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Udo S, Ogbu PS, Tsaku PA, Tukur A, NewMarch A. An evaluation of mental health integration in the neglected tropical diseases program in Zamfara, North-west Nigeria. Int Health 2024; 16:i52-i59. [PMID: 38547351 PMCID: PMC10977942 DOI: 10.1093/inthealth/ihae003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/18/2023] [Accepted: 01/09/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Mental health and neglected tropical diseases (NTDs) are critical in healthcare systems, especially in low- and middle-income countries. Several policies are planned or designed by health stakeholders to address the mental health needs of people affected by NTDs. Still, the impact of such policies seems to be of no consequence. METHODS The GAD-7 and PHQ-9 tools were used to determine the rate of depression and anxiety, respectively, among people affected by skin NTDs (leprosy and lymphatic filariasis [LF]) in Zamfara State, North-west Nigeria. The study also evaluated the barriers to the uptake of mental health services for people affected by skin NTDs in the state. We assessed 48 people affected by NTDs (leprosy, 32; lymphatic filariasis, 16) along with a corresponding 48 people who served as controls in the study. Qualitative interviews were carried out with the participants to elicit the barriers to mental health services for people affected by NTDs. Additionally, 48 selected healthcare workers from the state were assessed for their skills and capacity to offer mental health services. RESULTS We found anxiety disorder present in 100% of the people living with LF and in 62% of the people living with leprosy. Depression was also found in 56% and 75% of the people living with leprosy and LF, respectively. An assessment of the barriers to the uptake of mental health services reveals that most people with NTDs are constrained by a lack of money to visit hospitals, the fear of stigmatisation and discrimination and long distances to health centres. Regarding the healthcare workers, the skills and capacity to offer mental health services were very low. CONCLUSIONS We conclude that for mental health services to be integrated into the community health system for people with NTDs, there should be a concerted effort by all stakeholders and the intervention should be context specific instead of generalised. CONTEXTE La santé mentale et les maladies tropicales négligées (MTN) sont des problématiques centrales dans la santé, en particulier dans les pays à revenu faible ou intermédiaire. Plusieurs politiques sont conçues par les acteurs de la santé publique pour répondre aux besoins de soins en santé mentale pour les personnes touchées par les MTN. Pourtant, le bilan reste mitigé quant à l'efficacité de ces soins. MÉTHODES Les outils GAD-7 et PHQ-9 ont été utilisés pour déterminer le taux de dépression et d'anxiété chez les personnes atteintes de MTN cutanées (lèpre et filariose lymphatique) dans l'État de Zamfara, au nord-ouest du Nigeria. L'étude a également évalué les obstacles à l'utilisation des services de santé mentale pour les personnes atteintes de MTN cutanées dans l'État. Nous avons évalué 48 personnes atteintes de MTN (lèpre : 32, filariose lymphatique : 16) ainsi que 48 personnes correspondantes qui ont servi de témoins dans l'étude. Des entretiens qualitatifs ont été menés avec les participants afin d'identifier les obstacles aux services de santé mentale pour les personnes atteintes de MTN. En outre, 48 professionnels de la santé sélectionnés dans l'État ont été évalués pour déterminer leurs compétences et leur capacité à offrir des services de santé mentale. RÉSULTATS Nous avons trouvé des troubles anxieux chez 100% des personnes atteintes de filariose lymphatique et chez 62% des personnes atteintes de lèpre. La dépression touche 56% et 75% des personnes vivant avec la lèpre et la filariose lymphatique respectivement. Une évaluation des obstacles à l'utilisation des services de santé mentale révèle que la plupart des personnes atteintes de MTN sont limitées par le manque d'argent pour se rendre à l'hôpital, la peur de la stigmatisation et de la discrimination, et les longues distances à parcourir pour se rendre dans les centres de santé. Les compétences et les capacités des professionnels de la santé à offrir des services de santé mentale sont très faibles. CONCLUSION L'efficacité d'un protocole de soins pour les patients atteints de MTN (traitant la pathologie physique et d'éventuelles pathologies psychiatriques associées) nécessite une intégration des services de santé mentale dans le système de santé communautaire. ANTECEDENTES La salud mental y las enfermedades tropicales desatendidas (ETDs), son fundamentales en los sistemas sanitarios, especialmente en los países de renta baja y media. Las partes interesadas en la sanidad planean o diseñan varias políticas para abordar las necesidades de salud mental de las personas afectadas por ETDs. Sin embargo, el impacto de dichas políticas parece ser nulo. MÉTODOS Se utilizaron las herramientas GAD-7 y PHQ-9 para determinar la tasa de depresión y ansiedad, respectivamente, entre las personas afectadas por ETDs cutáneas (lepra y filariasis linfática) en el Estado de Zamfara, al noroeste de Nigeria. El estudio también evaluó las barreras para la aceptación de los servicios de salud mental por parte de las personas afectadas por ETDs cutáneas en el Estado. Se evaluó a 48 personas afectadas por ETDs (lepra: 32; filariasis linfática: 16) y a otras 48 que sirvieron de control en el estudio. Se llevaron a cabo entrevistas cualitativas con los participantes para determinar las barreras a los servicios de salud mental para las personas afectadas por ETDs. Además, se evaluaron las habilidades y la capacidad para ofrecer servicios de salud mental de 48 profesionales sanitarios del Estado. RESULTADOS Encontramos trastorno de ansiedad presente en el 100% de las personas que vivían con filariasis linfática y en el 62% de las personas que vivían con lepra. También se encontró depresión en el 56% y el 75% de las personas que vivían con lepra y filariasis linfática respectivamente. Una evaluación de los obstáculos para la utilización de los servicios de salud mental revela que la mayoría de las personas con ETDs se ven limitadas por la falta de dinero para acudir a los hospitales, el miedo a la estigmatización, la discriminación y las largas distancias hasta los centros sanitarios. Por parte del personal sanitario, los conocimientos y la capacidad para ofrecer servicios de salud mental eran muy escasos. CONCLUSIONES Para que los servicios de salud mental para personas con ETD se integren en el sistema sanitario comunitario, debe haber una concertación entre todas las partes interesadas y la intervención debe ser específica para cada contexto en lugar de generalizada.
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Affiliation(s)
- Sunday Udo
- Leprosy Mission Nigeria, 12/14 Kings Drive, Fort Royal Homes Estate, Lugbe, Abuja, Nigeria
| | - Pius Sunday Ogbu
- Leprosy Mission Nigeria, 12/14 Kings Drive, Fort Royal Homes Estate, Lugbe, Abuja, Nigeria
| | - Paul A Tsaku
- Leprosy Mission Nigeria, 12/14 Kings Drive, Fort Royal Homes Estate, Lugbe, Abuja, Nigeria
| | - Aliyu Tukur
- Zamfara State Tuberculosis Buruli Ulcer, and Leprosy Control Programme, Gusau, Nigeria
| | - Andrew NewMarch
- Leprosy Mission Australia, 37-39 Ellingworth Parade, Box Hill, VIC 3128 Australia
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Ojo TM, Afolayan OG, Alex-Okoh MO. Windows of opportunity in integrating mental health into care of neglected tropical diseases: the Nigeria experience. Int Health 2024; 16:i7-i8. [PMID: 38547343 PMCID: PMC10977950 DOI: 10.1093/inthealth/ihad109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 11/15/2023] [Indexed: 04/02/2024] Open
Abstract
In this invited commentary, the Mental Health and the Neglected Tropical Diseases(NTDs) Program leads in the Nigerian Federal Ministry of Health and Social Welfare share the opportunities that have arisen from recent global progress in normative guidance and political interest in the intersection of mental health and NTDs. They describe the new collaboration that has taken place between their programs, e.g. contributing to the World Health Organization Essential Care Package for Mental Health, Stigma and NTDs and integration of mental health for the first time into the new National NTD Masterplan.
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Affiliation(s)
- Tunde M Ojo
- Department of Public Health, Federal Ministry of Health and Social Welfare, Abuja, Nigeria
- Department of Psychiatry, University of Abuja, Abuja, Nigeria
| | - Oluwole G Afolayan
- Department of Public Health, Federal Ministry of Health and Social Welfare, Abuja, Nigeria
| | - Morenike O Alex-Okoh
- Department of Public Health, Federal Ministry of Health and Social Welfare, Abuja, Nigeria
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Nganda M, Luhaka P, Kukola J, Ding Y, Bulambo C, Kadima J, Kim J, Marshall S, Mulamba R, Ngenyibungi S, Ngondu F, Seekles M, Sabuni L, Dean L. Participatory development of a community mental wellbeing support package for people affected by skin neglected tropical diseases in the Kasai province, Democratic Republic of Congo. Int Health 2024; 16:i30-i41. [PMID: 38547352 PMCID: PMC10977949 DOI: 10.1093/inthealth/ihae008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/14/2023] [Accepted: 01/10/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Skin neglected tropical diseases (NTDs) produce signs and symptoms that are often physically challenging, stigmatizing and have a negative impact on the mental wellbeing of people affected. In the Democratic Republic of Congo (DRC), little is known about the mental wellbeing experiences of people affected by skin NTDs and support is lacking. We collaborated with ongoing NTD programs, the Ministry of Health and people affected to evidence experiences and opportunities for change and co-developed a mental wellbeing support package for people affected and local health system actors. METHODS This implementation research study used the photovoice method alongside key-informant interviews to evidence mental wellbeing challenges in people affected by skin NTDs and explore opportunities for change. These were used to co-develop a skin NTD mental wellbeing support package with people affected, community members and local health system actors through a participatory workshop. RESULTS Stigma, discrimination, decreased livelihoods and mental wellbeing challenges were evidenced by people affected by skin NTDs, their communities and health system actors. Participants identified and co-established community-led peer support groups, strengthened with basic knowledge on psychosocial support, and income-generating or recreational initiatives to support mental wellbeing of people affected by skin NTDs. CONCLUSIONS Co-developing a support package with persons affected, community members and health system actors is a step towards holistic care for people affected by skin NTDs and promotes uptake and ownership of intervention components. CONTEXTE Les maladies tropicales négligées (MTN) cutanées produisent des signes et des symptômes qui sont souvent difficiles à supporter physiquement, ils sont également stigmatisants et ont un impact négatif sur le bien-être mental des personnes touchées. En République Démocratique du Congo (RDC), on sait peu de choses sur le bien-être mental des personnes atteintes de MTN cutanées, et le soutien fait défaut. Nous avons collaboré avec les programmes de lutte contre les MTN en cours, le ministère de la santé et les personnes touchées pour mettre en évidence les expériences et les possibilités de changement, et nous avons élaboré un programme de soutien au bien-être mental pour les personnes touchées et les acteurs du système de santé local. MÉTHODES UTILISÉES Cette étude de recherche sur la mise en œuvre a utilisé la méthode photovoice, ainsi que des entretiens avec des informateurs clés, afin de mettre en évidence les problèmes de bien-être mental des personnes touchées par les MNT cutanées. Ces éléments ont été utilisés pour élaborer un programme de soutien au bien-être mental des MNT cutanées avec les personnes concernées, les membres de la communauté et les acteurs du système de santé local dans le cadre d'un atelier participatif. RÉSULTATS La stigmatisation, la discrimination, la diminution des moyens de subsistance et les problèmes de bien-être mental ont été mis en évidence par les personnes atteintes de MTN cutanées, leurs communautés et les acteurs du système de santé. Les participants ont identifié et mis en place des groupes communautaires de soutien par les pairs, renforcés par des connaissances de base en matière de soutien psychosocial, et des initiatives génératrices de revenus/récréatives pour soutenir le bien-être mental des personnes touchées par les MTN cutanées. CONCLUSIONS L'élaboration d'un ensemble de mesures de soutien en collaboration avec les personnes concernées, les membres de la communauté et les acteurs du système de santé, constitue une étape vers une prise en charge holistique des personnes atteintes de MNT cutanées et favorise l'adoption et l'appropriation des composantes de l'intervention. ANTECEDENTES Las enfermedades tropicales desatendidas (ETDs) cutáneas producen signos y síntomas que a menudo suponen un reto físico, estigmatizan y tienen un impacto negativo en el bienestar mental de las personas afectadas. En la República Democrática del Congo (RDC), se sabe poco sobre las experiencias de bienestar mental de las personas afectadas por ETDs cutáneas, y falta apoyo. Colaboramos con los programas en curso sobre las ETDs, el Ministerio de Sanidad y las personas afectadas para poner de manifiesto las experiencias y las oportunidades de cambio, y desarrollamos de manera conjunta un paquete de apoyo al bienestar mental para las personas afectadas y los agentes del sistema sanitario local. MÉTODOS Este estudio de investigación utilizó el método fotovoz, junto con entrevistas a informantes clave, para poner de manifiesto los desafíos de bienestar mental de las personas afectadas por ETDs cutáneas y explorar las oportunidades de cambio. Estos datos se utilizaron para desarrollar un paquete de apoyo al bienestar mental de manera conjunta con las personas afectadas por las ETDs cutáneas, los miembros de la comunidad y los actores del sistema sanitario local a través de un taller participativo. RESULTADOS El estigma, la discriminación, la disminución de los medios de subsistencia y los problemas de bienestar mental fueron evidenciados por las personas afectadas por ETD cutáneas, sus comunidades y los agentes del sistema sanitario. Los participantes identificaron y establecieron conjuntamente grupos de apoyo entre pares dirigidos por la comunidad, fortalecidos con conocimientos básicos sobre apoyo psicosocial e iniciativasrecreativas y generadoras de ingresos para apoyar el bienestar mental de las personas afectadas por las ETD cutáneas. CONCLUSIÓNS El desarrollo conjunto de un paquete de medidas de apoyo con las personas afectadas, los miembros de la comunidad y los actores del sistema sanitario es un paso hacia la atención holística de las personas afectadas por las NTDs a y promueve la adopción y apropiación de los componentes de la intervención.
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Affiliation(s)
- Motto Nganda
- Liverpool School of Tropical Medicine, Department of International Public Health, Liverpool, L3 5QA, UK
| | - Pierre Luhaka
- Leprosy Mission DRC, 283, Avenue Kato, Commune de Lingwala, B.P. 14347, Kinshasa, Democratic Republic of Congo
| | - Junior Kukola
- Leprosy Mission DRC, 283, Avenue Kato, Commune de Lingwala, B.P. 14347, Kinshasa, Democratic Republic of Congo
| | - Yan Ding
- Liverpool School of Tropical Medicine, Department of International Public Health, Liverpool, L3 5QA, UK
| | - Christian Bulambo
- Leprosy Mission DRC, 283, Avenue Kato, Commune de Lingwala, B.P. 14347, Kinshasa, Democratic Republic of Congo
| | - Jacob Kadima
- Leprosy Mission DRC, 283, Avenue Kato, Commune de Lingwala, B.P. 14347, Kinshasa, Democratic Republic of Congo
| | - Joy Kim
- Effect Hope, Markham, ON, Canada
| | | | - Raphael Mulamba
- Leprosy Mission DRC, 283, Avenue Kato, Commune de Lingwala, B.P. 14347, Kinshasa, Democratic Republic of Congo
| | | | - Florent Ngondu
- Ministry of Health, National Leprosy Programme, Kinshasa, Democratic Republic of Congo
| | - Maaike Seekles
- Liverpool School of Tropical Medicine, Department of International Public Health, Liverpool, L3 5QA, UK
| | - Louis Sabuni
- Leprosy Mission DRC, 283, Avenue Kato, Commune de Lingwala, B.P. 14347, Kinshasa, Democratic Republic of Congo
| | - Laura Dean
- Liverpool School of Tropical Medicine, Department of International Public Health, Liverpool, L3 5QA, UK
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Kollie KK, Theobald S, Jones L, Kpadeh O, Nallo G, Borbor D, Taylor M, Dean L, Phillip M, Godwin-Akpan TG, Mensah DF, Wickenden A, Kollie JT, Rogers E, Zaizay Z, Stewart M. Multimethod evaluation of health services integration for neglected tropical diseases requiring case management in Liberia. BMJ Glob Health 2024; 9:e012599. [PMID: 38238023 PMCID: PMC10806886 DOI: 10.1136/bmjgh-2023-012599] [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: 04/17/2023] [Accepted: 12/13/2023] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION The WHO neglected tropical disease (NTD) roadmap stresses the importance of integrating NTDs requiring case management (CM) within the health system. The NTDs programme of Liberia is among the first to implement an integrated approach and evaluate its impact. METHODS A retrospective study of three of five CM-NTD-endemic counties that implemented the integrated approach was compared with cluster-matched counties with non-integrated CM-NTD. We compared trends in CM-NTD integrated versus non-integrated county clusters. We conducted a pre-post comparison of WHO high-level outcomes using data collected during intervention years compared with baseline in control counties. Changes in health outcomes, effect sizes for different diseases and rate ratios with statistically significant differences were determined. Complementary qualitative research explored CM-NTD stakeholders' perceptions, analysed through the framework approach, which is a transparent, multistage approach for qualitative thematic interdisciplinary data analysis. RESULTS The detection rates for all diseases combined improved significantly in the intervention compared with the control clusters. Besides leprosy, detection rates improved with large effects, over fourfold increase with statistically significant effects for individual diseases (p<0.000; 95% CI 3.5 to 5.4). Access to CM-NTD services increased in integrated counties by 71 facilities, compared with three facilities in non-integrated counties. Qualitative findings highlight training and supervision as inputs underpinning increases in case detection, but challenges with refresher training, medicine supply and incentives negatively impact quality, equity and access. CONCLUSIONS Integrating CM-NTDs improves case detection, accessibility and availability of CM-NTD services, promoting universal health coverage. Early case detection and the quality of care need further strengthening.
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Affiliation(s)
- Karsor K Kollie
- Health Services, Ministry of Health, Congo Town Back Road, Monrovia, Liberia
| | - Sally Theobald
- International Public Health, Liverpool School of Tropical Medicine, Pembroke Place Liverpool L3 5QA, UK
| | - Lent Jones
- The University of Liberia, Pacific Institute for Research Evaluation, Monrovia, Liberia
| | - Otis Kpadeh
- The University of Liberia, Pacific Institute for Research Evaluation, Monrovia, Liberia
| | - Gartee Nallo
- The University of Liberia, Pacific Institute for Research Evaluation, Monrovia, Liberia
| | - Darwosu Borbor
- Cuttington University Graduate School Research Student, Monrovia, Liberia
| | - Mark Taylor
- Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place Liverpool L3 5QA, UK
| | - Laura Dean
- International Public Health, Liverpool School of Tropical Medicine, Pembroke Place Liverpool L3 5QA, UK
| | - Maneesh Phillip
- Effect Hope, 90 Allstate Parkway Markham ON L3R 6H3, Ontario, Canada
| | | | | | - Anna Wickenden
- International Public Health, Liverpool School of Tropical Medicine, Pembroke Place Liverpool L3 5QA, UK
- Effect Hope, 90 Allstate Parkway Markham ON L3R 6H3, Ontario, Canada
| | - Jewel T Kollie
- A. M. Dogliotti School of Medicine, University of Liberia, Monrovia, Liberia
| | - Emerson Rogers
- Health Services, Ministry of Health, Congo Town Back Road, Monrovia, Liberia
| | - Zeela Zaizay
- Action Transforming Lives, Congo Town Back Road Monrovia, Liberia
| | - Martyn Stewart
- Education, Liverpool School of Tropical Medicine, Pembroke Place Liverpool L3 5QA, UK
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Eaton J, Afolaranmi T, Tsaku P, Nwefoh E, Ode P, Baird T, Sunday P, Obindo T. Integration of services for Neglected Tropical Diseases and mental health in Nigeria: development of a practical model informed by international recommendations, contextual factors and service-user perspectives. Int Health 2023; 15:iii47-iii58. [PMID: 38118161 PMCID: PMC10732674 DOI: 10.1093/inthealth/ihad074] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/08/2022] [Revised: 01/20/2023] [Accepted: 08/06/2023] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND Mental health care is now recognised as essential for people affected by NTDs, but accessible services are rare. This paper presents results of a prevalence study for depression and anxiety among people living with leprosy and lymphatic filariasis, and collation of user perspectives on needs and priorities for a new service. METHODS Prevalence of mental conditions was carried out with 141 people living with leprosy and lymphatic filariasis and matched controls. Those who screened positive for depression or anxiety were interviewed in a qualitative study to understand their experiences of living with the conditions, and what their priorities would be for services and support. Results contributed to the process of developing a contextually adapted collaborative care model for implementation in the primary care system in Nigeria, using a Theory of Change approach. RESULTS We found high rates of depression, anxiety, and reduced wellbeing, with strong correlation across measures. The qualitative study revealed experiences of stigma and exclusion, and concern for financial and economic needs, and a desire for provision of free services and support for livelihoods. CONCLUSION Services should be designed with good understanding of local needs and service user priorities. CONTEXTE Les soins de santé mentale sont désormais reconnus comme essentiels pour les personnes touchées par les MTN, mais les services accessibles sont rares. Cet article présente les résultats d'une étude de prévalence de la dépression et de l'anxiété chez les personnes vivant avec la lèpre et la filariose lymphatique, ainsi que la collecte des points de vue des utilisateurs sur les besoins et les priorités d'un nouveau service. MÉTHODES UTILISÉES Une étude de prévalence des troubles mentaux a été menée auprès de 141 personnes vivant avec la lèpre et la filariose lymphatique et de témoins appariés. Celles qui ont été dépistées positives pour la dépression ou l'anxiété ont été interrogées dans le cadre d'une étude qualitative afin de comprendre leur expérience de la vie avec ces maladies et leurs priorités en matière de services et de soutien. Les résultats ont contribué au processus d'élaboration d'un modèle de soins collaboratifs adapté au contexte et destiné à être mis en œuvre dans le système de soins primaires au Nigeria, à l'aide d'une approche fondée sur la théorie du changement. RÉSULTATS Nous avons constaté des taux élevés de dépression, d'anxiété et de diminution du bien-être, avec une forte corrélation entre les mesures. L'étude qualitative a révélé des expériences de stigmatisation et d'exclusion, des préoccupations concernant les besoins financiers et économiques, ainsi qu'un désir de services gratuits et de soutien aux moyens de subsistance. CONCLUSION Les services doivent être conçus en tenant compte des besoins locaux et des priorités des utilisateurs. ANTECEDENTES Actualmente se reconoce que la atención de salud mental es esencial para las personas afectadas por ETD, pero los servicios accesibles son escasos. los servicios accesibles son escasos. Este documento presenta los resultados de un estudio de prevalencia de depresión y ansiedad entre las personas que viven con lepra y filariasis linfática, y las perspectivas de los usuarios sobre las necesidades y prioridades de un nuevo servicio. MÉTODOS Se realizó un estudio de prevalencia de trastornos mentales con 141 personas que vivían con lepra y filariasis linfática y controles emparejados. Los que dieron positivo en depresión o ansiedad fueron entrevistados en un estudio cualitativo para conocer sus de vivir con estas enfermedades y cuáles serían sus prioridades en cuanto a servicios y apoyo. servicios y apoyo. Los resultados contribuyeron al proceso de desarrollo de un modelo de atención para su aplicación en el sistema de atención primaria de Nigeria, utilizando un enfoque basado en la Teoría del Cambio. RESULTADOS Encontramos altas tasas de depresión, ansiedad y reducción del bienestar, con una fuerte correlación entre las medidas. correlación entre las medidas. El estudio cualitativo reveló experiencias de estigmatización y de estigmatización y exclusión, preocupación por las necesidades financieras y servicios gratuitos y apoyo a los medios de subsistencia. CONCLUSIÓN Los servicios deben diseñarse teniendo en cuenta las necesidades locales y las prioridades de los usuarios de los usuarios.
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Affiliation(s)
- Julian Eaton
- CBM Global, and Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | | | - Paul Tsaku
- The Leprosy Mission Nigeria, Fort Royal Homes Estate, 12 King's Drive, 900102 Lugbe, Abuja, Nigeria
| | - Emeka Nwefoh
- CBM Global Country Office, 8 Huambo Crescent, Wuse 7, 904101 Abuja, Nigeria
| | - Philip Ode
- CBM Global Country Office, 8 Huambo Crescent, Wuse 7, 904101 Abuja, Nigeria
- CBM UK, Cambridge, CB5 8HY, UK
| | | | - Pius Sunday
- The Leprosy Mission Nigeria, Fort Royal Homes Estate, 12 King's Drive, 900102 Lugbe, Abuja, Nigeria
| | - Taiwo Obindo
- Department of Psychiatry, University of Jos, Plateau State 930001, Nigeria
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Araújo SCM, Câmara JT, Guedes TB. Snakebites in Northeastern Brazil: accessing clinical-epidemiological profile as a strategy to deal with Neglected Tropical Diseases. Rev Soc Bras Med Trop 2023; 56:e02242023. [PMID: 37820102 PMCID: PMC10561396 DOI: 10.1590/0037-8682-0224-2023] [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] [Received: 05/15/2023] [Accepted: 08/23/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Brazil ranks first in the number of snakebites in South America. A detailed analysis of these cases is required to improve the public health planning. In this study, we retrospectively examined the clinical and epidemiological profiles of snakebites in Maranhão between January 2009 and December 2019. METHODS Data were obtained from the compulsory notification forms provided by the Health Department of Maranhão. RESULTS A total of 17,658 cases were recorded during the study period. Most of the bites were from snakes belonging to the genus Bothrops. Medical care was mostly within three hours after the bite. Most cases were classified as mild and most victims recovered; however, 139 deaths were recorded. Most bites occurred among people aged 20-39 years, mainly among rural workers. The most frequent local clinical manifestations were pain, edema, and ecchymosis. The most common systemic clinical manifestations include neuroparalysis, vagal syndrome, and myolysis. Most snakebites occurred between January and March. The municipalities with the highest number of notifications were Buriticupu (936 cases), Arame (705 cases), and Grajaú (627 cases). CONCLUSIONS The clinical profile of snakebites in Maranhão is similar to that observed in other states of Northeast Brazil. However, we found that some systemic manifestations are not compatible with the etiology of snakebites, which leads us to believe that the problem could be the lack of knowledge of the health professionals at the site of envenomation, who may not be ready for attendance, and an important lack of health centers with snake antivenom to treat snakebites.
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Affiliation(s)
- Sâmia Caroline Melo Araújo
- Universidade Estadual do Maranhão, Programa de Pós-Graduação em Biodiversidade, Ambiente e Saúde, Caxias, MA, Brasil
| | - Joseneide Teixeira Câmara
- Universidade Estadual do Maranhão, Programa de Pós-Graduação em Biodiversidade, Ambiente e Saúde, Caxias, MA, Brasil
| | - Thaís B. Guedes
- Universidade Estadual de Campinas, Instituto de Biologia, Departamento de Biologia Animal, Campinas, SP, Brasil
- Gothenburg Global Biodiversity Center, University of Gothenburg, Department of Biological and Environmental Sciences, Göteborg, Sweden
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Aamar H, Siddiqui JA, Siddiqui A, Essar MY. Neglected tropical diseases in Pakistan: challenges, efforts, and recommendations. Int J Surg 2023; 109:143-144. [PMID: 36799830 PMCID: PMC10389540 DOI: 10.1097/js9.0000000000000186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/23/2022] [Indexed: 02/18/2023]
Affiliation(s)
- Humna Aamar
- Faculty of Medicine, Sindh Medical College, Jinnah Sindh Medical University
| | | | - Amna Siddiqui
- Department of Medicine, Karachi Medical and Dental College, Karachi, Pakistan
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Larkin H. How Early COVID-19 Restrictions Effected Progress on Neglected Tropical Diseases. JAMA 2022; 328:2294-2295. [PMID: 36538303 DOI: 10.1001/jama.2022.20042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Tora A, Kinfe M, Ali O, Mengiste A, Ahimed A, Fekadu A, Davey G, Semrau M. A qualitative process evaluation of a community conversation intervention to reduce stigma related to lower limb lymphoedema in Northern Ethiopia. BMC Health Serv Res 2022; 22:1043. [PMID: 35974337 PMCID: PMC9380383 DOI: 10.1186/s12913-022-08335-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 07/11/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Lower limb lymphoedema (swelling of the lower leg) due to Neglected Tropical Diseases (NTDs) such as podoconiosis, lymphatic filariasis and leprosy is common in Ethiopia, imposing huge burdens on affected individuals and communities. Stigma significantly increases the disease burden and acts as a major barrier to accessing lymphoedema care services. A multi-component stigma reduction intervention was implemented in Northern Ethiopia. Community Conversation (CC) was one of the components implemented, and aimed to reduce stigma and enhance access to and uptake of integrated lymphoedema care services with the active engagement of community members. METHODS A cross-sectional qualitative process evaluation was conducted to document lessons focusing on CC's relevance, outcomes and implementation challenges. Data were collected from a total of 55 purposively selected participants (26 from the CC intervention site and 29 from the control site) through key informant interviews, in-depth individual interviews and focus group discussions. RESULTS Community Conversations increased acceptability of health messages about lymphoedema and created peer learning opportunities for unaffected community members. Improvement in the awareness of CC participants about the causes, prevention and treatment of lymphoedema contributed significantly to the reduction of stigmatizing attitudes and discriminatory behaviors, thereby improving access to and utilization of lymphoedema care services provided through primary health care facilities. However, a range of challenges affecting implementation of CC and outcome quality were identified, including perceived complexity of the facilitation guide among facilitators, expectation of incentives among CC participants, inadequate implementation of facilitation principles and procedures, inadequacy of supportive supervision, and low engagement of untrained health workers in CC. CONCLUSIONS With these challenges addressed, the implementation of CC integrated with other lymphoedema care services shows potential to reduce stigma and promote access to lymphoedema care services.
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Affiliation(s)
- Abebayehu Tora
- Department of Sociology, Wolaita Sodo University, Wolaita Sodo, Wolaita Sodo, Ethiopia.
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT- Africa), Addis Ababa University, Addis Ababa, Ethiopia.
| | - Mersha Kinfe
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT- Africa), Addis Ababa University, Addis Ababa, Ethiopia
| | - Oumer Ali
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT- Africa), Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Global Health Research, Brighton and Sussex Medical School (BSMS), Brighton, UK
- Armauer Hansen Research Institute, Addis Ababa, Addis Ababa, Ethiopia
| | - Asrat Mengiste
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT- Africa), Addis Ababa University, Addis Ababa, Ethiopia
| | - Abdulkadir Ahimed
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT- Africa), Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebaw Fekadu
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT- Africa), Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Global Health Research, Brighton and Sussex Medical School (BSMS), Brighton, UK
| | - Gail Davey
- Centre for Global Health Research, Brighton and Sussex Medical School (BSMS), Brighton, UK
- School of Public Health, Addis Ababa University, Addis Ababa, Addis Ababa, Ethiopia
| | - Maya Semrau
- Centre for Global Health Research, Brighton and Sussex Medical School (BSMS), Brighton, UK.
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11
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The Lancet. Neglected tropical diseases: ending the neglect of populations. Lancet 2022; 399:411. [PMID: 35093213 DOI: 10.1016/s0140-6736(22)00161-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Moos B, Roberts R, Aye M. The Myanmar military coup: Propelling the 2030 milestones for neglected tropical diseases further out of reach. PLoS Negl Trop Dis 2021; 15:e0009532. [PMID: 34264950 PMCID: PMC8281985 DOI: 10.1371/journal.pntd.0009532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
| | - Russell Roberts
- Royal College of Physicians and Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom
| | - Mo Aye
- Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
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Affiliation(s)
| | | | | | - Peter Chiodini
- London School of Hygiene and Tropical Medicine, London, UK
- Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK
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Amazigo UV, Leak SGA, Zoure HGM, Okoronkwo C, Diop Ly M, Isiyaku S, Crump A, Okeibunor JC, Boatin B. Community-directed distributors-The "foot soldiers" in the fight to control and eliminate neglected tropical diseases. PLoS Negl Trop Dis 2021; 15:e0009088. [PMID: 33661903 PMCID: PMC7932156 DOI: 10.1371/journal.pntd.0009088] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The neglected tropical diseases (NTDs) affect hundreds of millions of people, predominantly in rural, often difficult-to-access areas, poorly served by national health services. Here, we review the contributions of 4.8 million community-directed distributors (CDDs) of medicines over 2 decades in 146,000 communities in 27 sub-Saharan African countries to control or eliminate onchocerciasis and lymphatic filariasis (LF). We examine their role in the control of other NTDs, malaria, HIV/AIDS interventions, immunisation campaigns, and support to overstretched health service personnel. We are of the opinion that CDDs as community selected, trained, and experienced “foot soldiers,” some of whom were involved in the Ebola outbreak responses at the community level in Liberia, if retrained, can assist community leaders and support health workers (HWs) in the ongoing Coronavirus Disease 2019 (COVID-19) crisis. The review highlights the improved treatment coverage where there are women CDDs, the benefits and lessons from the work of CDDs, their long-term engagement, and the challenges they face in healthcare delivery. It underscores the value of utilising the CDD model for strong community engagement and recommends the model, with some review, to hasten the achievement of the NTD 2030 goal and assist the health system cope with evolving epidemics and other challenges. We propose that, based on the unprecedented progress made in the control of NTDs directly linked to community engagement and contributions of CDDs “foot soldiers,” they deserve regional and global recognition. We also suggest that the World Health Organization (WHO) and other international stakeholders promote policy and guidance for countries to adapt this model for the elimination of NTDs and to strengthen national health services. This will enhance the accomplishment of some Sustainable Development Goals (SDGs) by 2030 in sub-Saharan Africa. Community-directed distributors (CDDs), sometimes known as community health workers (CHWs), have proved to be critical in the delivery of medicines and other tools for the control of neglected tropical diseases (NTDs), prevention of malaria, and other beneficial health interventions. The distributors are the unsung heroes and heroines without whom the health of hundreds of thousands of communities in rural Africa would be worse than it is today. In this paper, we document more than 2 decades (1997–2019) of the contributions of 146,000 communities and 4.8 million CDDs of medicines for NTDs, unpaid or minimally compensated, some have provided 18 years of uninterrupted service. We report on the burden of work and their perspectives of the challenges involved in mass drug administration (MDA) across 27 countries in sub-Saharan Africa. We suggest that they have not been adequately recognised and that harnessing such community human resources could contribute to improving health system’s responses to the ongoing Coronavirus Disease 2019 (COVID-19) crisis. We recommend policy measures for a wider application of existing networks of CDDs by countries’ health systems to consolidate and accelerate the achievements made as well as for the attainment of the goals set forth in the newly developed World Health Organization (WHO) NTD Roadmap.
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Affiliation(s)
- Uche V. Amazigo
- African Programme for Onchocerciasis Control, World Health Organization, Enugu, Nigeria
- * E-mail:
| | - Stephen G. A. Leak
- African Programme for Onchocerciasis Control, World Health Organization, Macclesfield, Cheshire, United Kingdom
| | | | | | | | | | | | | | - Boakye Boatin
- Onchocerciasis Control Programme in West Africa, World Health Organization, Accra, Ghana
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Affiliation(s)
- Abdulrazaq G. Habib
- Health Economics & Outcomes Research (H-CORE) Group, Department of Medicine, Bayero University, Kano, Nigeria
- Venom and Antivenom Research Project (VASP), Bayero University, Kano, Nigeria
- African Snakebite Research Group (ASRG) Project, Bayero University, Kano, Nigeria
- Africa Center of Excellence in Population Health and Policy, Bayero University, Kano, Nigeria
- * E-mail:
| | - Baba M. Musa
- Health Economics & Outcomes Research (H-CORE) Group, Department of Medicine, Bayero University, Kano, Nigeria
- Africa Center of Excellence in Population Health and Policy, Bayero University, Kano, Nigeria
| | - Garba Iliyasu
- Health Economics & Outcomes Research (H-CORE) Group, Department of Medicine, Bayero University, Kano, Nigeria
- Venom and Antivenom Research Project (VASP), Bayero University, Kano, Nigeria
- African Snakebite Research Group (ASRG) Project, Bayero University, Kano, Nigeria
- Africa Center of Excellence in Population Health and Policy, Bayero University, Kano, Nigeria
| | - Muhammad Hamza
- Venom and Antivenom Research Project (VASP), Bayero University, Kano, Nigeria
- African Snakebite Research Group (ASRG) Project, Bayero University, Kano, Nigeria
| | - Andreas Kuznik
- Regeneron Pharmaceuticals, Tarrytown, New York, United States of America
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Abstract
Skin disease is a common illness in most tropical regions where the pattern of clinical, presentations is dominated by infections. Along with common diseases such as pyodermas and fungal infections, a group of conditions known collectively as the neglected tropical diseases of the skin or Skin NTDs, which are the targets for worldwide control or elimination are also seen in health care facilities. These diseases range from the common, such a scabies, to those that are less frequent including leprosy and mycetoma. The initiative to use skin presentations of tropical diseases as a route to diagnosis by front line health workers is both logical and welcome. However, this requires training and monitoring and as the work gets under way, it is critically important that time invested in this programme is backed by firm and lasting commitment at regional and national levels.
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Affiliation(s)
- Roderick J Hay
- The International Foundation for Dermatology, Willan House, 4 Fitzroy sqaure, London W1T 5HQ, United Kingdom.
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York A. The 7th London Centre for NTDs conference. Lancet Infect Dis 2020; 20:413. [PMID: 32105639 DOI: 10.1016/s1473-3099(20)30145-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Ozano K, Dean L, Yoshimura M, MacPherson E, Linou N, Otmani del Barrio M, Halleux CM, Ogundahunsi O, Theobald S. A call to action for universal health coverage: Why we need to address gender inequities in the neglected tropical diseases community. PLoS Negl Trop Dis 2020; 14:e0007786. [PMID: 32163416 PMCID: PMC7067373 DOI: 10.1371/journal.pntd.0007786] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Kim Ozano
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- * E-mail:
| | - Laura Dean
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Mami Yoshimura
- United Nations Development Program, New York, United States of America
| | | | - Natalia Linou
- United Nations Development Program, New York, United States of America
| | - Mariam Otmani del Barrio
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Christine M. Halleux
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Olumide Ogundahunsi
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Sally Theobald
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Affiliation(s)
- Peter J. Hotez
- Texas Children’s Hospital Center for Vaccine Development, Department of Pediatrics and Molecular Virology & Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America
- Hagler Institute for Advanced Study at Texas A&M University, College Station, Texas, United States of America
- Department of Biology, Baylor University, Waco, Texas, United States of America
- James A Baker III Institute of Public Policy, Rice University, Houston, Texas, United States of America
- * E-mail:
| | - Cory Booker
- United States Senator for the State of New Jersey, Washington DC, United States of America
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Affiliation(s)
- Alexander Kumar
- School of Population Health and Environmental Sciences, King's College London, London SE1 1UL, UK. http://www.alexanderkumar.com
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Aya Pastrana N, Somerville C, Suggs LS. The gender responsiveness of social marketing interventions focused on neglected tropical diseases. Glob Health Action 2020; 13:1711335. [PMID: 31955668 PMCID: PMC7006634 DOI: 10.1080/16549716.2019.1711335] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/24/2019] [Indexed: 11/17/2022] Open
Abstract
Background: Gender is a determinant of health that intersects with other social stratifiers to shape the health and well-being of populations. Despite the recognition of gender in the global health agenda, limited evidence exists about the integration of gender considerations in interventions, including social marketing interventions, for the prevention and control of neglected tropical diseases. Social marketing is an ethical approach to behavior change aiming to benefit individuals, communities, and society. Since behaviors are gendered and affect disease transmission and healthcare patterns, one would expect social marketing interventions to be gender responsive.Objective: This study aims to understand the extent to which social marketing interventions focusing on neglected tropical diseases are gender responsive.Methods: This study uses data from social marketing interventions collected in a systematic review, this study examined 20 interventions addressing eight neglected tropical diseases in 13 countries. A modified version of the World Health Organization Gender Assessment Tool (GAT) was used to determine the gender responsiveness of the interventions, which was complemented by coding for intersectional sex and gender data. These results are presented in 12 themes.Results: One schistosomiasis intervention implemented in China was assessed as gender responsive. It was not possible to answer many questions from the GAT due to limited data reported in the publications describing the interventions. Despite this, strengths and limitations were found in all the interventions in relation to the use of sex and gender concepts, the disaggregation of data, the consideration of environmental factors, and the involvement of women or men in the different stages of the interventions.Conclusions: Many interventions showed positive actions towards gender responsiveness. However, only one was classified as gender responsive. Others failed to supply enough data for assessment. Recommendations about how sex and gender could be integrated into social marketing interventions are provided.
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Affiliation(s)
- Nathaly Aya Pastrana
- BeCHANGE Research Group, Institute for Public Communication, Università della Svizzera italiana, Lugano, Switzerland
| | - Claire Somerville
- Gender Centre, Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - L. Suzanne Suggs
- BeCHANGE Research Group, Institute for Public Communication, Università della Svizzera italiana, Lugano, Switzerland
- Swiss School of Public Health+, Zurich, Switzerland
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Brenes-Chacón H, Gutiérrez JM, Camacho-Badilla K, Soriano-Fallas A, Ulloa-Gutierrez R, Valverde-Muñoz K, Ávila-Agüero ML. Snakebite envenoming in children: A neglected tropical disease in a Costa Rican pediatric tertiary care center. Acta Trop 2019; 200:105176. [PMID: 31526777 DOI: 10.1016/j.actatropica.2019.105176] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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] [Received: 07/25/2019] [Revised: 09/13/2019] [Accepted: 09/13/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND Introduced in June 2017 by the World Health Organization (WHO) as a Neglected Tropical Diseases, snakebite envenoming is a global health problem. In Costa Rica, an incidence of 15 per 100,000 inhabitants and a mortality rate of 0.15 per 100,000 inhabitants per year were reported from 2005-2012. Children are also affected and prone to complications. METHODS Retrospective descriptive 14-year study of children with envenomings by Viperidae snakebites managed at the tertiary pediatric hospital in Costa Rica. FINDINGS 80 patients (pts) were included and classified as having mild (17 pts, 29.3%), moderate (58 pts, 72.5%) or severe (5 pts, 6.2%) envenoming. 52/80 (65%) patients received treatment within the first four hours, three (3.75%) between 5-8 h, three between 9-12 h, four (4%) between 13-16 h, two (2.5%) between 17-20 h, and seven (8.75%) after 20 h. Edema was documented in 76/80 (95%), pain in 58 (72.5%), local bleeding in 23 (28.8%), emesis in 10 (12.5%), bullae formation in 8 (10%), and tissue necrosis in three (3.8%) pts. Complications presented according with degree of envenoming, being more common in severe cases: wound infection occurred in 14/58 (24.1%) with moderate envenoming and 5/5 pts with severe envenoming (p < 0.0001), bleeding presented in 3/58 (5.2%) with moderate cases, and 2/5 (40%) in pts with severe envenoming (p = 0.004); and compartmental syndrome occurred in 3/17 (17.6%) pts with mild envenoming, in 33/58 (56.9%), and 5/5 of moderate and severe envenomed pts, respectively (p = 0.0014). Sequelae were documented 25/80 (31%).
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Affiliation(s)
- Helena Brenes-Chacón
- Pediatric Infectious Diseases Division, Pediatric Hemato-Oncology Division, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Centro de Ciencias Médicas, Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica
| | - José María Gutiérrez
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Kattia Camacho-Badilla
- Pediatric Infectious Diseases Division, Pediatric Hemato-Oncology Division, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Centro de Ciencias Médicas, Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica
| | - Alejandra Soriano-Fallas
- Pediatric Infectious Diseases Division, Pediatric Hemato-Oncology Division, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Centro de Ciencias Médicas, Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica
| | - Rolando Ulloa-Gutierrez
- Pediatric Infectious Diseases Division, Pediatric Hemato-Oncology Division, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Centro de Ciencias Médicas, Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica
| | - Kathia Valverde-Muñoz
- Pediatric Infectious Diseases Division, Pediatric Hemato-Oncology Division, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Centro de Ciencias Médicas, Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica
| | - María L Ávila-Agüero
- Pediatric Infectious Diseases Division, Pediatric Hemato-Oncology Division, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Centro de Ciencias Médicas, Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica; Affiliated Researcher, Center for Infectious Disease Modeling and Analysis (CIDMA), Yale University New Haven, New Haven CT, USA.
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Wharton-Smith A, Rassi C, Batisso E, Ortu G, King R, Endriyas M, Counihan H, Hamade P, Getachew D. Gender-related factors affecting health seeking for neglected tropical diseases: findings from a qualitative study in Ethiopia. PLoS Negl Trop Dis 2019; 13:e0007840. [PMID: 31830026 PMCID: PMC6907747 DOI: 10.1371/journal.pntd.0007840] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 10/11/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Despite known gender-specific differences in terms of prevalence, transmission and exposure to neglected tropical diseases (NTDs), there is limited discussion of the influence of gender in NTD programmes and interventions. There is a paucity of research on how gender interacts with NTD service provision and uptake. This study, part of broader implementation research in Ethiopia, applied a gender lens to health seeking for five NTDs: lymphatic filariasis, podoconiosis, schistosomiasis, soil-transmitted helminth infection and trachoma. METHODOLOGY/PRINCIPAL FINDINGS The study was conducted in a district of the Southern Nations, Nationalities, and Peoples' Region of Ethiopia where the five NTDs are prevalent. A qualitative methodology was adopted to explore participants' perspectives and experiences. Data generation methods included 20 interviews and four focus group discussions. Community members, volunteer Health Development Army leaders, Health Extension Workers and a range of health workers at the health post, health centre and hospital level (n = 59) were purposively sampled. Interviews and focus group discussions were audio recorded, transcribed verbatim into English then analysed through open coding, drawing on constant comparative methods. Gender related factors affected care seeking for NTDs and were described as reasons for not seeking care, delayed care seeking and treating NTDs with natural remedies. Women faced additional challenges in seeking health care due to gender inequalities and power dynamics in their domestic partnerships. Participants recommended raising community awareness about NTDs, however this remains problematic due to gender and social norms around appropriate discourse with members of the opposite gender. CONCLUSIONS/SIGNIFICANCE The findings from this study provide crucial insights into how gender interacts with accessing health services, at different levels of the health system. If we are committed to leaving no one behind and achieving universal health coverage, it is essential to address gender disparities to access and utilisation of interventions delivered by national NTD programmes.
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Affiliation(s)
| | | | | | | | - Rebecca King
- The Nuffield Centre for International Health & Development, University of Leeds, Leeds, United Kingdom
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Affiliation(s)
- Shahzain Hasan
- Neuromind Hospital, Sir Syed University, Karachi 74800, Pakistan.
| | - Munsif Adil
- Medicare Cardiac and General Hospital, Karachi, Pakistan
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Capewell P, Atkins K, Weir W, Jamonneau V, Camara M, Clucas C, Swar NRK, Ngoyi DM, Rotureau B, Garside P, Galvani AP, Bucheton B, MacLeod A. Resolving the apparent transmission paradox of African sleeping sickness. PLoS Biol 2019; 17:e3000105. [PMID: 30633739 PMCID: PMC6345479 DOI: 10.1371/journal.pbio.3000105] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/24/2019] [Indexed: 01/08/2023] Open
Abstract
Human African trypanosomiasis (HAT), or African sleeping sickness, is a fatal disease found throughout sub-Saharan Africa. The disease is close to elimination in many areas, although it was similarly close to elimination once before and subsequently reemerged, despite seemingly low rates of transmission. Determining how these foci persisted and overcame an apparent transmission paradox is key to finally eliminating HAT. By assessing clinical, laboratory, and mathematical data, we propose that asymptomatic infections contribute to transmission through the presence of an overlooked reservoir of skin-dwelling parasites. Our assessment suggests that a combination of asymptomatic and parasitaemic cases is sufficient to maintain transmission at foci without animal reservoirs, and we argue that the current policy not to treat asymptomatic HAT should be reconsidered.
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Affiliation(s)
- Paul Capewell
- Wellcome Centre for Molecular Parasitology, College of Medical, Veterinary and Life Sciences, Glasgow Biomedical Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Katie Atkins
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Centre for Global Health, Usher Institute for Population Health Sciences and Bioinformatics, University of Edinburgh, Edinburgh, United Kingdom
| | - William Weir
- School of Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Vincent Jamonneau
- Unité Mixte de Recherche IRD-CIRAD 177, INTERTRYP, Institut de Recherche pour le Développement (IRD), Montpellier, France
| | - Mamadou Camara
- Programme National de Lutte contre la Trypanosomiase Humaine Africaine, Conakry, Guinea
| | - Caroline Clucas
- Wellcome Centre for Molecular Parasitology, College of Medical, Veterinary and Life Sciences, Glasgow Biomedical Research Centre, University of Glasgow, Glasgow, United Kingdom
| | | | | | - Brice Rotureau
- Trypanosome Transmission Group, Trypanosome Cell Biology Unit, INSERM U1201 and Department of Parasites and Insect Vectors, Institut Pasteur, Paris, France
| | - Paul Garside
- Wellcome Centre for Molecular Parasitology, College of Medical, Veterinary and Life Sciences, Glasgow Biomedical Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Alison P. Galvani
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Bruno Bucheton
- Unité Mixte de Recherche IRD-CIRAD 177, INTERTRYP, Institut de Recherche pour le Développement (IRD), Montpellier, France
- Programme National de Lutte contre la Trypanosomiase Humaine Africaine, Conakry, Guinea
| | - Annette MacLeod
- Wellcome Centre for Molecular Parasitology, College of Medical, Veterinary and Life Sciences, Glasgow Biomedical Research Centre, University of Glasgow, Glasgow, United Kingdom
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Franco JR, Cecchi G, Priotto G, Paone M, Diarra A, Grout L, Simarro PP, Zhao W, Argaw D. Monitoring the elimination of human African trypanosomiasis: Update to 2016. PLoS Negl Trop Dis 2018; 12:e0006890. [PMID: 30521525 PMCID: PMC6283345 DOI: 10.1371/journal.pntd.0006890] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 10/01/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Human African trypanosomiasis (HAT) is a neglected tropical disease targeted for elimination 'as a public health problem' by 2020. The indicators to monitor progress towards the target are based on the number of reported cases, the related areas and populations exposed at various levels of risk, and the coverage of surveillance activities. Based on data provided by the National Sleeping Sickness Control Programmes (NSSCP), Non-Governmental Organizations (NGOs) and research institutions-and assembled in the Atlas of HAT-the World Health Organization (WHO) provides here an update to 2016 for these indicators, as well as an analysis of the epidemiological situation. RESULTS Trends for the two primary indicators of elimination are on track for the 2020 goal: 2,164 cases of HAT were reported in 2016 (as compared to the milestone of 4,000 cases), and for the period 2012-2016 280,000 km2 are estimated to be at moderate risk or higher (i.e. ≥ 1 case/10,000 people/year), as compared to the milestone of 230,000 km2. These figures correspond to reductions of 92% and 61% as compared to the respective baselines (i.e. 26,550 HAT cases in the year 2000, and 709,000 km2 exposed at various levels of risk for the period 2000-2004). Among the secondary indicators, an overall improvement in the coverage of at risk populations by surveillance activities was observed. Regarding passive surveillance, the number of fixed health facilities providing gambiense HAT diagnosis or treatment expanded, with 1,338 enumerated in endemic countries in 2017 (+52% as compared to the survey completed only sixteen months earlier). Concerning rhodesiense HAT, 124 health facilities currently provide diagnosis or treatment. The broadening of passive surveillance is occurring in a context of fairly stable intensity of active case finding, with between 1.8 million and 2.4 million people screened per year over the period 2012-2016. DISCUSSION Elimination of HAT as a public health problem by 2020 seems within reach, as the epidemiological trends observed in previous years are confirmed in this latest 2016 monitoring update. However, looking beyond 2020, and in particular to the 2030 goal of elimination of transmission as zero cases for the gambiense form of the disease only, there is no room for complacency. Challenges still abound, including ensuring the effective integration of HAT control activities in the health system, sustaining the commitment of donors and HAT endemic countries, and clarifying the extent of the threat posed by cryptic reservoirs (e.g. human asymptomatic carriers and the possible animal reservoirs in gambiense HAT epidemiology). WHO provides through the network for HAT elimination the essential coordination of the wide range of stakeholders to ensure synergy of efforts.
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Affiliation(s)
- José R. Franco
- World Health Organization, Control of Neglected Tropical Diseases, Innovative and Intensified Disease Management, Geneva, Switzerland
- * E-mail:
| | - Giuliano Cecchi
- Food and Agriculture Organization of the United Nations, Sub-regional Office for Eastern Africa, Addis Ababa, Ethiopia
| | - Gerardo Priotto
- World Health Organization, Control of Neglected Tropical Diseases, Innovative and Intensified Disease Management, Geneva, Switzerland
| | - Massimo Paone
- Food and Agriculture Organization of the United Nations, Animal Production and Health Division, Rome, Italy
| | - Abdoulaye Diarra
- World Health Organization, Regional Office for Africa, Communicable Disease Unit, Brazzaville, Congo
| | - Lise Grout
- World Health Organization, Control of Neglected Tropical Diseases, Innovative and Intensified Disease Management, Geneva, Switzerland
| | - Pere P. Simarro
- Consultant World Health Organization, Control of Neglected Tropical Diseases, Innovative and Intensified Disease Management, Geneva, Switzerland
| | - Weining Zhao
- Food and Agriculture Organization of the United Nations, Animal Production and Health Division, Rome, Italy
| | - Daniel Argaw
- World Health Organization, Control of Neglected Tropical Diseases, Innovative and Intensified Disease Management, Geneva, Switzerland
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Affiliation(s)
- Michael B. Arndt
- PATH, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Judd L. Walson
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Department of Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Pediatrics, University of Washington, Seattle, Washington, United States of America
- Childhood Acute Illness and Nutrition Network, Nairobi, Kenya
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Santana RS, de Oliveira Lupatini E, Zanghelini F, de March Ronsoni R, Rech N, Leite SN. The different clinical guideline standards in Brazil: High cost treatment diseases versus poverty-related diseases. PLoS One 2018; 13:e0204723. [PMID: 30332422 PMCID: PMC6192575 DOI: 10.1371/journal.pone.0204723] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 09/13/2018] [Indexed: 01/09/2023] Open
Abstract
Each year, evidence-based clinical guidelines gain more space in the health professionals' practice and in services organization. Due to the scarcity of scientific publications focused on diseases of poverty, the development of well-founded clinical guidelines becomes more and more important. In view of that, this paper aims to evaluate the quality of Brazilian guidelines for those diseases. The AGREE II method was used to evaluate 16 guidelines for poverty-related diseases (PRD) and 16 guidelines for global diseases whose treatment require high-cost technologies (HCD), with the ultimate aim of comparing the results. It was found that, in general, the guideline development quality standard is higher for the HCD guidelines than for the PRD guidelines, with emphasis on the "rigour of development" (48% and 7%) and "editorial independence" (43% and 1%) domains, respectively, which had the greatest discrepancies. The HCD guidelines showed results close to or above international averages, whereas the PRD guidelines showed lower results in the 6 domains evaluated. It can be concluded that clinical protocol development priorities need some redirecting in order to qualify the guidelines that define the healthcare organization and the care of vulnerable populations.
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Affiliation(s)
| | | | - Fernando Zanghelini
- Postgraduate Program in Therapeutic Innovation, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | - Norberto Rech
- Department of Pharmaceutical Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Silvana Nair Leite
- Department of Pharmaceutical Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Abstract
The main problems of the system governing the development and dissemination of innovative medicines are known. Despite relatively low manufacturing costs, patented drugs are unduly expensive, and neglected diseases attract little pharmaceutical research. Both problems are compounded by patients who, discouraged by high prices, lack of access to competent medical services and low quality medicines, do not complete their treatment.
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Amon JJ, Addiss DG. "Equipping Practitioners": Linking Neglected Tropical Diseases and Human Rights. Health Hum Rights 2018; 20:5-10. [PMID: 30008548 PMCID: PMC6039747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Joseph J Amon
- Vice president for neglected tropical diseases at Helen Keller International in New York, USA
| | - David G Addiss
- Director of the focus area for compassion and ethics at the Task Force for Global Health in Decatur, USA
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Affiliation(s)
- Rebecca Y. Du
- Texas Children’s Hospital Center for Vaccine Development, Departments of Pediatrics and Molecular Virology and Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| | - Jeffrey D. Stanaway
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
| | - Peter J. Hotez
- Texas Children’s Hospital Center for Vaccine Development, Departments of Pediatrics and Molecular Virology and Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America
- Department of Biology, Baylor University, Waco, Texas, United States of America
- James A Baker III Institute, Rice University, Houston, Texas, United States of America
- Scowcroft Institute for International Affairs, Bush School of Public Policy and Public Service, College Station, Texas, United States of America
- * E-mail:
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Abstract
Concerted action is required to reverse downward trends in research and development
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Affiliation(s)
- Gavin Yamey
- Center for Policy Impact in Global Health, Duke University, Durham, NC, USA
| | | | - Peter H Kilmarx
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Marcel Yotebieng
- Division of Epidemiology, Ohio State University, Columbus, OH, USA
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Schioldann E, Mahmood MA, Kyaw MM, Halliday D, Thwin KT, Chit NN, Cumming R, Bacon D, Alfred S, White J, Warrell D, Peh CA. Why snakebite patients in Myanmar seek traditional healers despite availability of biomedical care at hospitals? Community perspectives on reasons. PLoS Negl Trop Dis 2018; 12:e0006299. [PMID: 29489824 PMCID: PMC5847227 DOI: 10.1371/journal.pntd.0006299] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/12/2018] [Accepted: 02/05/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Snakebite is a major public health problem in many developing countries. Farmers are particularly exposed to snakes, and due to their rural location often experience delays in accessing formal healthcare. The reasons to use traditional healers may include difficulties in accessing formal healthcare, certain beliefs about snakes and snake venom, tradition, and trust in the capacity of traditional healers. Traditional healing, however, may have serious consequences in terms of delays or added complications. There is little in-depth current information about the reasons for its continued use for snakebite. As part of a health services development project to improve health outcomes for snakebite patients, community attitudes to the use of traditional healers were explored in the Mandalay region of Myanmar. METHODOLOGY & FINDINGS With the objective of learning from local communities, information was generated in three communities using participatory appraisal methods with the communities, and focus group discussions with the local healthcare staff. Many snakebite victims in these communities use traditional healing. Reasons include transport difficulties, low cost for traditional healing, inadequacy of anti-snake venom in the formal healthcare sector, and traditional beliefs, as traditional healing practices are rooted in many cultural and traditional factors. The communities reported that even if access to medical care were improved, traditional healing would continue to be used. CONCLUSION These findings point to the need for working with traditional healers for prevention, appropriate first aid and timely access to effective treatment for snakebite.
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Affiliation(s)
- Eliza Schioldann
- School of Public Health, University of Adelaide, Adelaide, Australia
| | | | - Mya Myitzu Kyaw
- Project Field Team, Myanmar Snakebite Project, Mandalay, Myanmar
| | - Dale Halliday
- School of Public Health, University of Adelaide, Adelaide, Australia
| | - Khin Thida Thwin
- Ministry of Health and Sport, University of Medicine 1 & Yangon Specialist Hospital, Yangon, Myanmar
| | - Nyein Nyein Chit
- Regional Department of Public Health, Ministry of Health, Mandalay, Myanmar
| | - Robert Cumming
- School of Public Health, University of Sydney, Sydney, Australia
| | - David Bacon
- School of Public Health, University of Adelaide, Adelaide, Australia
| | - Sam Alfred
- Emergency Department, Royal Adelaide Hospital, Adelaide, Australia
| | - Julian White
- Toxinology Department, Women’s & Children Hospital, Adelaide, Australia
| | - David Warrell
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Chen Au Peh
- Department of Renal Medicine, Royal Adelaide Hospital, Adelaide, Australia
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Abstract
Together, malaria and the neglected tropical diseases (NTDs) kill more than 800,000 people annually, while creating long-term disability in millions more. International support for mass drug administration, bed nets, and other preventive measures has resulted in huge public health gains, while support for translational research is leading to the development of some new neglected disease drugs, diagnostics, and vaccines. However, funding for basic science research has not kept up, such that we are missing opportunities to create a more innovative pipeline of control tools for parasitic and related diseases. There is an urgent need to expand basic science approaches for neglected diseases, especially in the areas of systems biology and immunology; ecology, evolution, and mathematical biology; functional and comparative OMICs; gene editing; expanded use of model organisms; and a new single-cell combinatorial indexing RNA sequencing approach. The world’s poor deserve access to innovation for neglected diseases. It should be considered a fundamental human right.
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Affiliation(s)
- Peter J. Hotez
- Texas Children’s Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America
- Department of Biology, Baylor University, Waco, Texas, United States of America
- * E-mail:
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Abstract
Mathematical and computational modeling can transform decision making for neglected tropical diseases (NTDs) if the right model is used for the right question. Modeling can help better understand and address the complex systems involved in making decisions for NTD prevention and control. However, all models, modelers, and modeling are not the same. Thus, decision makers need to better understand if a particular model actually fits their needs. Here are a series of questions that a decision maker can ask when determining whether a model is right for him or her.
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Affiliation(s)
- Bruce Y. Lee
- Public Health Computational and Operations Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Global Obesity Prevention Center, Johns Hopkins University, Baltimore, Maryland, United States of America
- * E-mail:
| | - Sarah M. Bartsch
- Public Health Computational and Operations Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Global Obesity Prevention Center, Johns Hopkins University, Baltimore, Maryland, United States of America
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Barros de Alencar MVO, de Castro E Sousa JM, Rolim HML, de Medeiros MDGF, Cerqueira GS, de Castro Almeida FR, Citó AMDGL, Ferreira PMP, Lopes JAD, de Carvalho Melo-Cavalcante AA, Islam MT. Diterpenes as lead molecules against neglected tropical diseases. Phytother Res 2016; 31:175-201. [PMID: 27896890 DOI: 10.1002/ptr.5749] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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] [Received: 07/05/2016] [Revised: 10/29/2016] [Accepted: 10/31/2016] [Indexed: 01/19/2023]
Abstract
Nowadays, neglected tropical diseases (NTDs) are reported to be present everywhere. Poor and developing areas in the world have received great attention to NTDs. Drug resistance, safety profile, and various challenges stimulate the search for alternative medications. Plant-based drugs are viewed with great interest, as they are believed to be devoid of side effects. Diterpenes, a family of essential oils, have showed attractive biological effects. A systematic review of the literature was carried out to summarize available evidences of diterpenes against NTDs. For this, databases were searched using specific search terms. Among the 2338 collected reports, a total of 181 articles were included in this review. Of them, 148 dealt with investigations using single organisms, and 33 used multiple organisms. No mechanisms of action were reported in the case of 164 reports. A total of 93.92% were related to nonclinical studies, and 4.42% and 1.66% dealt with preclinical and clinical studies, respectively. The review displays that many diterpenes are effective upon Chagas disease, chikungunya, echinococcosis, dengue, leishmaniasis, leprosy, lymphatic filariasis, malaria, schistosomiasis, and tuberculosis. Indeed, diterpenes are amazing drug candidates against NTDs. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
| | - João Marcelo de Castro E Sousa
- Department of Biological Sciences, Federal University of Piauí, Picos, (Piauí), 64.607-670, Brazil
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
| | - Hercília Maria Lins Rolim
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
- Department of Pharmacy, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
| | - Maria das Graças Freire de Medeiros
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
- Department of Pharmacy, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
| | - Gilberto Santos Cerqueira
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
- Postgraduate Program in Biotechnology, Biotechnology and Biodiversity Center for Research (BIOTEC), Federal University of Piauí (LAFFEX), Parnaíba, Piauí, 64.218-470, Brazil
| | - Fernanda Regina de Castro Almeida
- Postgraduate Program in Biotechnology (RENORBIO), Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
- Department of Biochemistry and Pharmacology, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
| | - Antônia Maria das Graças Lopes Citó
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
- Department of Chemistry, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
| | - Paulo Michel Pinheiro Ferreira
- Postgraduate Program in Biotechnology (RENORBIO), Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
- Department of Biophysics and Physiology, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
| | | | - Ana Amélia de Carvalho Melo-Cavalcante
- Postgraduate Program in Biotechnology (RENORBIO), Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
| | - Md Torequl Islam
- Postgraduate Program in Biotechnology (RENORBIO), Federal University of Piauí, Teresina, Piauí, 64.049-550, Brazil
- Department of Pharmacy, Southern University Bangladesh, Mehedibag, Chittagong, 4000, Bangladesh
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Ekins S, Diaz N, Chung J, Mathews P, McMurtray A. Enabling Anyone to Translate Clinically Relevant Ideas to Therapies. Pharm Res 2016; 34:1-6. [PMID: 27620174 DOI: 10.1007/s11095-016-2039-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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] [Received: 07/08/2016] [Accepted: 09/07/2016] [Indexed: 11/25/2022]
Abstract
How do we inspire new ideas that could lead to potential treatments for rare or neglected diseases, and allow for serendipity that could help to catalyze them? How many potentially good ideas are lost because they are never tested? What if those ideas could have lead to new therapeutic approaches and major healthcare advances? If a clinician or anyone for that matter, has a new idea they want to test to develop a molecule or therapeutic that they could translate to the clinic, how would they do it without a laboratory or funding? These are not idle theoretical questions but addressing them could have potentially huge economic implications for nations. If we fail to capture the diversity of ideas and test them we may also lose out on the next blockbuster treatments. Many of those involved in the process of ideation may be discouraged and simply not know where to go. We try to address these questions and describe how there are options to raising funding, how even small scale investments can foster preclinical or clinical translation, and how there are several approaches to outsourcing the experiments, whether to collaborators or commercial enterprises. While these are not new or far from complete solutions, they are first steps that can be taken by virtually anyone while we work on other solutions to build a more concrete structure for the "idea-hypothesis testing-proof of concept-translation-breakthrough pathway".
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Affiliation(s)
- Sean Ekins
- Collaborations Pharmaceuticals, Inc., 5616 Hilltop Needmore Road, Fuquay-Varina, Noth Carolina, 27526, USA.
- Phoenix Nest, Inc., P.O. BOX 150057, Brooklyn, New York, 11215, USA.
| | - Natalie Diaz
- Department of Neurology, Los Angeles Biomedical Research Institute, Torrance, California, 90502, USA
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California, 90095, USA
- Department of Neurology, Harbor-UCLA Medical Center, Torrance, California, 90509, USA
| | - Julia Chung
- Department of Psychiatry, Los Angeles Biomedical Research Institute, Torrance, California, 90502, USA
- Department of Psychiatry, Harbor-UCLA Medical Center, Torrance, California, 90509, USA
- Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles, California, 90095, USA
| | - Paul Mathews
- Department of Neurology, Los Angeles Biomedical Research Institute, Torrance, California, 90502, USA
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California, 90095, USA
| | - Aaron McMurtray
- Department of Neurology, Los Angeles Biomedical Research Institute, Torrance, California, 90502, USA
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California, 90095, USA
- Department of Neurology, Harbor-UCLA Medical Center, Torrance, California, 90509, USA
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Zamanian M, Andersen EC. Prospects and challenges of CRISPR/Cas genome editing for the study and control of neglected vector-borne nematode diseases. FEBS J 2016; 283:3204-21. [PMID: 27300487 PMCID: PMC5053252 DOI: 10.1111/febs.13781] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/05/2016] [Accepted: 06/13/2016] [Indexed: 01/19/2023]
Abstract
Neglected tropical diseases caused by parasitic nematodes inflict an immense health and socioeconomic burden throughout much of the developing world. Current estimates indicate that more than two billion people are infected with nematodes, resulting in the loss of 14 million disability-adjusted life years per annum. Although these parasites cause significant mortality, they primarily cause chronic morbidity through a wide range of severe clinical ailments. Treatment options for nematode infections are restricted to a small number of anthelmintic drugs, and the rapid expansion of anthelmintic mass drug administration raises concerns of drug resistance. Preservation of existing drugs is necessary, as well as the development of new treatment options and methods of control. We focus this review on how the democratization of CRISPR/Cas9 genome editing technology can be enlisted to improve our understanding of the biology of nematode parasites and our ability to treat the infections they cause. We will first explore how this robust method of genome manipulation can be used to newly exploit the powerful model nematode Caenorhabditis elegans for parasitology research. We will then discuss potential avenues to develop CRISPR/Cas9 editing protocols in filarial nematodes. Lastly, we will propose potential ways in which CRISPR/Cas9 can be used to engineer gene drives that target the transmission of mosquito-borne filarial nematodes.
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Affiliation(s)
- Mostafa Zamanian
- Department of Molecular BiosciencesNorthwestern UniversityEvanstonILUSA
| | - Erik C. Andersen
- Department of Molecular BiosciencesNorthwestern UniversityEvanstonILUSA
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Abstract
Mansonella ozzardi (Nematoda: Onchocercidae) is an understudied filarial nematode, originally described by Patrick Manson in 1897, that can be transmitted by two families of dipteran vectors, biting midges (most of them members of the genus Culicoides) and black flies (genus Simulium). With a patchy geographic distribution from southern Mexico to northwestern Argentina, human infection with M. ozzardi is highly prevalent in some of the Caribbean islands, along riverine communities in the Amazon Basin, and on both sides of the border between Bolivia and Argentina. There is no clinical entity unequivocally associated with M. ozzardi infection, although fever, arthralgia, headache, cold lower extremities, and itchy cutaneous rashes are occasionally mentioned in case report series. More recently, ocular manifestations (especially keratitis) have been associated with mansonelliasis, opening an important area of investigation. Here, we briefly review the biology, epidemiology, pathogenesis, and clinical aspects of M. ozzardi infection and point to some existing knowledge gaps, aiming to stimulate a research agenda to help filling them.
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Affiliation(s)
- Nathália F. Lima
- Department de Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | | | | | - Marcelo U. Ferreira
- Department de Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
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Lachenal G, Owona Ntsama J, Ze Bekolo D, Kombang Ekodogo T, Manton J. Neglected Actors in Neglected Tropical Diseases Research: Historical Perspectives on Health Workers and Contemporary Buruli Ulcer Research in Ayos, Cameroon. PLoS Negl Trop Dis 2016; 10:e0004488. [PMID: 27101371 PMCID: PMC4839562 DOI: 10.1371/journal.pntd.0004488] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Guillaume Lachenal
- SPHERE UMR 7219, Université Paris Diderot and Institut Universitaire de France, Paris, France
- * E-mail: (GL); (JM)
| | - Joseph Owona Ntsama
- Fondation Paul Ango Ela pour la Géopolitique en Afrique Centrale, Yaoundé, Cameroon
| | | | | | - John Manton
- Centre for History in Public Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail: (GL); (JM)
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Vento S, Cainelli F. Autommune Diseases in Low and Middle Income Countries: A Neglected Issue in Global Health. Isr Med Assoc J 2016; 18:54-55. [PMID: 26964282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Durieux-Paillard S. [Migration and infectious diseases: there are more than Ebola]. Rev Med Suisse 2014; 10:2292-2293. [PMID: 25562985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Lopez AD, Williams TN, Levin A, Tonelli M, Singh JA, Burney PGJ, Rehm J, Volkow ND, Koob G, Ferri CP. Remembering the forgotten non-communicable diseases. BMC Med 2014; 12:200. [PMID: 25604462 PMCID: PMC4207624 DOI: 10.1186/s12916-014-0200-8] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 10/03/2014] [Indexed: 12/15/2022] Open
Abstract
The forthcoming post-Millennium Development Goals era will bring about new challenges in global health. Low- and middle-income countries will have to contend with a dual burden of infectious and non-communicable diseases (NCDs). Some of these NCDs, such as neoplasms, COPD, cardiovascular diseases and diabetes, cause much health loss worldwide and are already widely recognised as doing so. However, 55% of the global NCD burden arises from other NCDs, which tend to be ignored in terms of premature mortality and quality of life reduction. Here, experts in some of these 'forgotten NCDs' review the clinical impact of these diseases along with the consequences of their ignoring their medical importance, and discuss ways in which they can be given higher global health priority in order to decrease the growing burden of disease and disability.
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Affiliation(s)
- Alan D Lopez
- School of Population and Global Health, The University of Melbourne, Building 379, 207 Bouverie St, Carlton, Melbourne, VIC, 3053, Australia.
| | - Thomas N Williams
- Department of Medicine, Imperial College, St Mary's Hospital, London, W21NY, UK.
- KEMRI/Wellcome Trust Research Programme, PO Box 230, Kilifi, Kenya.
| | - Adeera Levin
- University of British Columbia, St Paul's Hospital, 1081 Burrard Street Rm 6010 A, Vancouver, BC, V6Z1Y8, Canada.
| | - Marcello Tonelli
- , 7th Floor, TRW Building, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.
| | - Jasvinder A Singh
- Medicine Service and Center for Surgical Medical Acute care Research and Transitions, VA Medical Center, 510, 20th street South, Birmingham, AL, FOT 805B, USA.
- Department of Medicine at School of Medicine, and Division of Epidemiology at School of Public Health, University of Alabama, 1720 Second Ave. South, Birmingham, AL, 35294-0022, USA.
- Department of Orthopedic Surgery, Mayo Clinic College of Medicine, 200 1st St SW, Rochester, MN, 55905, USA.
| | - Peter G J Burney
- National Heart and Lung Institute, Imperial College, London, UK.
| | - Jürgen Rehm
- Centre for Addiction and Mental Health, Toronto, Canada.
- Clinical Psychology and Psychotherapy, Technical Universität Dresden, Dresden, Germany.
- Addiction Policy, Dalla Lana School of Public Health, University of Toronto (UofT), Toronto, Canada.
- Department of Psychiatry, Faculty of Medicine, UofT, Toronto, Canada.
- Institute of Medical Science, UofT, Toronto, Canada.
| | - Nora D Volkow
- National Institute on Drug Abuse, National Institutes of Health, Rockville, MD, USA.
| | - George Koob
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, 20892-9304, USA.
| | - Cleusa P Ferri
- Institute of Education and Health Sciences, Hospital Alemao Oswaldo Cruz, Rua João Julião, 245 - Bloco D CEP 01323-903, São Paulo, SP, Brazil.
- Department of Psychobiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Botucatu, 862- 1o andar, São Paulo, CEP, 04023-062, Brazil.
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Reid J, Potet J, Athersuch K, Grovestock M, Sanjuan JR. Legislation governing the US incentive scheme for neglected diseases needs to be amended, urges MSF. BMJ 2014; 349:g5861. [PMID: 25269564 DOI: 10.1136/bmj.g5861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Jennifer Reid
- Médecins Sans Frontières-Access Campaign, 333 7th Avenue, 2nd Floor, New York, NY 10001, USA
| | - Julien Potet
- Médecins Sans Frontières-Access Campaign, 8 Rue Saint Sabin, 75011 Paris, France
| | - Katy Athersuch
- Médecins Sans Frontières-Access Campaign, Rue de Lausanne 78, CH-1211 Geneva 21, Switzerland
| | - Maisy Grovestock
- Médecins Sans Frontières-Access Campaign, Rue de Lausanne 78, CH-1211 Geneva 21, Switzerland
| | - Judit Rius Sanjuan
- Médecins Sans Frontières-Access Campaign, 333 7th Avenue, 2nd Floor, New York, NY 10001, USA
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Dhimal M, Karki KB. The hidden burden of Neglected Tropical Diseases: a call for inter-sectoral collaboration in Nepal. J Nepal Health Res Counc 2014; 12:I-IV. [PMID: 26032064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- M Dhimal
- Nepal Health Research Council, Kathmandu, Nepal
| | - K B Karki
- Nepal Health Research Council, Kathmandu, Nepal
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