31/10/08

Latin America ‘suffering high burden of neglected disease’

A technician carrying out a routine test for lymphatic filariasis in Brazil Copyright: WHO/TDR/Crump

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[SANTIAGO] The burden of neglected tropical diseases (NTDs) in Latin America and the Caribbean may exceed conditions such as HIV/AIDS, tuberculosis and malaria, say researchers.

They assessed the impact of neglected tropical diseases in the region and compared it to that of HIV/AIDS, tuberculosis and malaria.

The disease burden of all NTDs in the region is estimated at 1.4–4.9 million disability-adjusted life years (DALYs) — years of healthy life lost due to poor health or disability.

In comparison, the DALYs for HIV/AIDS, tuberculosis and malaria together are 4.2 million.

The parasitic diseases hookworm infection, ascariasis, and trichuriasis are the three most prevalent NTDs in Latin America and the Caribbean, with 235 million people infected.

"These intestinal worms affect children and interfere with their growth and development. They also impair IQ, cognition and memory, and therefore school performance. On this basis, chronic hookworm infection has been shown to reduce future wage earning by 43 per cent," Peter J. Hotez, president of the Sabin Vaccine Institute and co-author of the study, told SciDev.Net.

NTDs in the region occur more predominantly among poor people. They are also more common in rural areas, among indigenous groups, people of African descent, women and children, say the authors.

Chagas disease is particularly prevalent, with around 8–9 million people affected and 50,000 new cases annually. According to the analysis, in Latin America and the Caribbean, the burden of disease caused by this infection "is between five and ten times greater than malaria [and] its economic impact represents a significant percentage of the external debt of the region".

But in coming years, schistosomiasis could be eliminated in the Caribbean with low-cost treatments and the same could happen with lymphatic filariasis and onchocerciasis in Latin America, say the researchers.

For example, the total cost of anti-parasitic drugs for lymphatic filariasis over eight years is estimated at less than 50 US cents per person. 

"We need modest funds for mass drug administration, particularly in
Hispaniola [the Dominican Republic and Haiti] where schistosomiasis and lymphatic filariasis are endemic, and the remaining pockets of onchocerciasis in Brazil, Colombia, Ecuador, Guatemala, Mexico and Venezuela," said Hotez.

The main challenges for Latin American and Caribbean countries to control NTDs are "to get them on the radar screen of political leaders and create an atmosphere of advocacy to mobilise resources in order to get the job done", he adds. 

Link to the full paper in PLoS Neglected Tropical Disease

References

PLoS Neglected Tropical Diseases 10.1371/journal.pntd.0000300 (2008)