Forgotten people, forgotten diseases : the neglected tropical diseases and their impact on global health and development

281 Pages·2013·114.505 MB·English

by  Peter J Hotez, American Society for Microbiology

secoNd ediTioN
Forgotten
PeoPle
Forgotten
DISeASeS
The NeglecTed Tropical diseases
aNd Their impacT oN
global healTh aNd developmeNT
HotezTitlePpFINAL.indd 1 3/26/13 10:26 AM

secoNd ediTioN
Forgotten
PeoPle
Forgotten
DISeASeS
The NeglecTed Tropical diseases
aNd Their impacT oN
global healTh aNd developmeNT
Peter J. HoteZ, M.D., PH.D.
National school of Tropical medicine, baylor college of medicine
sabin vaccine institute and Texas children’s hospital center for vaccine development
James a. baker iii institute, rice University
houston, Texas
Washington, DC
HotezTitlePpFINAL.indd 2 3/26/13 10:26 AM
Cover photo: Malawi, 2010. Courtesy Elizabeth Jordan.
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Library of Congress Cataloging-in-Publication Data
Hotez, Peter J.
Forgotten people, forgotten diseases : the neglected tropical diseases and their impact on
global health and development / Peter J. Hotez. — 2nd ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-55581-874-6 (print) — ISBN 978-1-55581-875-3 (e-book)
I. American Society for Microbiology. II. Title.
[DNLM: 1. Parasitic Diseases—prevention & control. 2. Developing Countries—economics.
3. Neglected Diseases—prevention & control. 4. Tropical Medicine. 5. World Health. WC 695]
RC961
362.196′9883—dc23
2013001419
doi:10.1128/ISBN978-1-55581-875-3
Printed in the United States of America
10 9 8 7 6 5 4 3 2 1
Address editorial correspondence to: ASM Press, 1752 N St., N.W., Washington, DC 20036-
2904, USA.
Send orders to: ASM Press, P.O. Box 605, Herndon, VA 20172, USA.
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Online: http://estore.asm.org
Dedicated to my youngest daughter,
Rachel Kate Hotez,
who teaches me every day about disabilities
To my parents, Edward and Jean Hotez
To the memory of my brother,
Richard Eric Hotes, M.D.
To Mort and Chris Hyman
and the Hyman family
And to the Bill & Melinda Gates Foundation
and the National Institutes of Health,
U.S. Department of Health and Human Services,
for the opportunity to devote my life
to the Neglected Tropical Diseases
v

Contents
Foreword to the Second Edition, Soledad O’Brien ix
Preface to the Second Edition xi
Preface to the First Edition xv
Acknowledgments xvii
chapter 1 Introduction to the Neglected Tropical Diseases: the Ancient
Afflictions of Stigma and Poverty 1
chapter 2 “The Unholy Trinity”: the Soil-Transmitted Helminth
Infections Ascariasis, Trichuriasis, and Hookworm
Infection 17
chapter 3 Schistosomiasis (Snail Fever) 41
chapter 4 The Filarial Infections: Lymphatic Filariasis (Elephantiasis)
and Dracunculiasis (Guinea Worm) 57
chapter 5 The Blinding Neglected Tropical Diseases: Onchocerciasis
(River Blindness) and Trachoma 77
chapter 6 The Mycobacterial Infections: Buruli Ulcer and Leprosy 97
chapter 7 The Kinetoplastid Infections: Human African
Trypanosomiasis (Sleeping Sickness), Chagas Disease, and the
Leishmaniases 115
chapter 8 The Urban Neglected Tropical Diseases: Leptospirosis,
Dengue, and Rabies 149
chapter 9 The Neglected Tropical Diseases of North America 165
chapter 10 The Global Network for Neglected Tropical Diseases 189
chapter 11 Future Trends in Control of Neglected Tropical Diseases and
the Antipoverty Vaccines 213
chapter 12 Repairing the World 231
Appendix: What Are the NTDs? 242
Index 245
About the Author 255
vii

Foreword to the Second Edition
Dr. Peter Hotez seems a lot like your friendly local doctor when you first meet
him. He has these fine, circular glasses, a wide thin smile, and wears hand-
tied bow ties with his lab coat. You expect him to pull out a popsicle stick at
any moment, squash down your tongue, and implore you to say “Ah.” But Dr.
Hotez practices so much more than community medicine. His patients span
the globe, and he aspires to bring his mix of human compassion and quality
health care to the world’s most vulnerable people, those stricken by the double
plague of interrelated poverty and illness.
One way he’s doing this is by educating people about the links between
poverty and disease. Dr. Hotez tell us that neglected tropical diseases (NTDs)
are not only the most common afflictions of the world’s poor but can actually
cause poverty, by keeping chronic sufferers from being able to work, study,
or care for their families. That includes impoverished farmers with elephan-
tiasis, trachoma, or river blindness, which cost billions of dollars annually in
lost agricultural productivity. Also, children stricken by hookworm and other
intestinal worm infections that reduce intelligence and the cognitive and rea-
soning abilities they need to study and eventually work. NTDs are also the
most common disease to affect girls and women in developing countries, like
schistosomiasis, which renders them more susceptible to acquiring AIDS, or
diseases like elephantiasis, leishmaniasis, and Buruli ulcer that disfigure and
bring shame and stigma and hinder plans for marriage or children.
NTDs are pervasive in poor communities, in developing countries like
Africa and Haiti, but even more disturbingly among the poor living in large
middle-income nations—the BRICS countries of Brazil, India, and China for
example. I can tell you from my own reporting and travels that disease is also
destroying the aspirations of the poor and racial and ethnic minorities in pock-
ets of extreme rural and urban poverty in the United States. Chagas disease, a
cause of severe heart disease and death, is widespread in Texas and other south-
ern states both among people and animals. The medicines we have available to
treat Chagas disease are too toxic to be given to pregnant women, even though
tens of thousands of women in North America suffer from Chagas disease dur-
ing their pregnancy and several thousand give birth to infected newborns. But
there are at least five other NTDs affecting millions of people in the U.S.—most
ix