Review Article

Emerging and Neglected Infectious Diseases: Insights, Advances, and Challenges

Table 3

Major neglected tropical diseases.

DiseaseCausative agentTransmissionPathogenesisAffected populationsTreatment and managementPrevention/public health response

 Buruli ulcerMycobacterium ulcerans (Bacterium)Mode unknownDestruction of skin & soft tissues, leading to ulcerPoor rural communities; more in Africa, 33 countriesRifampicin, streptomycin/amikacin, or surgeryEarly detection and antibiotic treatment

Chagas diseaseTrypanosoma cruzi (protozoan parasite)Vector-borneCardiac or mixed alterations in chronic infection~8 M people infected worldwide, mostly Latin AmericaCurable with benznidazole and nifurtimoxVector (triatomine bug) control

Dengue and chikungunyaDengue virus sp.: DENV 1, DENV 2, DENV 3 & DENV 4 (Flaviviruses)Dengue & chikungunya: mosquito sp. (Aedes aegypti & Ae. albopictus) Fatal: plasma leaking, bleeding, and organ impairmentWorldwide, ~100 countries; 50–100 mil infections/year. Esp. Asia & Latin AmericaDengue: vaccine available; chikungunya: no vaccineControl of mosquito vectors

Dracunculiasis (Guinea worm disease)Dracunculus medinensis (Nematode parasite)Drinking water containing parasite-infected water-fleas (Cyclops)Rarely fatal
Leads to oedema and ulcer, usually of the feet
22 cases in 4 African countries in 2015No vaccine available yetImproved drinking water sources. Near eradication

EchinococcosisE. granulosus and
E. multilocularis (Echinococcus parasites)
Through faeces of dogs, foxes & other carnivoresInvolves liver and other organs. Progressive and fatal if untreated>I M people worldwide affected at any one time Expensive and complicated to treatComplex
Regular deworming of domestic carnivores helps

Endemic treponematoses (Yaws)T. Pallidum subspecies pertenue (bacterium)Person-to-person (nonsexual) with infected fluidDisfigurement of the nose and bones; hyperkeratosisAfrica, Asia, Latin America, and the Pacific Azithromycin
Benzathine penicillin
No vaccine: early diagnosis and targeted treatment

Foodborne trematodiasesTrematode parasite sp. Clonorchis, Opisthorchis, Fasciola, and ParagonimusZoonotic: consumption of raw/poorly cooked foodOrgan-specific, reflects adult worm final location>70 countries worldwide, mainly East Asia and South AmericaUse of anthelminthic medicinesReduce infection risk; control associated morbidity

Human African trypanosomiasis (sleeping sickness)Trypanosoma parasite sp.
T. brucei gambiense (98%)
T. brucei rhodesiense (2%)
By bites of infected tsetse fly (of Glossina genus)Affects central nervous system, causing neurological (and sleep) disordersOccurs in 36 sub-Saharan Africa countries (>70% of cases occur in DR Congo)Drugs available. Depends on disease stage and parasite speciesFree antitrypanosome medicines provided by WHO; efforts at elimination

LeishmaniasisProtozoan Leishmania parasites (over 20 species)Bite of infected female phlebotomine sandfliesInfection rarely leads to disease developmentWorldwide. Risk increased by povertyComplex; depends on several factorsComplex; combination of intervention strategies

Leprosy (Hansen disease)Mycobacterium leprae (bacterium)By air (from nose & mouth) through close contactDamage of peripheral nerves leading to paralysisSoutheast Asia RegionMultidrug (Dapsone, rifampicin & clofazimine)Early diagnosis and treatment to avert disability

Lymphatic filariasis (elephantiasis) Filarioidea nematodes: Wuchereria bancrofti, Brugia malayi, and B. timoriBy mosquito sp. (Culex, Anopheles, and Aedes)Invade lymphatic system; disrupt immune systemWHO Southeast Asia & Africa; >120 M peopleAlbendazole + ivermectin/diethylcarbamazine citrateMorbidity management; mass drug administration

Onchocerciasis (river blindness)Onchocerca volvulus (parasite)Bite of blackfly (Simulium damnosum sp. mainly)Parasites migrate throughout the body, casing a variety of symptoms36 countries: Africa, Arabian peninsula & AmericasIvermectin (manufactured Merck & Co, free)Yearly ivermectin administration to affected populations

RabiesRabies virusBites/scratches of affected domestic/wild animalsAffects central nervous system, leads to deathAll continents but Antarctica. Mostly in Asia & AfricaPostexposure prophylaxis (with vaccine course)Preventive immunization of people; vaccinating dogs

Schistosomiasis (Bilharzia)Schistosoma parasite sp.: S. haematobium, S. mansoni, and S. japonicumContact with infested fresh water bodiesLive in blood vessels, body tissues & damage organsAt least 90% of estimated cases are in AfricaDrug available: Praziquantel therapyGood water/sanitation, snail control; preventive therapy

Soil-transmitted helminthiasesHelminth parasite species Ascaris lumbricoides, Trichuris trichiura, Necator americanus & A. duodenaleParasite eggs in human faeces-contaminated soilIntestinal damage and blood loss. Rarely fatalWorldwide: esp. sub-Saharan Africa, the Americas, China, and East Asia. ~2 billion peopleMedicines available: Albendazole and MebendazoleDeworming people at risk, improved sanitation, education

Taeniasis/ cysticercosisTaenia (tapeworm) parasites
T. solium (pork tapeworm)T. saginata (beef tapeworm)
Ingestion of larval cysts through contaminated food (pork or beef) or waterIntestinal; central nervous system attack. Can be fatalAfrica, Asia, and Latin AmericaDrug available: Praziquantel and niclosamideVeterinary, human health, and environmental approach

 TrachomaChlamydia trachomatis (bacterium)Eye-seeking flies, poor water and sanitationLeading infectious cause of blindness globally51 countries, 1.2 M people blind, 232 M at riskSurgery, antibiotics, and facial cleanlinessEnvironmental improvement; target: elimination by 2020

Note. M: million.
Source of list: http://www.who.int/neglected_diseases/diseases/en/.