humans , Neglected Diseases/drug therapy , Neglected Diseases/epidemiology , Neglected Diseases/prevention & control , SARS-CoV-2
19.
Trans R Soc Trop Med Hyg ; 115(5): 441-446, 2021 05 08.
Article in English | MEDLINE | ID: covidwho-1078854

ABSTRACT

The COVID-19 pandemic hit at a time when the Ascend West and Central Africa programme was nearing the end of its first year of a 3-y programme. This article reflects on key lessons learnt from the rapid adaptation of an integrated neglected tropical disease (NTD) programme to support COVID-19 responses in 11 countries. It shares the experiences of adopting a flexible and directive approach, leveraging the NTD network and relationships, and working in collaboration with multiple ministry departments, commercial sector partners and the UK Foreign Commonwealth Development Office to repurpose over £6 million of budget.


Subject(s)
COVID-19/prevention & control , Community Participation , Delivery of Health Care, Integrated , Pandemics/prevention & control , Tropical Medicine/methods , Communication , Community Health Workers , Humans , Neglected Diseases/prevention & control , Public Health , Risk , SARS-CoV-2
20.
Am J Trop Med Hyg ; 103(5): 1758-1761, 2020 11.
Article in English | MEDLINE | ID: covidwho-1076799

ABSTRACT

We calculated carbon emissions associated with air travel of 4,834 participants at the 2019 annual conference of the American Society of Tropical Medicine and Hygiene (ASTMH). Together, participants traveled a total of 27.7 million miles or 44.6 million kilometers. This equates to 58 return trips to the moon. Estimated carbon dioxide equivalent (CO2e) emissions were 8,646 metric tons or the total weekly carbon footprint of approximately 9,366 average American households. These emissions contribute to climate change and thus may exacerbate many of the global diseases that conference attendees seek to combat. Options to reduce conference travel-associated emissions include 1) alternating in-person and online conferences, 2) offering a hybrid in-person/online conference, and 3) decentralizing the conference with multiple conference venues. Decentralized ASTMH conferences may allow for up to 64% reduction in travel distance and 58% reduction in CO2e emissions. Given the urgency of the climate crisis and the clear association between global warming and global health, ways to reduce carbon emissions should be considered.


Subject(s)
Carbon Footprint , Hygiene , Societies, Scientific/organization & administration , Travel , Tropical Medicine , Climate Change , Humans , United States
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