Climate change, malaria and neglected tropical diseases: a scoping review.

To explore the effects of climate change on malaria and 20 neglected tropical diseases (NTDs), and potential effect amelioration through mitigation and adaptation, we searched for papers published from January 2010 to October 2023. We descriptively synthesised extracted data. We analysed numbers of papers meeting our inclusion criteria by country and national disease burden, healthcare access and quality index (HAQI), as well as by climate vulnerability score. From 42 693 retrieved records, 1543 full-text papers were assessed. Of 511 papers meeting the inclusion criteria, 185 studied malaria, 181 dengue and chikungunya and 53 leishmaniasis; other NTDs were relatively understudied. Mitigation was considered in 174 papers (34%) and adaption strategies in 24 (5%). Amplitude and direction of effects of climate change on malaria and NTDs are likely to vary by disease and location, be non-linear and evolve over time. Available analyses do not allow confident prediction of the overall global impact of climate change on these diseases. For dengue and chikungunya and the group of non-vector-borne NTDs, the literature privileged consideration of current low-burden countries with a high HAQI. No leishmaniasis papers considered outcomes in East Africa. Comprehensive, collaborative and standardised modelling efforts are needed to better understand how climate change will directly and indirectly affect malaria and NTDs.

Eliminating morbidity caused by neglected tropical diseases by 2030.

The objective of this manuscript is to provide selective examples of the work of the Pan American Health Organization/World Health Organization (PAHO/WHO) Collaborating Centre for Research and Training in Parasite Epidemiology and Control which contribute to the WHO goal of eliminating neglected tropical diseases by 2030. This PAHO/WHO CC specifically aligns its activities with the Sustainable Development Goals and with the goals outlined in the WHO Road Map for Neglected Tropical Diseases 2021-2030. Its role is to contribute to advancing global action on NTDs, primarily through policy development and knowledge translation. Three important projects have recently been completed: 1. Finalizing the Monitoring and Evaluation Framework for the NTD Road Map (published May 2021; this PAHO/WHO CC was a member of the working group); 2. Developing new guidelines for the preventive chemotherapy of Taenia solium taeniasis (published September 2021; this PAHO/WHO CC was co-Chair; and 3. Formulating a policy brief on deworming for adolescent girls and women of reproductive age (published January 2022; this PAHO/WHO CC is co-lead). These projects are the result of the integration of expertise and experience from multiple partners, including from PAHO and WHO (where both organizations provided key leadership), this PAHO/WHO CC, government ministries, civil society organizations and universities, among others. In conclusion, this PAHO/WHO CC contributes timely guidance to country-led evidence-informed public health policy, to cost-effective program implementation and to the identification of priority research topics - all focused, ultimately, on eliminating NTD-attributable morbidity by 2030.

El objetivo de este artículo es proporcionar ejemplos seleccionados de la labor del centro colaborador de investigación y capacitación en epidemiología y control de parásitos de la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS), que contribuye al objetivo de la OMS de eliminar las enfermedades tropicales desatendidas para el 2030. Este centro colaborador de la OPS/OMS alinea sus actividades específicamente con los Objetivos de Desarrollo Sostenible y con los objetivos descritos en la Hoja de ruta sobre enfermedades tropicales desatendidas 2021-2030 de la OMS. Su función es contribuir al avance de las medidas mundiales sobre las enfermedades tropicales desatendidas, principalmente mediante la elaboración de políticas y la traducción de conocimiento. Recientemente se han completado tres proyectos importantes: 1) finalización del marco de seguimiento y evaluación de la Hoja de ruta sobre enfermedades tropicales desatendidas (publicado en mayo del 2021; este centro colaborador de la OPS/OMS formó parte del grupo de trabajo); 2) elaboración de nuevas directrices para la quimioterapia preventiva de la teniasis por Taenia solium (publicado en septiembre del 2021; este centro colaborador fue copresidente); y 3) formulación de un informe de políticas sobre la desparasitación de las adolescentes y las mujeres en edad reproductiva (publicado en enero del 2022; este centro colaborador fue coautor). Estos proyectos son el resultado de la integración del conocimiento y la experiencia de múltiples asociados, como la OPS y la OMS (ambas organizaciones ofrecieron un liderazgo clave), este centro colaborador de la OPS/OMS, así como varios ministerios gubernamentales, organizaciones de la sociedad civil y universidades, entre otros. En conclusión, este centro colaborador de la OPS/OMS ofrece orientaciones oportunas para las políticas de salud pública basadas en la evidencia lideradas por los países, la ejecución de programas costo-efectivos y la determinación de los temas de investigación prioritarios, todo ello destinado, en última instancia, a eliminar la morbilidad atribuible a las enfermedades tropicales desatendidas para el 2030.

O objetivo deste manuscrito é fornecer exemplos seletivos do trabalho do Centro Colaborador de Pesquisa e Treinamento em Epidemiologia e Controle de Parasitos da Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS) que contribuem para a meta da OMS de eliminar até 2030 as doenças tropicais negligenciadas. Este CC da OPAS/OMS alinha especificamente suas atividades com os Objetivos de Desenvolvimento Sustentável e com as metas delineadas no Roteiro da OMS para Doenças Tropicais Negligenciadas 2021-2030. Seu papel é contribuir para o avanço da ação global contra doenças tropicais negligenciadas, principalmente por meio do desenvolvimento de políticas e da tradução de conhecimentos. Três importantes projetos foram concluídos recentemente: 1. Finalização da Estrutura de Monitoramento e Avaliação do Roteiro para as DTN (publicada em maio de 2021 ­ este CC da OPAS/OMS foi membro do grupo de trabalho); 2. Desenvolvimento de novas diretrizes para a quimioprofilaxia da teníase por Taenia solium (publicado em setembro de 2021 ­ este CC da OPAS/OMS foi copresidente); e 3. Formulação de orientação para políticas de desparasitação para adolescentes e mulheres em idade reprodutiva (publicado em janeiro de 2022 ­ este CC da OPAS/OMS foi cogestor). Esses projetos são o resultado da integração de conhecimentos e experiência de múltiplos parceiros, incluindo a OPAS e a OMS (onde ambas as organizações forneceram liderança essencial), este CC da OPAS/OMS, ministérios governamentais, organizações da sociedade civil e universidades, entre outros. Em suma, este CC da OPAS/OMS contribui com orientações oportunas para uma política de saúde pública liderada pelos países e informada com base em evidências, para a implementação de programas com boa relação custo-benefício e para a identificação de tópicos prioritários de pesquisa ­ todos focados, em última análise, na eliminação da morbidade atribuível às DTN até 2030.

Eliminating morbidity caused by neglected tropical diseases by 2030

[ABSTRACT]. The objective of this manuscript is to provide selective examples of the work of the Pan American Health Orga- nization/World Health Organization (PAHO/WHO) Collaborating Centre for Research and Training in Parasite Epidemiology and Control which contribute to the WHO goal of eliminating neglected tropical diseases by 2030. This PAHO/WHO CC specifically aligns its activities with the Sustainable Development Goals and with the goals outlined in the WHO Road Map for Neglected Tropical Diseases 2021-2030. Its role is to contribute to advancing global action on NTDs, primarily through policy development and knowledge translation. Three important projects have recently been completed: 1. Finalizing the Monitoring and Evaluation Framework for the NTD Road Map (published May 2021; this PAHO/WHO CC was a member of the working group); 2. Devel- oping new guidelines for the preventive chemotherapy of Taenia solium taeniasis (published September 2021; this PAHO/WHO CC was co-Chair; and 3. Formulating a policy brief on deworming for adolescent girls and women of reproductive age (published January 2022; this PAHO/WHO CC is co-lead). These projects are the result of the integration of expertise and experience from multiple partners, including from PAHO and WHO (where both organizations provided key leadership), this PAHO/WHO CC, government ministries, civil society organizations and universities, among others. In conclusion, this PAHO/WHO CC contributes timely guidance to country-led evidence-informed public health policy, to cost-effective program implementation and to the identification of priority research topics – all focused, ultimately, on eliminating NTD-attributable morbidity by 2030.

[RESUMEN]. El objetivo de este artículo es proporcionar ejemplos seleccionados de la labor del centro colaborador de investigación y capacitación en epidemiología y control de parásitos de la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS), que contribuye al objetivo de la OMS de eliminar las enfermedades tropicales desatendidas para el 2030. Este centro colaborador de la OPS/OMS alinea sus actividades específicamente con los Objetivos de Desarrollo Sostenible y con los objetivos descritos en la Hoja de ruta sobre enfermedades tropicales desatendidas 2021-2030 de la OMS. Su función es contribuir al avance de las medidas mundiales sobre las enfermedades tropicales desatendidas, principalmente mediante la elaboración de políticas y la traducción de conocimiento. Recientemente se han completado tres proyectos importantes: 1) finalización del marco de seguimiento y evaluación de la Hoja de ruta sobre enfermedades tropicales desatendidas (publicado en mayo del 2021; este centro colaborador de la OPS/OMS formó parte del grupo de trabajo); 2) elaboración de nuevas directrices para la quimioterapia preventiva de la teniasis por Taenia solium (publicado en septiembre del 2021; este centro colaborador fue copresidente); y 3) formulación de un informe de políticas sobre la desparasitación de las adolescentes y las mujeres en edad reproductiva (publicado en enero del 2022; este centro colaborador fue coautor). Estos proyectos son el resultado de la integración del conocimiento y la experiencia de múltiples asociados, como la OPS y la OMS (ambas organi- zaciones ofrecieron un liderazgo clave), este centro colaborador de la OPS/OMS, así como varios ministerios gubernamentales, organizaciones de la sociedad civil y universidades, entre otros. En conclusión, este centro colaborador de la OPS/OMS ofrece orientaciones oportunas para las políticas de salud pública basadas en la evidencia lideradas por los países, la ejecución de programas costo-efectivos y la determinación de los temas de investigación prioritarios, todo ello destinado, en última instancia, a eliminar la morbilidad atribuible a las enfermedades tropicales desatendidas para el 2030.

[RESUMO]. O objetivo deste manuscrito é fornecer exemplos seletivos do trabalho do Centro Colaborador de Pesquisa e Treinamento em Epidemiologia e Controle de Parasitos da Organização Pan-Americana da Saúde/Organi- zação Mundial da Saúde (OPAS/OMS) que contribuem para a meta da OMS de eliminar até 2030 as doenças tropicais negligenciadas. Este CC da OPAS/OMS alinha especificamente suas atividades com os Objetivos de Desenvolvimento Sustentável e com as metas delineadas no Roteiro da OMS para Doenças Tropicais Negligenciadas 2021-2030. Seu papel é contribuir para o avanço da ação global contra doenças tropicais negligenciadas, principalmente por meio do desenvolvimento de políticas e da tradução de conhecimentos. Três importantes projetos foram concluídos recentemente: 1. Finalização da Estrutura de Monitoramento e Avaliação do Roteiro para as DTN (publicada em maio de 2021 – este CC da OPAS/OMS foi membro do grupo de trabalho); 2. Desenvolvimento de novas diretrizes para a quimioprofilaxia da teníase por Taenia solium (publicado em setembro de 2021 – este CC da OPAS/OMS foi copresidente); e 3. Formulação de orientação para políticas de desparasitação para adolescentes e mulheres em idade reprodutiva (publicado em janeiro de 2022 – este CC da OPAS/OMS foi cogestor). Esses projetos são o resultado da integração de conhecimen- tos e experiência de múltiplos parceiros, incluindo a OPAS e a OMS (onde ambas as organizações forneceram liderança essencial), este CC da OPAS/OMS, ministérios governamentais, organizações da sociedade civil e universidades, entre outros. Em suma, este CC da OPAS/OMS contribui com orientações oportunas para uma política de saúde pública liderada pelos países e informada com base em evidências, para a implementação de programas com boa relação custo-benefício e para a identificação de tópicos prioritários de pesquisa – todos focados, em última análise, na eliminação da morbidade atribuível às DTN até 2030.

Eliminating morbidity caused by neglected tropical diseases by 2030 / Eliminar la morbilidad causada por las enfermedades tropicales desatendidas para el 2030 / Eliminação até 2030 da morbidade causada pelas doenças tropicais negligenciadas

ABSTRACT The objective of this manuscript is to provide selective examples of the work of the Pan American Health Organization/World Health Organization (PAHO/WHO) Collaborating Centre for Research and Training in Parasite Epidemiology and Control which contribute to the WHO goal of eliminating neglected tropical diseases by 2030. This PAHO/WHO CC specifically aligns its activities with the Sustainable Development Goals and with the goals outlined in the WHO Road Map for Neglected Tropical Diseases 2021-2030. Its role is to contribute to advancing global action on NTDs, primarily through policy development and knowledge translation. Three important projects have recently been completed: 1. Finalizing the Monitoring and Evaluation Framework for the NTD Road Map (published May 2021; this PAHO/WHO CC was a member of the working group); 2. Developing new guidelines for the preventive chemotherapy of Taenia solium taeniasis (published September 2021; this PAHO/WHO CC was co-Chair; and 3. Formulating a policy brief on deworming for adolescent girls and women of reproductive age (published January 2022; this PAHO/WHO CC is co-lead). These projects are the result of the integration of expertise and experience from multiple partners, including from PAHO and WHO (where both organizations provided key leadership), this PAHO/WHO CC, government ministries, civil society organizations and universities, among others. In conclusion, this PAHO/WHO CC contributes timely guidance to country-led evidence-informed public health policy, to cost-effective program implementation and to the identification of priority research topics - all focused, ultimately, on eliminating NTD-attributable morbidity by 2030.

RESUMEN El objetivo de este artículo es proporcionar ejemplos seleccionados de la labor del centro colaborador de investigación y capacitación en epidemiología y control de parásitos de la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS), que contribuye al objetivo de la OMS de eliminar las enfermedades tropicales desatendidas para el 2030. Este centro colaborador de la OPS/OMS alinea sus actividades específicamente con los Objetivos de Desarrollo Sostenible y con los objetivos descritos en la Hoja de ruta sobre enfermedades tropicales desatendidas 2021-2030 de la OMS. Su función es contribuir al avance de las medidas mundiales sobre las enfermedades tropicales desatendidas, principalmente mediante la elaboración de políticas y la traducción de conocimiento. Recientemente se han completado tres proyectos importantes: 1) finalización del marco de seguimiento y evaluación de la Hoja de ruta sobre enfermedades tropicales desatendidas (publicado en mayo del 2021; este centro colaborador de la OPS/OMS formó parte del grupo de trabajo); 2) elaboración de nuevas directrices para la quimioterapia preventiva de la teniasis por Taenia solium (publicado en septiembre del 2021; este centro colaborador fue copresidente); y 3) formulación de un informe de políticas sobre la desparasitación de las adolescentes y las mujeres en edad reproductiva (publicado en enero del 2022; este centro colaborador fue coautor). Estos proyectos son el resultado de la integración del conocimiento y la experiencia de múltiples asociados, como la OPS y la OMS (ambas organizaciones ofrecieron un liderazgo clave), este centro colaborador de la OPS/OMS, así como varios ministerios gubernamentales, organizaciones de la sociedad civil y universidades, entre otros. En conclusión, este centro colaborador de la OPS/OMS ofrece orientaciones oportunas para las políticas de salud pública basadas en la evidencia lideradas por los países, la ejecución de programas costo-efectivos y la determinación de los temas de investigación prioritarios, todo ello destinado, en última instancia, a eliminar la morbilidad atribuible a las enfermedades tropicales desatendidas para el 2030.

RESUMO O objetivo deste manuscrito é fornecer exemplos seletivos do trabalho do Centro Colaborador de Pesquisa e Treinamento em Epidemiologia e Controle de Parasitos da Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS) que contribuem para a meta da OMS de eliminar até 2030 as doenças tropicais negligenciadas. Este CC da OPAS/OMS alinha especificamente suas atividades com os Objetivos de Desenvolvimento Sustentável e com as metas delineadas no Roteiro da OMS para Doenças Tropicais Negligenciadas 2021-2030. Seu papel é contribuir para o avanço da ação global contra doenças tropicais negligenciadas, principalmente por meio do desenvolvimento de políticas e da tradução de conhecimentos. Três importantes projetos foram concluídos recentemente: 1. Finalização da Estrutura de Monitoramento e Avaliação do Roteiro para as DTN (publicada em maio de 2021 - este CC da OPAS/OMS foi membro do grupo de trabalho); 2. Desenvolvimento de novas diretrizes para a quimioprofilaxia da teníase por Taenia solium (publicado em setembro de 2021 - este CC da OPAS/OMS foi copresidente); e 3. Formulação de orientação para políticas de desparasitação para adolescentes e mulheres em idade reprodutiva (publicado em janeiro de 2022 - este CC da OPAS/OMS foi cogestor). Esses projetos são o resultado da integração de conhecimentos e experiência de múltiplos parceiros, incluindo a OPAS e a OMS (onde ambas as organizações forneceram liderança essencial), este CC da OPAS/OMS, ministérios governamentais, organizações da sociedade civil e universidades, entre outros. Em suma, este CC da OPAS/OMS contribui com orientações oportunas para uma política de saúde pública liderada pelos países e informada com base em evidências, para a implementação de programas com boa relação custo-benefício e para a identificação de tópicos prioritários de pesquisa - todos focados, em última análise, na eliminação da morbidade atribuível às DTN até 2030.

Current status of the knowledge on the epidemiology of tungiasis in the Americas.

Objectives: To present the state-of-the-knowledge on the epidemiology of tungiasis in the Region of the Americas. Methods: A search of publications on the epidemiology of tungiasis in the Americas was performed in PubMed and LILACS databases from January 2007 to June 2021. In addition, a manual literature search on articles on the epidemiology of tungiasis was performed. Results: A total of 83 articles were analyzed which contained relevant information on tungiasis cases and their geographical distribution, prevalence and risk factors, life cycle, sites where transmission takes place, and zoonotic aspects. The on-host and off-host life cycles have been researched in detail. In certain contexts, the whole life cycle is completed indoors enabling transmission around the whole year. Cases were reported from 10 countries; 71% of them were from Brazil. In the general population, the prevalence varied between 1.0% and 82.6% according to the settings. Age-specific prevalence indicated that children and the elderly bear the highest disease burden. Risk factor studies indicate that tungiasis is associated with severe poverty. Conclusions: In the Americas, there are important gaps in information and knowledge of tungiasis. Understanding the burden, epidemiology, distribution, magnitude, related risk factors, and reservoirs, among others, is needed to develop and implement integrated control measures tailored to the context and patterns of transmission in the affected communities.

Current status of the knowledge on the epidemiology of tungiasis in the Americas

[ABSTRACT]. Objectives. To present the state-of-the-knowledge on the epidemiology of tungiasis in the Region of the Americas. Methods. A search of publications on the epidemiology of tungiasis in the Americas was performed in PubMed and LILACS databases from January 2007 to June 2021. In addition, a manual literature search on articles on the epidemiology of tungiasis was performed. Results. A total of 83 articles were analyzed which contained relevant information on tungiasis cases and their geographical distribution, prevalence and risk factors, life cycle, sites where transmission takes place, and zoonotic aspects. The on-host and off-host life cycles have been researched in detail. In certain contexts, the whole life cycle is completed indoors enabling transmission around the whole year. Cases were reported from 10 countries; 71% of them were from Brazil. In the general population, the prevalence varied between 1.0% and 82.6% according to the settings. Age-specific prevalence indicated that children and the elderly bear the highest disease burden. Risk factor studies indicate that tungiasis is associated with severe poverty. Conclusions. In the Americas, there are important gaps in information and knowledge of tungiasis. Understanding the burden, epidemiology, distribution, magnitude, related risk factors, and reservoirs, among others, is needed to develop and implement integrated control measures tailored to the context and patterns of transmission in the affected communities.

[RESUMEN]. Objetivos. Presentar el estado del conocimiento sobre las características epidemiológicas de la tungiasis en la Región de las Américas. Métodos. Se hizo una búsqueda de publicaciones sobre las características epidemiológicas de la tungiasis en la Región en las bases de datos PubMed y LILACS en el período comprendido entre enero del 2007 y junio del 2021. Además, se realizó una búsqueda bibliográfica manual de artículos sobre las características epidemiológicas de la tungiasis. Resultados. Se analizaron en total 83 artículos que contenían información pertinente sobre casos de tungiasis y su distribución geográfica, prevalencia y factores de riesgo, ciclo de vida, lugares donde se produce la transmisión y aspectos zoonóticos. Se investigaron en detalle los ciclos de vida dentro y fuera del huésped. En ciertos contextos, la totalidad del ciclo de vida se completa en espacios cerrados, lo que permite la transmisión durante todo el año. Se notificaron casos en 10 países, con 71% de los casos notificados en Brasil. En la población general, la prevalencia varió entre 1,0% y 82,6% según el entorno. La prevalencia específica por edad indica que la población infantil y las personas mayores tienen la mayor carga de morbilidad. Los estudios relativos a los factores de riesgo indican que la tungiasis está relacionada con la pobreza extrema. Conclusiones. En la Región, hay lagunas importantes en la información y el conocimiento sobre la tungiasis. Es necesario comprender la carga, las características epidemiológicas, la distribución, la magnitud, los factores de riesgo relacionados y los reservorios, entre otros factores, para elaborar y aplicar medidas de control integradas adaptadas al contexto y los patrones de transmisión en las comunidades afectadas.

[RESUMO]. Objetivos. Apresentar o estado do conhecimento sobre a epidemiologia da tungíase na Região das Américas. Métodos. Realizou-se uma pesquisa de estudos publicados de janeiro de 2007 a junho de 2021 sobre a epidemiologia da tungíase nas Américas nas bases de dados PubMed e LILACS, bem como uma pesquisa bibliográfica manual de artigos sobre a epidemiologia da tungíase. Resultados. Analisou-se um total de 83 artigos com informações de interesse sobre casos de tungíase e sua distribuição geográfica, prevalência e fatores de risco, ciclo vital, locais de transmissão e aspectos zoonóticos. Os ciclos vitais dentro e fora do hospedeiro foram pesquisados em detalhes. Em determinados contextos, todo o ciclo vital ocorre em ambientes fechados, o que possibilita a transmissão durante todo o ano. Relataram-se casos de 10 países; 71% deles no Brasil. Na população em geral, a prevalência variou de 1,0% a 82,6%, de acordo com o local. A prevalência específica por idade mostrou que a maior carga de doença ocorre em crianças e pessoas idosas. Estudos dos fatores de risco indicam que a tungíase está associada à extrema pobreza. Conclusões. Nas Américas, existem importantes lacunas de informação e conhecimento sobre a tungíase. É necessário compreender fatores como carga, epidemiologia, distribuição, magnitude, fatores de risco relacionados e reservatórios, entre outros, para desenvolver e implementar medidas integradas de controle adequadas ao contexto e aos padrões de transmissão nas comunidades afetadas.

Current status of the knowledge on the epidemiology of tungiasis in the Americas / Estado actual del conocimiento sobre las características epidemiológicas de la tungiasis en la Región de las Américas / Situação atual do conhecimento sobre a epidemiologia da tungíase nas Américas

ABSTRACT Objectives. To present the state-of-the-knowledge on the epidemiology of tungiasis in the Region of the Americas. Methods. A search of publications on the epidemiology of tungiasis in the Americas was performed in PubMed and LILACS databases from January 2007 to June 2021. In addition, a manual literature search on articles on the epidemiology of tungiasis was performed. Results. A total of 83 articles were analyzed which contained relevant information on tungiasis cases and their geographical distribution, prevalence and risk factors, life cycle, sites where transmission takes place, and zoonotic aspects. The on-host and off-host life cycles have been researched in detail. In certain contexts, the whole life cycle is completed indoors enabling transmission around the whole year. Cases were reported from 10 countries; 71% of them were from Brazil. In the general population, the prevalence varied between 1.0% and 82.6% according to the settings. Age-specific prevalence indicated that children and the elderly bear the highest disease burden. Risk factor studies indicate that tungiasis is associated with severe poverty. Conclusions. In the Americas, there are important gaps in information and knowledge of tungiasis. Understanding the burden, epidemiology, distribution, magnitude, related risk factors, and reservoirs, among others, is needed to develop and implement integrated control measures tailored to the context and patterns of transmission in the affected communities.

RESUMEN Objetivos. Presentar el estado del conocimiento sobre las características epidemiológicas de la tungiasis en la Región de las Américas. Métodos. Se hizo una búsqueda de publicaciones sobre las características epidemiológicas de la tungiasis en la Región en las bases de datos PubMed y LILACS en el período comprendido entre enero del 2007 y junio del 2021. Además, se realizó una búsqueda bibliográfica manual de artículos sobre las características epidemiológicas de la tungiasis. Resultados. Se analizaron en total 83 artículos que contenían información pertinente sobre casos de tungiasis y su distribución geográfica, prevalencia y factores de riesgo, ciclo de vida, lugares donde se produce la transmisión y aspectos zoonóticos. Se investigaron en detalle los ciclos de vida dentro y fuera del huésped. En ciertos contextos, la totalidad del ciclo de vida se completa en espacios cerrados, lo que permite la transmisión durante todo el año. Se notificaron casos en 10 países, con 71% de los casos notificados en Brasil. En la población general, la prevalencia varió entre 1,0% y 82,6% según el entorno. La prevalencia específica por edad indica que la población infantil y las personas mayores tienen la mayor carga de morbilidad. Los estudios relativos a los factores de riesgo indican que la tungiasis está relacionada con la pobreza extrema. Conclusiones. En la Región, hay lagunas importantes en la información y el conocimiento sobre la tungiasis. Es necesario comprender la carga, las características epidemiológicas, la distribución, la magnitud, los factores de riesgo relacionados y los reservorios, entre otros factores, para elaborar y aplicar medidas de control integradas adaptadas al contexto y los patrones de transmisión en las comunidades afectadas.

RESUMO Objetivos. Apresentar o estado do conhecimento sobre a epidemiologia da tungíase na Região das Américas. Métodos. Realizou-se uma pesquisa de estudos publicados de janeiro de 2007 a junho de 2021 sobre a epidemiologia da tungíase nas Américas nas bases de dados PubMed e LILACS, bem como uma pesquisa bibliográfica manual de artigos sobre a epidemiologia da tungíase. Resultados. Analisou-se um total de 83 artigos com informações de interesse sobre casos de tungíase e sua distribuição geográfica, prevalência e fatores de risco, ciclo vital, locais de transmissão e aspectos zoonóticos. Os ciclos vitais dentro e fora do hospedeiro foram pesquisados em detalhes. Em determinados contextos, todo o ciclo vital ocorre em ambientes fechados, o que possibilita a transmissão durante todo o ano. Relataram-se casos de 10 países; 71% deles no Brasil. Na população em geral, a prevalência variou de 1,0% a 82,6%, de acordo com o local. A prevalência específica por idade mostrou que a maior carga de doença ocorre em crianças e pessoas idosas. Estudos dos fatores de risco indicam que a tungíase está associada à extrema pobreza. Conclusões. Nas Américas, existem importantes lacunas de informação e conhecimento sobre a tungíase. É necessário compreender fatores como carga, epidemiologia, distribuição, magnitude, fatores de risco relacionados e reservatórios, entre outros, para desenvolver e implementar medidas integradas de controle adequadas ao contexto e aos padrões de transmissão nas comunidades afetadas.

Progress towards elimination of lymphatic filariasis in the Americas region.

In South and Central America, lymphatic filariasis (LF) is caused by Wuchereria bancrofti, which is transmitted by Culex quinquefasciatus, the only vector species in this region. Of the seven countries considered endemic for LF in the Americas in the last decade, Costa Rica, Suriname and Trinidad and Tobago were removed from the World Health Organization list in 2011. The remaining countries, Brazil, Dominican Republic, Guyana and Haiti, have achieved important progress in recent years. Brazil was the first country in the Americas to stop mass drug administration (MDA) and to establish post-MDA surveillance. Dominican Republic stopped MDA in all LF-endemic foci: La Ciénaga and Southwest passed the third Transmission Assessment Survey (TAS) and the Eastern focus passed TAS-1 in 2018. Haiti passed the TAS and interrupted transmission in >80% of endemic communes, achieving effective drug coverage. Guyana implemented effective coverage in MDAs in 2017 and 2018 and in 2019 scaled up the treatment for 100% of the geographical region, introducing ivermectin in the MDA in order to achieve LF elimination by the year 2026. The Americas region is on its way to eliminating LF transmission. However, efforts should be made to improve morbidity management to prevent disability of the already affected populations.

Piloting a surveillance system to monitor the global patterns of drug efficacy and the emergence of anthelmintic resistance in soil-transmitted helminth control programs: a Starworms study protocol.

To eliminate soil-transmitted helminth (STH) infections as a public health problem, the administration of benzimidazole (BZ) drugs to children has recently intensified. But, as drug pressure increases, the development of anthelmintic drug resistance (AR) becomes a major concern. Currently, there is no global surveillance system to monitor drug efficacy and the emergence of AR. Consequently, it is unclear what the current efficacy of the used drugs is and whether AR is already present. The aim of this study is to pilot a global surveillance system to assess anthelmintic drug efficacy and the emergence of AR in STH control programs. For this, we will incorporate drug efficacy trials into national STH control programs of eight countries (Bangladesh, Cambodia, Lao PDR, Vietnam, Ghana, Rwanda, Senegal and a yet to be defined country in the Americas). In each country, one trial will be performed in one program implementation unit to assess the efficacy of BZ drugs against STHs in school-aged children by faecal egg count reduction test. Stool samples will be collected before and after treatment with BZs for Kato-Katz analysis and preserved to purify parasite DNA. The presence and frequency of known single nucleotide polymorphisms (SNPs) in the ß-tubulin genes of the different STHs will subsequently be assessed. This study will provide a global pattern of drug efficacy and emergence of AR in STH control programs. The results will provide complementary insights on the validity of known SNPs in the ß-tubulin gene as a marker for AR in human STHs as well as information on the technical and financial resources required to set up a surveillance system. Finally, the collected stool samples will be an important resource to validate different molecular technologies for the detection of AR markers or to identify novel potential molecular markers associated with AR in STH.

Systematic review of the effectiveness of selected drugs for preventive chemotherapy for Taenia solium taeniasis.

BACKGROUND: Preventive chemotherapy is a useful tool for the control of Taenia solium taeniasis and cysticercosis. The aim of this systematic review is to assess the scientific evidence concerning the effectiveness and safety of different drugs in preventive chemotherapy for T. solium taeniasis in endemic populations. METHODS: A systematic review was conducted of controlled and uncontrolled studies, assessing the efficacy and adverse effects (among other outcomes) of albendazole, niclosamide and/or praziquantel for preventive chemotherapy of T. solium taeniasis. A comprehensive search was conducted for published and unpublished studies. Two reviewers screened articles, completed the data extraction and assessment of risk of bias. A meta-analysis of cure rate and relative reduction in prevalence was performed. The protocol for this review was registered on the International prospective register of systematic reviews (PROSPERO), number CRD42018112533. RESULTS: We identified 3555 records, of which we included 20 primary studies reported across 33 articles. Meta-analyses of drug and dose showed that a single dose of praziquantel 10mg/kg, albendazole 400mg per day for three consecutive days, or niclosamide 2g, resulted in better cure rates for T. solium taeniasis (99.5%, 96.4% and 84.3%, respectively) than praziquantel 5mg/kg or single dose albendazole 400mg (89.0% and 52.0%, respectively). These findings have a low certainty of evidence due to high risk of bias in individual studies and heterogeneity in combined estimates. In relation to side-effects, most studies reported either no or only mild and transient side-effects within the first three days following drug administration for all drugs and doses. CONCLUSION: Evidence indicated that praziquantel 10mg/kg, niclosamide 2g, and triple dose albendazole 400mg were effective as taenicides and could be considered for use in mass drug administration programs for the control of T. solium taeniasis. Evidence was not found that any of these drugs caused severe side effects at the indicated doses, although the extent of the available evidence was limited.

Epidemiological situation of yaws in the Americas: A systematic review in the context of a regional elimination goal.

BACKGROUND: Yaws is targeted for eradication by 2020 in the WHA66.12 resolution of the World Health Assembly. The objective of this study was to describe the occurrence of yaws in the Americas and to contribute to the compilation of evidence based on published data to undertake the certification of yaws eradication. METHODOLOGY: A systematic review of the epidemiological situation of yaws in the Americas was performed by searching in MEDLINE, Embase, LILACS, SCOPUS, Web of Science, DARE and Cochrane Database of Systematic Reviews. Experts on the topic were consulted, and institutional WHO/PAHO library databases were reviewed. PRINCIPAL FINDINGS: Seventy-five full-text articles published between 1839 and 2012 met the inclusion criteria. Haiti and Jamaica were the two countries with the highest number of papers (14.7% and 12.0%, respectively). Three-quarters of the studies were conducted before 1970. Thirty-three countries reported yaws case count or prevalence data. The largest foci in the history were described in Brazil and Haiti. The most recent cases reported were recorded in eight countries: Suriname, Guyana, Colombia, Haiti, Martinique, Dominica, Trinidad and Tobago, and Brazil. Gaps in information and heterogeneity were detected in the methodologies used and outcome reporting, making cross-national and chronological comparisons difficult. CONCLUSIONS: The lack of recent yaws publications may reflect, in the best-case scenario, the interruption of yaws transmission. It should be possible to reach the eradication goal in the region of the Americas, but it is necessary to collect more information. We suggest updating the epidemiological status of yaws, especially in two countries that need to assess ongoing transmission. Twenty-four countries need to demonstrate the interruption of transmission and declare its status of yaws endemicity, and sixteen countries should declare if they are yaws-free. It is necessary to formally verify the achievement of this goal in Ecuador.

Elimination of onchocerciasis from Colombia: first proof of concept of river blindness elimination in the world.

BACKGROUND: Onchocerciasis is a chronic parasitic infection originally endemic in 13 discrete regional foci distributed among six countries of Latin America (Brazil, Colombia, Ecuador, Guatemala, Mexico and Venezuela). In Colombia, this disease was discovered in 1965 in the Pacific Coast of the country. The National Onchocerciasis Elimination Program was established in 1993 with the aim of eliminating disease morbidity and infection transmission. In 2013, the World Health Organization (WHO) verified Colombia as free of onchocerciasis, becoming the first country in the world to reach such a goal. This report provides the empirical evidence of the elimination of Onchocerca volvulus transmission by Simulium exiguum (s.l.) after 12 years of 6-monthly mass drug administration of Mectizan® (ivermectin) to all the eligible residents living in this endemic area. METHODS: From 1996 onwards, a biannual community-based mass ivermectin administration programme was implemented, complemented by health education and community participation. In-depth parasitological, serological and entomological surveys were conducted periodically between 1998 and 2007 to evaluate the impact of ivermectin treatment according to the 2001 WHO guidelines. When the interruption of parasite transmission was demonstrated, the drug distribution ceased and a three-year post-treatment surveillance (PTS) period (2008-2010) was initiated. RESULTS: After 23 rounds of treatment, parasitological and ophthalmological assessments showed absence of microfilariae in skin and anterior chamber of the eyes. Serological tests proved lack of antibodies against O. volvulus in children under 10 years-old. A total of 10,500 S. exiguum flies tested by PCR had no L3 infection (infectivity rate = 0.0095%; 95% CI: 0.0029-0.049) during 2004, indicating interruption of parasite transmission. However, biannual ivermectin treatments continued until 2007 followed by a 3-year PTS period at the end of which 13,481 flies were analyzed and no infective flies were found (infectivity rate = 0%; 95% CI: 0.0-0.014). CONCLUSIONS: These results fulfilled the WHO criteria for onchocerciasis elimination. Consequently, in 2013 Colombia was verified as free of onchocerciasis, demonstrating that elimination of this neglected tropical disease is an achievable goal and paving the way for an elimination agenda to be followed by other endemic countries in Latin America and Africa.

Risk factors for treatment interruption and severe adverse effects to benznidazole in adult patients with Chagas disease.

BACKGROUND: Etiological treatment of Chagas disease in chronic asymptomatic patients is still in debate and the adverse effects of traditional drugs are one of the main concerns in clinical practice. This study evaluated retrospectively the safety profile of benznidazole (BZN) and identified predictive factors for definite treatment interruption and development of severe reactions in adult patients treated with BZN in Colombia. METHODS: Retrospective follow-up study conducted by review of medical records of adults with chronic Chagas disease treated with BZN in Colombia. A parametric survival analysis based on a generalized gamma distribution was used for assessing risk factors for treatment interruption. A multinomial logistic regression model was used to estimate the probability of severe adverse drug reactions (ADRs). Statistical associations were expressed as time ratios (TR) and adjusted odds ratios (aOR) respectively. RESULTS: In total 224 adults patients treated with BZN were included; 172 (76.8%) completed the standard therapy (60 days of treatment), 205 (91.5%) presented ADRs and 52 cases (23.2%) required treatment interruption. The predominant symptoms were: rash (37.9%), itching (33.7%), epigastric pain (26.4%), abdominal bloating (24.2%) and nausea (22.1%). ADRs were mild (57.4%), moderate (35.5%) and severe (7.3%). Time to treatment interruption was significantly shorter when using doses of BZN ≥ 6 mg/kg/day (TR 0.55; 95% CI 0.39-0.76), presenting severe ADRs (TR 0.12; 95% CI: 0.07-0.19) and eosinophilia (TR 0.68; 95% CI: 0.49-0.94). Female sex (aOR 3.98; 95% CI 1.56-10.16), dose of BZN ≥ 6 mg/kg/day (aOR 1.41; 95% CI 1.17-1.70) and presence of > 3 ADRs (aOR 6.47; 95% CI 1.24-34.34) were considered as risk factors for developing severe ADRs. CONCLUSIONS: Dose, severity of ADRs, eosinophilia and female sex were the main predictors for treatment interruption or severe ADRs. The potential implications of these findings are discussed.

Risk factors associated with Chagas disease in pregnant women in Santander, a highly endemic Colombian area.

OBJECTIVE: To determine the prevalence and risk factors associated with Chagas disease in pregnant women in an endemic area of Santander, Colombia. METHODS: Cross-sectional study included 23 municipalities of Santander, Colombia. Serological IFAT and ELISA tests were undertaken to detect IgG anti- Trypanosoma cruzi. A questionnaire was conducted for assessing the risk factors of each participant. Newborns were evaluated at birth and followed up to 1 year of age to determine congenital infection. RESULTS: An overall prevalence of 3.2% (95% CI 2.4-4.2) among 1518 pregnant women was detected. Prevalences by provinces were as follows: Guanentina: 6.0% (95% CI 4.1-8.5), García Rovira: 2.9% (95% CI: 1.5-4.8) and Comunera: 0.4% (0.4-2.3). The main risk factors identified were age >32 years old (OR: 2.1; 95% CI: 1.1-3.9); currently having a thatched roof (OR: 11.8; CI95% 2.2-63.2) and a thatched roof during childhood (OR: 3.0; 95% CI: 1.4-6.6); having below primary school education level (OR: 4.6; 95% CI: 2.2-9.5); and a history of a close contact with the vector (triatomine bugs) at least once during their lifetime (OR: 6.9; 95% CI: 3.7-12.9). No congenital cases were detected by parasitological or serological techniques. CONCLUSIONS: Prevalence of Chagas disease in pregnant women is a potential source of infection in this Colombian endemic area. The main risk factors associated with seropositivity were related to conditions favouring the contact with the vector. The results show that it is necessary to continue an active surveillance in order to offer diagnosis and treatment to mothers and their newborns in addition to screening to pregnant women from endemic areas.

Safety Profile of Nifurtimox and Treatment Interruption for Chronic Chagas Disease in Colombian Adults.

Nifurtimox (NFX) is one of the approved drugs used to treat Chagas disease. Safety profile studies and models on risk factors for treatment interruption in adults are scarce in Latin America. This study evaluated retrospectively the medical records of adult Chagas disease patients treated with NFX between 2007 and 2012 in Bogotá, Colombia. An accelerated failure time model was used, and associations were expressed as time ratio (TR). In total, 76 adult patients with NFX were included: 60 (79.0%) completed 60 days of treatment, 61 (80.3%) presented adverse drug reactions (ADRs), and 16 (21.0%) required treatment interruption. The predominant symptoms were epigastric pain (23.7%), nauseas (18.4%), sleep disturbances (18.4%), loss of appetite (17.1%), and temporary loss of memory (15.2%). ADRs were classified as mild (64.5%), moderate (30.4%), and severe (5.1%). Time of treatment was significantly longer when presenting ≤ 3 ADRs (TR: 1.78; 95% CI: 1.04-3.03), presence of non-severe ADRs (TR: 6.52; 95% CI: 3.24-13.1), doses of NFX ≤ 8 mg/kg/day (TR: 1.78; 95% CI: 0.90-3.49), and age < 48 years (TR: 1.57; 95% CI: 0.90-2.74). Treatment with NFX in adults caused a high frequency of ADRs, but most of the cases were mild and did not require treatment interruption. Severity and number of ADRs were the main predictors for treatment interruption.