Forgotten diseases, where no one looks

Health

R.Ibarra

Madrid

Updated:

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These are viral, parasitic and bacterial diseases that affect one sixth of the world’s population, causing more than 534 thousand deaths per year and a loss of about 57 million years of productive life (DALYs). Unfortunately, these diseases mainly affect the poorest and most marginalized communities in the world, which does not seem to be a sufficient incentive for research.

They have lasting health, social and economic impacts on individuals and societies. For example, they prevent children from going to school or adults from going to work. And on many occasions, they relegate the affected person and their families to discrimination and social isolation.

In Spain, neglected tropical diseases are having a great impact on our health system, due to the growing number of travelers and immigrants.

Health professionals are concerned to recognize and treat some of these diseases and to be able to provide quality health care.

Health professionals are concerned to recognize and treat some of these diseases and to be able to provide quality health care

But not only immigrants and travelers play an important role in the transmission of acute infections from one geographical area to another, some vectors can serve as a bridge for the introduction of a typically tropical infection. Most of these tropical vectors are not found in our country or are not effective, but globalization and especially climate change can change this.

For example, the spread of the tiger mosquito (Aedes albopictus) in southern Europe, vector of the virus Chikungunya, the appearance of autochthonous cases of dengue in the south of France, Croatia and the Azores, the cases of malaria in Greece and the case of autochthonous malaria in Spain are good examples of this new scenario.

A paradigmatic case is Chagas disease, endemic in 21 Latin American countries, but very present in Spain, where it is estimated that there are between 40,000 and 68,000 people infected by the T. cruzi parasite.

Vertical transmission, during pregnancy or childbirth, is the most common route of infection. According to the WHO, each year, 9,000 babies are born with the disease. Although the etiology and clinical manifestations of Chagas disease are known, due to the fact that it often does not present symptoms, years can go by without people knowing that they are infected and, if not treated, they will develop serious complications in the heart or intestine. , being able to cause death.

Another disease that is also present in Spain is Leishmaniasis. In the Mediterranean basin, the predominant infecting species is Leishmania infantum, whose infection produces mainly visceral manifestations. Both diseases present important challenges for public health both nationally and internationally.

NTDs were one of the few health and development issues that didn’t have a specific promotion day, until last year. During its 74th World Health Assembly, held in May 2020, the WHO declared January 30 as “World Neglected Tropical Diseases Day”.

The Anesvad Foundation has been fighting for more than 50 years to eradicate these forgotten diseases in the most remote places.

On the occasion of this day, it has launched the awareness campaign “Where no one looks”, with which it wants to make society aware of this invisible reality. «Skin diseases that can be detected and treated quickly, effectively and cheaply, but which are of no interest because the people who suffer from them are invisible, such as leprosy, Buruli ulcer, yaws and lymphatic filariasis» , they assure from the Foundation.

Leprosy

In 2020, 131 countries shared information on leprosy, with 127,506 new cases. Brazil, India e Indonesia they continue to report the majority of the leprosy burden in 2020. Most of the countries with high detection rates of new cases are in the Africa and South-East Asia regions.

In Spain, in 2020, 2 new cases were reported: 1 in the Balearic Islands and another in the Basque Country. At the end of the year, there were 16 people in treatment: 5 in Madrid; 2 in Castilla-La Mancha, Catalonia and the Valencian Community; and 1 in Andalusia, the Balearic Islands, Cantabria, Castilla y León and the Basque Country, informs the coordinator of international cooperation projects of the Fontilles Foundation, Eduardo de Miguel.

The disease ceases to be contagious from the application of the first dose

Leprosy is an infectious and chronic disease caused by the bacterium Mycobacterium leprae. If not treated in time, it can cause progressive and permanent damage to the skin, nerves, mucosa of the respiratory tract and eyes. But it is curable thanks to the treatment of the Multiterapia (MDT), which has been applied since 1982 and consists of the combination of three drugs (dapsone, rifampin, and clofazimine) for a period ranging from 6 to 12 months. The disease ceases to be contagious from the application of the first dose.

But nevertheless, the stigma associated with leprosy in developing countries it remains one of the main impediments to its detection and treatment. The isolation and marginalization of these people prevent their full development and fuel the cycle of poverty in which they are immersed.

Bald-Elm

Other diseases in which Anesvad works are Soon and the ulcer Buruli.

Yaws is an endemic pathology in 15 countries and in 2020, 87,877 suspected cases of yaws were reported to the WHO in 11 countries, but only 346 cases were confirmed in 7 countries. In this infectious and disfiguring disease, which is transmitted when small skin lesions come into contact with an infected person, detection remains one of the greatest challenges.

The paradox is that it is cured with a single oral dose of azithromycin, an antibiotic that we find in any pharmacy and that costs less than 4.50 euros, for which, denounces from this foundation, “it could be eradicated if sufficient resources were mobilized to detect cases and treat them in time.”

The isolation and marginalization of these people prevent their full development and fuel the cycle of poverty in which they are immersed.

Refering to buruli ulcer, present in more than 33 countries since 2002, mainly in those with tropical and subtropical climates, is a disabling infection caused by the bacterium Mycobacterum ulcerans for which there is cheap and effective antibiotic treatment but, if not treated in time, it can cause problems morbidity, stigma and disability.

The list is very long, there are more than 20, some more familiar, such as dengue, rabies or trachoma, and others totally unknown and ignored, such as hookworm, ascariasis, cysticercosis, schistosomiasis, onchocerciasis, etc.

The WHO has proposed a very ambitious plan to end these diseases by 2030.

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