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Villamizar-Monsalve MA, López-Abán J, Vicente B, Peláez R, Muro A. Current drug strategies for the treatment and control of schistosomiasis. Expert Opin Pharmacother 2024:1-12. [PMID: 38511392 DOI: 10.1080/14656566.2024.2333372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/18/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION Schistosomiasis, one of the current Neglected Tropical Diseases (NTDs) affects over 230 million people globally, with nearly 700 million at risk in more than 74 countries. Praziquantel (PZQ) has served as the primary treatment for the past four decades; however, its effectiveness is limited as it solely eliminates adult worms. In regions where infections are frequent, PZQ exhibits only temporary efficacy and has restricted potential to disrupt the prolonged transmission of the disease. AREAS COVERED A comprehensive exploration using the PubMed database was conducted to review current pharmacotherapy approaches for schistosomiasis. This review also encompasses recent research findings related to potential novel therapeutics and the repurposing of existing drugs. EXPERT OPINION Current schistosoma treatment strategies, primarily relying on PZQ, face challenges like temporary effectiveness and limited impact on disease transmission. Drug repurposing, due to economic constraints, is decisive for NTDs. Despite PZQ's efficacy, its failure to prevent reinfection highlights the need for complementary strategies, especially in regions with persistent environmental foci. Integrating therapies against diverse schistosome stages boosts efficacy and impedes resistance. Uncovering novel agents is essential to address resistance concerns in tackling this neglected tropical disease. Integrated strategies present a comprehensive approach to navigate the complex challenges.
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Affiliation(s)
- María Alejandra Villamizar-Monsalve
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Salamanca, Spain
| | - Julio López-Abán
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Salamanca, Spain
| | - Belén Vicente
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Salamanca, Spain
| | - Rafael Peláez
- Organic and Pharmaceutical Chemistry Department, Biomedical Research Institute of Salamanca Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Salamanca, Spain
| | - Antonio Muro
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Salamanca, Spain
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Forson AO, Awuah RB, Mohammed AR, Owusu-Asenso CM, Akosah-Brempong G, Abdulai A, Sraku IK, Dhikrullahi SB, Atakora SB, Attah SK, Afrane YA. Coverage of preventive measures and surveillance for neglected tropical diseases in hard-to-reach communities in Ghana. BMC Public Health 2023; 23:1784. [PMID: 37710219 PMCID: PMC10500849 DOI: 10.1186/s12889-023-16652-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Neglected tropical diseases (NTDs) are a major public health burden which mainly affects poor populations living in tropical environments and hard-to-reach areas. The study sought to examine coverage of preventive efforts, and case surveillance for NTDs in hard-to-reach communities in Ghana. METHODS The study investigated treatment efforts for lymphatic filariasis (LF), and onchocerciasis and schistosomiasis/soil transmitted helminths (SCH/STH) at household level, in difficult-to-access communities in Ghana. A total of 621 households were sampled from 6 communities in the Western, Oti and Greater Accra regions. RESULTS Over 95% of the households surveyed were covered under mass drug administration (MDA) campaigns for lymphatic filariasis (LF) and onchocerciasis. More than 80% of households had received at least two visits by community drug distributors under the MDA campaigns in the last two years preceding the study. In addition, over 90% of households in the LF and onchocerciasis endemic communities had at least one member using anthelminthic medications under the MDA campaigns in the 12 months preceding the study. However, households where no member had taken anthelminthic medications in 12 months preceding the study were over 6 times likely to have someone in the household with LF. CONCLUSIONS This study determined that SCH/STH, LF and onchocerciasis are of serious public health concern in some communities in Ghana. There is an urgent need for holistic practical disease control plan involving both financial and community support to ensure total control of NTDs in difficult-to-access communities is achieved.
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Affiliation(s)
- Akua Obeng Forson
- Department of Medical Microbiology, Centre for Vector-Borne Diseases Research, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
| | - Raphael Baffour Awuah
- Regional Institute for Population Studies (RIPS), University of Ghana, Legon. Accra, Ghana
| | - Abdul Rahim Mohammed
- Department of Medical Microbiology, Centre for Vector-Borne Diseases Research, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana
| | - Christopher Mfum Owusu-Asenso
- Department of Medical Microbiology, Centre for Vector-Borne Diseases Research, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana
| | - Gabriel Akosah-Brempong
- Department of Medical Microbiology, Centre for Vector-Borne Diseases Research, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana
| | - Anisa Abdulai
- Department of Medical Microbiology, Centre for Vector-Borne Diseases Research, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana
| | - Isaac Kwame Sraku
- Department of Medical Microbiology, Centre for Vector-Borne Diseases Research, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana
| | - Shittu B Dhikrullahi
- Department of Medical Microbiology, Centre for Vector-Borne Diseases Research, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana
| | - Sefa Bonsu Atakora
- Department of Medical Microbiology, Centre for Vector-Borne Diseases Research, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana
| | - Simon K Attah
- Department of Medical Microbiology, Centre for Vector-Borne Diseases Research, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana
| | - Yaw Asare Afrane
- Department of Medical Microbiology, Centre for Vector-Borne Diseases Research, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana.
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Ulasi II, Burdmann EA, Ijoma CK, Chou LF, Yang CW. Neglected and Emerging Infections of The Kidney. Semin Nephrol 2023; 43:151472. [PMID: 38216373 DOI: 10.1016/j.semnephrol.2023.151472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Abstract
Individuals, societies, and the environment are affected by neglected and emerging diseases. These diseases result in a variety of severe outcomes, including permanent disabilities, chronic diseases such as chronic kidney disease, and even mortality. Consequences include high health care expenditures, loss of means of support, social stigma, and social exclusion. The burden of these diseases is exacerbated in low- and middle-income countries owing to poverty, inadequate fundamental infrastructure, and the absence of health and social protection systems. The World Health Organization is committed to promoting the following public health strategies to prevent and control neglected tropical diseases: preventive chemotherapy; intensive case management; vector control; provision of safe drinkable water, sanitation, and hygiene; and veterinary public health. In addition, it promotes a One Health strategy, which is a collaborative, multisectoral, and interdisciplinary approach to achieving the greatest health outcomes by recognizing the interdependence of human beings, animals, plants, and their shared environment. This article provides knowledge and strategies for the prevention and treatment of neglected and emerging diseases, with a particular concentration on kidney diseases, as part of a comprehensive approach to One Health.
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Affiliation(s)
- Ifeoma I Ulasi
- Renal Unit, Department of Medicine, College of Medicine, University of Nigeria-University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria; Renal Unit, Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
| | - Emmanuel A Burdmann
- Laboratório de Investigação Médica (LIM 12), Faculdade de Medicina da Universidade de So Paulo, So Paulo, Brazil
| | - Chinwuba K Ijoma
- Renal Unit, Department of Medicine, College of Medicine, University of Nigeria-University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Li-Fang Chou
- Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chih-Wei Yang
- Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Beld L, Jung H, Bulman CA, Rosa BA, Fischer PU, Janetka JW, Lustigman S, Sakanari JA, Mitreva M. Aspartyl Protease Inhibitors as Anti-Filarial Drugs. Pathogens 2022; 11:707. [PMID: 35745561 DOI: 10.3390/pathogens11060707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/05/2022] [Accepted: 06/13/2022] [Indexed: 12/30/2022] Open
Abstract
The current treatments for lymphatic filariasis and onchocerciasis do not effectively kill the adult parasitic nematodes, allowing these chronic and debilitating diseases to persist in millions of people. Thus, the discovery of new drugs with macrofilaricidal potential to treat these filarial diseases is critical. To facilitate this need, we first investigated the effects of three aspartyl protease inhibitors (APIs) that are FDA-approved as HIV antiretroviral drugs on the adult filarial nematode, Brugia malayi and the endosymbiotic bacteria, Wolbachia. From the three hits, nelfinavir had the best potency with an IC50 value of 7.78 µM, followed by ritonavir and lopinavir with IC50 values of 14.3 µM and 16.9 µM, respectively. The three APIs have a direct effect on killing adult B. malayi after 6 days of exposure in vitro and did not affect the Wolbachia titers. Sequence conservation and stage-specific gene expression analysis identified Bm8660 as the most likely primary aspartic protease target for these drug(s). Immunolocalization using antibodies raised against the Bm8660 ortholog of Onchocerca volvulus showed it is strongly expressed in female B. malayi, especially in metabolically active tissues such as lateral and dorsal/ventral chords, hypodermis, and uterus tissue. Global transcriptional response analysis using adult female B. pahangi treated with APIs identified four additional aspartic proteases differentially regulated by the three effective drugs, as well as significant enrichment of various pathways including ubiquitin mediated proteolysis, protein kinases, and MAPK/AMPK/FoxO signaling. In vitro testing against the adult gastro-intestinal nematode Trichuris muris suggested broad-spectrum potential for these APIs. This study suggests that APIs may serve as new leads to be further explored for drug discovery to treat parasitic nematode infections.
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Falisse JB, Mpanya A. Clinical trials as disease control? The political economy of sleeping sickness in the Democratic Republic of the Congo (1996-2016). Soc Sci Med 2022; 299:114882. [PMID: 35299059 DOI: 10.1016/j.socscimed.2022.114882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 01/28/2022] [Accepted: 03/06/2022] [Indexed: 10/18/2022]
Abstract
Human African Trypanosomiasis (HAT), commonly known as sleeping sickness, is closer than ever to being eliminated as a public health problem. The main narratives for the impressive drop in cases allude to drugs discovery and global financing and coordination. They raise questions about the relationship between well-funded international clinical research and much less well-endowed national disease control programmes. They need to be complemented with a solid understanding of how (and why) national programmes that do most of the frontline work are structured and operate. We analyse archives and in-depth interviews with key stakeholders and explore the role the national HAT programme played in the Democratic Republic of the Congo (DRC), a country that consistently accounts for over 60% of HAT cases worldwide. The programme grew strongly between 1996, when it was barely surviving, and 2016. Our political economy lens highlights how the leadership of the programme managed to carve itself substantial autonomy within the health system, forged new international alliances, and used clinical trials and international research to not only improve treatment and diagnosis but also to enhance its under-resourced disease control system. The DRC, a country often described as 'fragile', stands out as having an efficient national HAT programme that made full use of a window of opportunity that arose in the early 2000s when international researchers and donors responded to the ambition to simplify disease control and make HAT treatment more humane. We discuss the sustainability of both the vertical approach embodied in the DRC's national HAT programme and its funding model at a time when the number of HAT cases is at an all-time low and better integration within the health system is urgent. Our study provides insights for collaborations between unevenly-resourced international research efforts and national health programmes.
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Affiliation(s)
- Jean-Benoît Falisse
- Centre of African Studies and Edinburgh Futures Institute, University of Edinburgh. 15a George Square, Edinburgh, EH8 9LD, United Kingdom.
| | - Alain Mpanya
- Institut Supérieur des Techniques Médicales de Lubumbashi (ISTM/Lubumbashi), the Democratic Republic of the Congo.
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Maheshwari KK, Bandyopadhyay D. Heterocycles in the Treatment of Neglected Tropical Diseases. Curr Med Chem 2021; 28:472-495. [PMID: 32072886 DOI: 10.2174/0929867327666200219141652] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/03/2020] [Accepted: 01/25/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Neglected Tropical Diseases (NTDs) affect a huge population of the world and the majority of the victims belong to the poor community of the developing countries. Until now, the World Health Organization (WHO) has identified 20 tropical diseases as NTDs that must be addressed with high priority. However, many heterocyclic scaffolds have demonstrated potent therapeutic activity against several NTDs. OBJECTIVE There are three major objectives: (1) To discuss the causes, symptoms, and current status of all the 20 NTDs; (2) To explore the available heterocyclic drugs, as well as their mechanisms of action (if known), that are being used to treat NTDs; (3) To develop general awareness on NTDs among the medicinal/health research community and beyond. METHODS The 20 NTDs have been discussed according to their alphabetic orders along with the possible heterocyclic remedies. The current status of treatment with an emphasis on the heterocyclic drugs (commercially available and investigational) has been outlined. In addition, a brief discussion of the impacts of NTDs on socio-economic conditions is included. RESULTS NTDs are often difficult to diagnose and the problem is worsened by the unhealthy hygiene, improper awareness, and inadequate healthcare in the developing countries where these diseases primarily affect poor people. The statistics include the duration of suffering, the number of individuals affected, and access to healthcare and medication. The mechanisms of action of various heterocyclic drugs, if reported, have been briefly summarized. CONCLUSION Scientists and pharmaceutical corporations should allocate more resources to reveal the in-depth mechanism of action of many heterocyclic drugs that are currently being used for the treatment of NTDs. Analysis of current heterocyclic compounds and the development of new medications can help in the fight to reduce/remove the devastating effects of NTDs. An opinion-based concise review has been presented. Based on the available literature, this is the first attempt to present all the 20 NTDs and related heterocyclic compounds under the same umbrella.
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Affiliation(s)
- Kush K Maheshwari
- Department of Chemistry, The University of Texas Rio Grande Valley, 1201 West University Drive, Edinburg, Texas 78539, United States
| | - Debasish Bandyopadhyay
- Department of Chemistry, The University of Texas Rio Grande Valley, 1201 West University Drive, Edinburg, Texas 78539, United States
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Madon S, Amaguru JO, Malecela MN, Michael E. Can mobile phones help control neglected tropical diseases? Experiences from Tanzania. Soc Sci Med 2013; 102:103-10. [PMID: 24565147 DOI: 10.1016/j.socscimed.2013.11.036] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 10/18/2013] [Accepted: 11/19/2013] [Indexed: 10/26/2022]
Abstract
The increasing proliferation of mobiles offers possibilities for improving health systems in developing countries. A case in point is Tanzania which has piloted a mobile phone-based Management Information System (MIS) for the control of neglected tropical diseases (NTDs) where village health workers (VHWs) were given mobile phones with web-based software to test the feasibility of using frontline health workers to capture data at point of source. Based on qualitative case study research carried out in 2011, we found that providing mobile phones to VHWs has helped to increase the efficiency of routine work boosting the motivation and self-esteem of VHWs. However, despite these advantages, the information generated from the mobile phone-based NTD MIS has yet to be used to support decentralised decision-making. Even with improved technology and political will, the biggest hindrance to local usage of information for health planning is the lack of synthesised and analysed health information from the district and national levels to the villages. Without inculcating a culture of providing health information feedback to frontline workers and community organisations, the benefits of the intervention will be limited. If not addressed, this will mean that mobiles have maintained the one-way upward flow of information for NTD control and simply made reporting more hi-tech.
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Affiliation(s)
- Shirin Madon
- Dept. of Intl. Development, London School of Economics & Political Science, Houghton Street, London WC2A 2AE, UK; Dept. of Management, London School of Economics & Political Science, Houghton Street, London WC2A 2AE, UK.
| | - Jackline Olanya Amaguru
- Department of Social Policy, London School of Economics & Political Science, Houghton Street, London WC2A 2AE, UK; CBM - Haiti, 10 Rue Latortue, Delmas, 48, Port au Prince, Haiti
| | - Mwele Ntuli Malecela
- National Institute for Medical Research, 2448, Ocean Road, P.O. Box 9653, Dar es Salaam, Tanzania
| | - Edwin Michael
- Dept. of Biological Sciences, University of Notre Dame, Notre Dame, IN 46556-0369, USA
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