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Fulltext Neglected tropical diseases among the Association of Southeast Asian Nations (ASEAN): overview and update

Hotez PJ, Bottazzi ME, Strych U, Chang LY, Lim YA, Goodenow MM, et al.

PLoS Negl Trop Dis, 2015 Apr;9(4):e0003575.
PMID: 25880767 DOI: 10.1371/journal.pntd.0003575

The ten member states of the Association of Southeast Asian Nations (ASEAN) constitute an economic powerhouse, yet these countries also harbor a mostly hidden burden of poverty and neglected tropical diseases (NTDs). Almost 200 million people live in extreme poverty in ASEAN countries, mostly in the low or lower middle-income countries of Indonesia, the Philippines, Myanmar, Viet Nam, and Cambodia, and many of them are affected by at least one NTD. However, NTDs are prevalent even among upper middle-income ASEAN countries such as Malaysia and Thailand, especially among the indigenous populations. The three major intestinal helminth infections are the most common NTDs; each helminthiasis is associated with approximately 100 million infections in the region. In addition, more than 10 million people suffer from either liver or intestinal fluke infections, as well as schistosomiasis and lymphatic filariasis (LF). Intestinal protozoan infections are widespread, while leishmaniasis has emerged in Thailand, and zoonotic malaria (Plasmodium knowlesi infection) causes severe morbidity in Malaysia. Melioidosis has emerged as an important bacterial NTD, as have selected rickettsial infections, and leptospirosis. Leprosy, yaws, and trachoma are still endemic in focal areas. Almost 70 million cases of dengue fever occur annually in ASEAN countries, such that this arboviral infection is now one of the most common and economically important NTDs in the region. A number of other arboviral and zoonotic viral infections have also emerged, including Japanese encephalitis; tick-borne viral infections; Nipah virus, a zoonosis present in fruit bats; and enterovirus 71 infection. There are urgent needs to expand surveillance activities in ASEAN countries, as well as to ensure mass drug administration is provided to populations at risk for intestinal helminth and fluke infections, LF, trachoma, and yaws. An ASEAN Network for Drugs, Diagnostics, Vaccines, and Traditional Medicines Innovation provides a policy framework for the development of new control and elimination tools. Together with prominent research institutions and universities, the World Health Organization (WHO), and its regional offices, these organizations could implement important public health improvements through NTD control and elimination in the coming decade.

Matched MeSH terms: Neglected Diseases/prevention & control
Fulltext Building country capacity to sustain NTD programs and progress: A call to action

Sodahlon Y, Ross DA, McPhillips-Tangum C, Lawrence J, Taylor R, McFarland DA, et al.

PLoS Negl Trop Dis, 2020 10;14(10):e0008565.
PMID: 33031387 DOI: 10.1371/journal.pntd.0008565
Matched MeSH terms: Neglected Diseases/prevention & control*
The rise or fall of neglected tropical diseases in East Asia Pacific

Hotez PJ

Acta Trop, 2020 Feb;202:105182.
PMID: 31550453 DOI: 10.1016/j.actatropica.2019.105182

While the East Asia Pacific (EAP) region has experienced tremendous economic growth and development, the resulting public health gains from reductions in its neglected tropical diseases (NTDs) have been less than expected due to opposing forces of urbanization, political instability, food insecurity, and climate change, together with co-morbidities with non-communicable diseases, including diabetes and hypertension. To be sure there's been progress towards the elimination of lymphatic filariasis and trachoma through mass drug administration, and there are opportunities to extend MDA to yaws and scabies, but for most of the other NTDs we'll require new biotechnologies. So far, EAP's major technology hubs in China, Japan, Malaysia, Singapore, South Korea, and Taiwan have mostly failed to shift their attention towards new innovations for the NTDs, including new drugs, diagnostics, and vaccines, and vector control. Unless this situation changes the EAP could be facing a new grim reality of unhealthy megacities beset by emerging arbovirus infections, widespread antimicrobial resistance, and urban helminth infections.

Matched MeSH terms: Neglected Diseases/prevention & control*
Fulltext An economic evaluation of vector control in the age of a dengue vaccine

Fitzpatrick C, Haines A, Bangert M, Farlow A, Hemingway J, Velayudhan R

PLoS Negl Trop Dis, 2017 Aug;11(8):e0005785.
PMID: 28806786 DOI: 10.1371/journal.pntd.0005785

INTRODUCTION: Dengue is a rapidly emerging vector-borne Neglected Tropical Disease, with a 30-fold increase in the number of cases reported since 1960. The economic cost of the illness is measured in the billions of dollars annually. Environmental change and unplanned urbanization are conspiring to raise the health and economic cost even further beyond the reach of health systems and households. The health-sector response has depended in large part on control of the Aedes aegypti and Ae. albopictus (mosquito) vectors. The cost-effectiveness of the first-ever dengue vaccine remains to be evaluated in the field. In this paper, we examine how it might affect the cost-effectiveness of sustained vector control.
METHODS: We employ a dynamic Markov model of the effects of vector control on dengue in both vectors and humans over a 15-year period, in six countries: Brazil, Columbia, Malaysia, Mexico, the Philippines, and Thailand. We evaluate the cost (direct medical costs and control programme costs) and cost-effectiveness of sustained vector control, outbreak response and/or medical case management, in the presence of a (hypothetical) highly targeted and low cost immunization strategy using a (non-hypothetical) medium-efficacy vaccine.
RESULTS: Sustained vector control using existing technologies would cost little more than outbreak response, given the associated costs of medical case management. If sustained use of existing or upcoming technologies (of similar price) reduce vector populations by 70-90%, the cost per disability-adjusted life year averted is 2013 US$ 679-1331 (best estimates) relative to no intervention. Sustained vector control could be highly cost-effective even with less effective technologies (50-70% reduction in vector populations) and in the presence of a highly targeted and low cost immunization strategy using a medium-efficacy vaccine.
DISCUSSION: Economic evaluation of the first-ever dengue vaccine is ongoing. However, even under very optimistic assumptions about a highly targeted and low cost immunization strategy, our results suggest that sustained vector control will continue to play an important role in mitigating the impact of environmental change and urbanization on human health. If additional benefits for the control of other Aedes borne diseases, such as Chikungunya, yellow fever and Zika fever are taken into account, the investment case is even stronger. High-burden endemic countries should proceed to map populations to be covered by sustained vector control.

Matched MeSH terms: Neglected Diseases/prevention & control