What are Neglected Tropical Diseases?

Neglected Tropical Diseases or NTDs are a group of parasitic (protozoans, flukes, roundworms, tapeworms, flatworms), bacterial and viral diseases that afflict some of the world’s poorest populations.  They are particularly common in tropical areas where people have little or no access to clean water, minimal or no sanitation, have limited protection from disease vectors such as mosquitoes, flies and snails, have limited or no access to medical care and have little or no political voice.  Seven of the most common NTDs are found in a number of countries but are most frequently found in low and middle-income countries of Africa, Asia, and Latin America.

These diseases are non-discriminatory and affect men and women equally, young and old, with children being the most vulnerable.  Many of these diseases cause severe disfigurement and lifelong disabilities.  They can impede physical and cognitive development in children, adversely affect pregnancy outcomes and contribute to mother, infant and child illness and death.  Those affected by these diseases may find it difficult to attend school or work and may be shunned by their community due to fear and lack of understanding about these diseases.  This then affects the person's ability to obtain an education, earn a living, provide for their family and thus traps them in an endless cycle of poverty and disease.  

One may think these diseases are problems of “third world” countries, however, that is not the case.  Some of these diseases are found within the United States in areas of extreme poverty that include Appalachia, the Mississippi Delta, the American South, Native American tribal lands and the borderlands between the United States and Mexico.  Incidence of these diseases is also on the rise due to the increased number of immigrants, refugees and asylees seeking residence within the United States who arrive infected and untreated.   Still other cases, unrelated to poverty or immigration, are being identified in ecotourists, military personnel, missionary workers and volunteers who now have greater access to countries where these diseases are endemic.

Why are they considered “neglected”?

These diseases generally plague the poorest of the poor and those who are most in need of access to medical care, clean water, clean living conditions and improved sanitation.  These people usually have little or no political voice and, historically, have been overlooked, forgotten or "neglected" while other diseases such as HIV and Malaria receive worldwide attention.

How many people are infected?

According to the World Health Organization over a billion people or one-sixth of the entire world’s population is suffering from one or more of these neglected tropical diseases.

What are these diseases?

The World Health Organization (WHO) has identified seventeen chronic, disabling diseases that are in need of immediate global attention and intervention.

These are:

· Buruli Ulcer (Mycobacterium ulcerans infection)

· Chagas disease

· Dengue/Severe dengue

· Dracunculiasis (also known as guinea-worm disease)

· Echinococcosis

· Foodborne trematodiases (flatworm or “fluke” infections such as Chlonorchiasis, Fascioliasis, Opisthorchiasis and Paragonimiasis)

· Human African trypanosomiasis (also known as Sleeping sickness)

· Leishmaniasis

· Leprosy

· Lymphatic filariasis (also known as Elephantiasis)

· Onchocerciasis (also known as River blindness)

· Rabies

· Schistosomiasis (also known as Schisto, Bilharzia and Snail Fever)

· Soil transmitted helminthiases (intestinal worms such as Ascaris lumbricoides, Trichuris trichiura and hookworms),

· Taeniasis/Cysticercosis

· Trachoma

· Yaws (Endemic treponematoses)

The WHO has also identified five other 'neglected' conditions that need global awareness and intervention due to the high incidence of illness, chronic disability and death associated with them.  

These are:

· Podoconiosis (extreme swelling of the legs that is not caused by an infectious or contagious agent, parasite, bacteria or virus but instead is due to long term exposure to irritant minerals in red clay soils)

· Snakebite (disease and death attributed to venomous snake bites)

· Strongyloidiasis (chronic roundworm infection that can have devastating effects if the infected person has suppression of their immune system)
· Mycetoma (a chronic, progressive, destructive morbid inflammatory disease usually of the foot but can affect any part of the body - previously called Madura foot)

· Scabies (a parasitic infestation of the skin which triggers a host immune response that leads to intense itching that is then frequently complicated by bacterial infection, leading to the development of skin sores that, may then lead to serious consequences such as septicaemia, heart disease and chronic kidney disease.)

What can be done?

Many neglected tropical diseases can be prevented, eliminated or even eradicated with improved access to current safe and cost-effective interventions such as medication, mosquito nets and improved sanitation and drinking water.  At least seven of these diseases can be controlled and even eradicated by current approved, low cost medication that has few side effects, can be administered to adults and children and only requires as one to two doses per year.   Some of these interventions are so simple that non-specialists such as schoolteachers, village heads and local volunteers in community-based preventive action programs could carry them out.

Over the past few years these diseases have been gaining attention and there are now several groups who have formed initiatives to try to combat these diseases and improve the health of millions.   These organizations include the World Health Organization, the Centers for Disease Control in collaboration with the US Global Health Initiative or GHI, the Gates Foundation and the National Institutes of Health.

Despite this, more attention to these diseases and the people they affect is needed.  Without further awareness and intervention these diseases will continue to flourish, trapping the poor in a cycle of poverty and disease and devastating these people and their communities.

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"Action is a great restorer and builder of confidence.  Inaction is not only the result, but the cause, of fear.  Perhaps the action you take will be successful; perhaps different action or adjustments will have to follow.  But any action is better than no action at all."

-  Norman Vincent Peale