Neglected Tropical Diseases - Sub-Saharan Africa PDF
Preview Neglected Tropical Diseases - Sub-Saharan Africa
Neglected Tropical Diseases John Gyapong Boakye Boatin Editors Neglected Tropical Diseases - Sub-Saharan Africa Neglected Tropical Diseases Series editor Peter J. Hotez , MD, PhD Dean, National School of Tropical Medicine, Texas Children’s Hospital Endowed Chair of Tropical Pediatrics, Professor of Pediatrics and Molecular Virology and Microbiology, Baylor College of Medicine, Houston , Texas , USA President, Sabin Vaccine Institute, Washington, District of Columbia, USA, Houston , Texas , USA University Professor of Biology, Baylor University, Waco , Texas , USA Baker Institute Fellow in Disease and Poverty, Rice University, Houston , Texas , USA More information about this series at http://www.springer.com/series/11165 John Gyapong (cid:129) Boakye Boatin Editors Neglected Tropical Diseases - Sub-Saharan Africa Editors John Gyapong Boakye Boatin Research, Innovation and Development Lymphatic Filariasis Support Centre University of Ghana University of Ghana Accra Accra Ghana Ghana ISSN 2194-8275 ISSN 2194-8283 (electronic) Neglected Tropical Diseases ISBN 978-3-319-25469-2 ISBN 978-3-319-25471-5 (eBook) DOI 10.1007/978-3-319-25471-5 Library of Congress Control Number: 2015958883 Springer Cham Heidelberg New York Dordrecht London © Springer International Publishing Switzerland 2016 T his work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. T he use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. T he publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper Springer International Publishing AG Switzerland is part of Springer Science+Business Media (www.springer.com) Foreword Today, Sub-Saharan Africa represents one of the most important global “hotspots” for highly endemic neglected tropical diseases (NTDs). First and foremost, NTDs are the major affl ictions of profound poverty, and such levels of poverty are perva- sive on the African continent. According to the World Bank, more than 900 million people live in Sub-Saharan Africa with approximately one-half living on less than $1.25 per day. NTDs thrive under these circumstances. The World Health Organization (WHO) has now determined the numbers of people who require mass drug administration for their NTDs, and indeed these numbers are disturbing. Overall 658.7 million people in WHO’s African region require mass drug administration for NTDs, including 468.4 million people for lymphatic fi lariasis, 324.2 million for soil- transmitted helminth infections, 240.7 million for schistosomiasis, and 168.8 mil- lion for onchocerciasis. Overall, the WHO African region accounts for less than 15 % of the world’s population, but almost 40 % of the people requiring treatment for their NTDs. A nother feature of Sub-Saharan Africa is its (unwelcome) exclusivity for some spe- cifi c NTDs. Today, the region accounts for all of the world’s cases of loiasis and human African trypanosomiasis (HAT), and (again according to the WHO) 92 and 99 % of the world’s population that requires mass treatment for schistosomiasis and onchocer- ciasis, respectively. Most of the planet’s podoconiosis and Buruli ulcer, and possibly trachoma and yaws, are also found in Sub-Saharan Africa. T he impact of this massive load of NTDs is felt at different levels. These diseases produce deleterious and direct negative consequences for public health through their long-term effects on disability, or in some cases by causing death (especially for HAT and leishmaniasis). In addition there are important indirect effects. For example, urogenital schistosomiasis (which is responsible for roughly two-thirds of the schistosomiasis) has now been shown to be a major co-factor in Africa’s HIV/ AIDS epidemic, while malaria, together with hookworm infection and schistoso- miasis, greatly exacerbate anemia. Both of these indirect effects represent important causes of ill health for Africa’s girls and women. v vi Foreword In addition to their health impact, Africa’s NTDs also exhibit important links to social forces. They promote poverty, as they make people too sick to work and impair child development. They are also inextricably linked to Africa’s civil and international wars. During the 1970s, 1980s, and 1990s in Angola, Democratic Republic of Congo, and Sudan, HAT may have killed annually ten times more people than those who died in the 2014–2015 West African Ebola virus infection outbreak. Just as the NTDs help promote poverty, diseases such as HAT may also cause destabilization and further promote confl ict on the African continent. Solving Africa’s NTD problem will require a multi-pronged approach including social scientists to design culturally sensitive interventions. We must expand mass treatments, especially for diseases such as schistosomiasis, a disease for which only about 10–15 % of children have access to praziquantel, together with case detection and treatment for NTDs such as HAT and leishmaniasis. Mass treatment needs to be accompanied by intersectoral approaches that embrace sanitation, clean water, and other environmental measures. In parallel, vector control will be needed for leish- maniasis, HAT, and other NTDs. The good news is that through these approaches we are beginning to see declines in the number of cases of lymphatic fi lariasis, onchocerciasis, and HAT, such that it is now possible to realistically discuss the potential for eliminating these NTDs. For others, we are going to need to enlarge programs of research and development, which must include capacity enhancement for African scientists. I am very excited about this new volume. Dr. John Owusu Gyapong and Dr. Boakye Boatin have assembled a top-fl ight team of African authors and scientists with direct fi rst-hand knowledge about these diseases. In this respect, this volume is practically unique – a book about disease and poverty in Africa written by scientists and public health experts from Africa. I would like to congratulate Drs. Gyapong and Boatin and the authors of each of the important book chapters, and Springer for creating this important series on NTDs! Houston, TX, USA Peter J. Hotez , MD, PhD Pref ace T his book sets out the neglected tropical diseases (NTDs) through the lens of sub- Saharan Africa (SSA). Twelve of the major NTDs are presented. They include Buruli ulcer, Guinea worm, human African trypanosomiasis, leishmaniasis, leprosy, Loa loa, and lymphatic fi lariasis. Others are onchocerciasis, podoconiosis, schisto- somiasis, soil-transmitted helminths, trachoma, and yaws. Additional areas which transcend all the NTDs such as health systems and their role in NTDs, the social and economic impact as well as vector control, an often less talked about area in recent times in the control of NTDs are also discussed. T he disease specifi c chapters are written following a theme which is common to all, but there are important variations on the theme within the structured sections. Each chapter therefore can be read independently on its own but read together with the chapters on health systems and social and economic implications will make them even more complete. Areas that have received detailed attention include diag- nostics especially for those diseases that are targeted for elimination, future control tools including drugs as well as critical research needed to help overcome the chal- lenges that have been identifi ed for each disease. A s expected most the challenges that have been identifi ed for the diseases cut across many of them, but some challenges are very disease specifi c. With this in mind, a section on the expected situation for each disease in the next decade is high- lighted for each of the chapters. The authors were drawn almost entirely from African research scientists and individuals who have either worked in their respective ministries of health, have come face to face with the realities of the ravages of NTDs in their countries, or have experience in the control of the diseases. I n taking on this assignment it was clear that there would be diffi culties in trying to work with so many contributors; however, the task was made less arduous by the willingness of the authors to work as a team and in close collaboration with each other. Many people who are not listed in the chapters helped in many ways to get the manuscripts together. Their contributions are well acknowledged. I t is our wish that this book, apart from providing some basic information on the specifi c NTDs and the special ways that NTDs present in SSA, will also be a good vii viii Preface source of a wide range of references on NTDs to readers. In a word, this book will be a useful read for all who are interested in doing something about NTDs in SSA. Accra, Ghana John O. Gyapong, MD, MPH, PhD Boakye A. Boatin, MD, MPH Acknowledgments The editorial team is grateful to Ms Grace Annan, a Senior Research and Administrative Assistant of the Offi ce of Research Innovation and Development of the University of Ghana, for her secretarial support. T he work was partly supported by a grant (Grant Number: G1001337) from the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement, through the Liverpool School of Tropical Medicine Council and managed by the School of Public Health, University of Ghana. ix
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