What are neglected tropical diseases? (Part 1)

The Clinton Global Initiative, UN Summit on Millennium Development Goals, and TEDxChange are only one week away. We present this series of five daily blogs on Neglected Tropical Diseases as an example of an area where philanthropists can make a big social impact. This is the first in a series of five posts that look at the impact of neglected tropical diseases and why philanthropists focused on health may be interested.

Aboubacar Ganame, an 11 year old from Burkina Faso in West Africa, happily shows cameras a glass vile containing the worms that no longer take refuge in his small body. Before being treated for multiple intestinal parasites, he endured years of chronic fatigue and blood in his urine. Now, after a single pill for each type of infection, he is able to attend school and has enough energy to play with his friends.

Neglected tropical diseases (NTDs) are just that: neglected. But in recent years, awareness and momentum is beginning to change this by helping to demonstrate how success is possible and happening right now. With effort, resources, and coordination, many of these diseases can be wiped out.

NTDs got a little nod in the New York Times recently in an article by the authority on the topic, Peter Hotez. He has been trying to get the word out that this group of diseases is very treatable.

In total, there are 13 neglected tropical diseases, which primarily affect the poorest of the poor, living without clean water or sanitation, in areas like Sub-Saharan Africa and other impoverished tropical regions. However, as Hotez points out, these diseases are closer to home than we may think. Countries like the Dominican Republic, Mexico and Haiti are all affected by one NTD or another. In the Dominican Republic alone, a quarter of a million people are infected with the blood parasite Schistosomiasis. In fact, these diseases can be found in many areas of the United States1, disproportionately affecting the impoverished living in rural parts of southern states like Florida and Louisiana.

How are these diseases transmitted?

  • Drinking contaminated water (e.g. Guinea worm invades the body through drinking water)
  • Contaminated food and water in areas of poor sanitation (areas that have no latrine system cannot keep waste away from drinking water)2
  • Being bit by an infected mosquito or fly (e.g. malaria, elephantiasis (lymphatic filariasis) and african sleeping sickness all enter the body through bug bites)
  • Swimming or bathing in infested waters (e.g. parasites can penetrate the skin and cause schistosomiasis)

What’s so bad about neglected tropical diseases?

  • While most are rarely fatal, these diseases are often chronic, debilitating and socially stigmatizing (e.g. adults infected with onchocerciasis develop skin lesions and opacities on their eyes causing blindness. Because diseases are poorly understood, people infected with elephantiasis (filariasis) are often rejected by their families and communities).3
  • Affected children show delays in growth and development (e.g. when children contract intestinal worms, such as roundworm [ascariasis], the worm lives off the body’s nutrients, depriving the child of needed nutrition. This can lead to low blood count, intestinal blockage, lung problems and cognitive developmental delays).4
  • Affected children are often unable to attend school (e.g. a guinea worm infection can require treatment for up to a month, and chronic reinfections mean a lot of missed school).
  • Years of infection and decreased productivity can have a huge effect on local economies (e.g. lymphatic filariasis is estimated to cost $811 million dollars lost per year in potential income in India alone).5

Takeaway Message for Philanthropists:

  • Most of these diseases can be treated easily with very inexpensive drugs.
  • There are many groups working toward effectively treating NTD’s
  • Donors can help already established groups get treatment to where it’s needed most.

In the next blog we’ll take a look at how inexpensive and effective treatments can be, and how dramatic a difference they can make in the lives of the poor.

Thanks to the authors, Isobel Harvey, former CHIP researcher and master’s candidate at the Thomas Jefferson University School of Nursing, and Carol McLaughlin, CHIP research director, for their contributions to this series.

1 Bern, C., Montgomery, S., Herwaldt, B., et al. (2007). Evaluation and Treatment of Chagas Disease in the United States. Journal of the American Medical Association,  298, 18, 2171-2181.

2 Hotez, P., Bundy, D., Beegle, K. (2006). Disease Control Priorities in Developing Countries. 2nd Edition, Oxford University Press: New York, NY.

3 Weiss, M. (2008). Stigma and the Social Burden of Neglected Tropical Diseases. PLoS Neglected Tropical Diseases 2(5): e237. doi:10.1371/journal.pntd.0000237

4 Hotez, P. (2008). Forgotten People, Forgotten Diseases: The neglected tropical diseases and their impact on global health and development. ASM Press, Washington, DC.

5 Ramaiah, K., Das, K., Michael, E., Guyatt, H. (2000). The economic burden of lymphatic filariasis in India. Parastiology Today, 16, 6.