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Zhou X.-N.,National Institute of Parasitic Diseases | Wayling S.,Special Programme for Research and Training in Tropical Diseases TDR | Bergquist R.,Ingerod
Advances in Parasitology | Year: 2010

Strengthening human and physical resources for health research is an important function of any sustainable public health approach. The process of successfully embedding research into health systems in developing countries calls for the participation of competent, national scientists, with input and support where appropriate from international research institutions. Without a research-friendly environment, it is not easy for institutions and control programmes to engage and deliver products that can contribute to improving general health status. For example, monitoring is an important component of disease control but this can now be built upon to design surveillance systems capable of reporting activities in real time based on geographical information systems and continuous internet access. Informed surveillance can take on a stronger role than just capturing transmission foci to also become instrumental in directing swift responses in a spatially explicit and cost-effective manner. Further, whenever assessments of impact and control measures for different diseases are similar as they are, for example, with respect to schistosomiasis and food-borne trematode infections, the amalgamation of separate control programmes becomes realistic even if diverse strategies were originally developed for the diseases in question. Developments like this are guiding the expansion of research capabilities to espouse the integration of multidisciplinary research into national disease control programmes. The deployment of public-private partnerships as vehicles for operational progress and the endorsement of regional networks as platforms for driving research, while at the same time supporting and promoting training and dispersion of new knowledge, represent further manifestations of innovation in disease control. Some Asian examples of how this can be accomplished are provided. © 2010 Elsevier Ltd.


Utzinger J.,Swiss Tropical and Public Health Institute | Utzinger J.,University of Basel | Bergquist R.,Ingerod | Olveda R.,Institute of Tropical Medicine | Zhou X.-N.,National Institute of Parasitic Diseases
Advances in Parasitology | Year: 2010

Besides the 'big three'-HIV/AIDS, malaria and tuberculosis-there are a host of diseases that, by comparison, are truly neglected. These so-called neglected tropical diseases (NTDs), many of which caused by helminths, are intimately linked with poverty and are rampant where housing is poor; access to clean water and adequate sanitation is lacking; hygiene and nutrition is substandard and populations are marginalised and vulnerable. More than a billion people are affected by NTDs, mainly in remote rural and deprived urban settings of the developing world. An overview of papers published in two special thematic volumes of the Advances in Parasitology is provided here under the umbrella of current status of research and control of important helminth infections. A total of 25 comprehensive reviews are presented, which summarise the latest available data pertaining to the diagnosis, epidemiology, pathogenesis, prevention, treatment, control and eventual elimination of NTDs in Southeast Asia and neighbourhood countries. The focus of the first volume provides the current regional status of schistosomiasis, lymphatic filariasis, food-borne trematodiases, echinococcosis and cysticercosis/taeniasis, less common parasitic diseases that can cause epidemic outbreaks and helminth infections affecting the central nervous system. The second volume deals with the tools and strategies for control, including diagnostics, drugs, vaccines and cutting-edge basic research (e.g. the '-omics' sciences). Moreover, cross-cutting themes such as multiparasitism, social sciences, capacity strengthening, geospatial health technologies, health metrics and modelling the potential impact of climate change on helminthic diseases are discussed. Hopefully, these two volumes will become useful for researchers and, most importantly, disease control managers for integrated and sustainable control, rigorous monitoring and eventual elimination of NTDs in Southeast Asia and elsewhere. © 2010 Elsevier Ltd.


Zhou X.-N.,National Institute of Parasitic Diseases | Bergquist R.,Ingerod | Leonardo L.,University of the Philippines at Manila | Yang G.-J.,Jiangsu Institute of Parasitic Diseases | And 3 more authors.
Advances in Parasitology | Year: 2010

Schistosomiasis japonica, a chronic and debilitating disease caused by the blood fluke Schistosoma japonicum, is still of considerable economic and public health concern in the People's Republic of China, the Philippines, and Indonesia. Despite major progress made over the past several decades with the control of schistosomiasis japonica in the aforementioned countries, the disease is emerging in some areas. We review the epidemiological status and transmission patterns of schistosomiasis japonica, placing it into a historical context, and discuss experiences and lessons with national control efforts. Our analyses reveal that an integrated control approach, implemented through intersectoral collaboration, is essential to bring down the prevalence and intensity of Schistosoma japonicum infections and disease-related morbidity, and to sustain these parameters at low levels. The need for innovation and a sufficiently flexible control approach to adapt interventions in response to the changing nature and challenges of schistosomiasis control from the initial phase of morbidity control to the final state of elimination is emphasised. The aim of the presentation and the analyses is to inspire researchers and disease control managers elsewhere in Asia, Africa, and the Americas to harness the experiences gained and the lessons presented here to improve the control and eventual elimination of schistosomiasis and parasitic diseases. © 2010 Elsevier Ltd.


Yang G.-J.,Wuxi Institute of Technology | Liu L.,Wuxi Institute of Technology | Zhu H.-R.,Wuxi Institute of Technology | Griffiths S.M.,Chinese University of Hong Kong | And 7 more authors.
The Lancet Infectious Diseases | Year: 2014

Non-communicable diseases dominate the public health arena in China, yet neglected tropical diseases (NTDs) are still widespread and create a substantial burden. We review the geographical distribution, prevalence, and epidemic characteristics of NTDs identified in China caused by helminths, protozoa, bacteria, and viruses. Lymphatic filariasis was eliminated in 2007, but schistosomiasis still affects up to 5% of local village residents in some endemic counties with around 300 000 people infected. China harbours more than 90% of the world's burden of alveolar echinococcosis and food-borne zoonoses are emerging. In 2010, the overall prevalence of soil-transmitted helminth infections caused by Ascaris lumbricoides, Trichuris trichiura, and hookworm was 11·4%, with 6·8% of these infections caused by A lumbricoides. Corresponding figures for food-borne trematodiasis, echinococcosis, and cysticercosis are more than 5%. Dengue, leishmaniasis, leprosy, rabies, and trachoma exist in many areas and should not be overlooked. Transmission of vector-borne diseases can be interrupted; nevertheless, epidemics occur in remote areas, creating a challenge for surveillance and control. Rigorous surveillance, followed by immediate and integrated response packages tailored to specific social and ecological systems, is essential for progress towards the elimination of NTDs in China. © 2014 Elsevier Ltd.


Malone J.B.,Louisiana State University | Robert Bergquist N.,Ingerod
Geospatial Health | Year: 2012

The prospects and opportunities for application of risk mapping and modelling of the neglected tropical diseases (NTDs) in Latin America are examined with the aim to broaden the interest in geospatial research there. Special reference is made to the potential use of geospatial tools in health planning and implementation of national disease control programmes.


Johansen M.V.,Copenhagen University | Sithithaworn P.,Khon Kaen University | Bergquist R.,Ingerod | Utzinger J.,Swiss Tropical and Public Health Institute | Utzinger J.,University of Basel
Advances in Parasitology | Year: 2010

Humans in Southeast Asia are at risk for at least 70 species of food-borne and water-borne trematodes, including blood flukes, intestinal flukes, liver flukes and lung flukes, which are shared with a great variety of animals. Co-infection with several other zoonotic trematodes is pervasive, and hence differential diagnosis represents a major challenge. Many zoonotic trematodes are commonly overlooked, leading to unreliable prevalence data, underappreciation of their veterinary and public health burden and impact, and general neglect with respect to treatment and control. Additionally, many eggs are indistinguishable by microscopy. For example, failure to address this diagnostic dilemma has resulted in overestimation of Clonorchis sinensis prevalence and underestimation of minute intestinal flukes. Test insensitivity is becoming a problem of prime interest as surveillance is gaining in importance and various control programmes now regularly register progress. Hence, the likelihood of underestimating the true burden of disease is growing in well-controlled areas when the faecal egg excretion among infected individuals approaches zero. While antibody testing has ultimate sensitivity, its use as a test of cure remains contentious. On the other hand, employing faecal egg detection as the diagnostic 'gold' standard makes many positive antibody test results (incorrectly) appear false. Polymerase chain reaction (PCR)-based diagnostics could solve this dilemma, but more experience is needed and costs must be brought down to permit large-scale use of this approach. The future development of virtual microscopy to be used for diagnosis of parasitic infections in the field could make ordinary microscopy obsolete by electronically capturing specimens at point-of-contact in remote areas. © 2010 Elsevier Ltd.


Cringoli G.,University of Naples Federico II | Rinaldi L.,University of Naples Federico II | Albonico M.,Ivo Of Carneri Foundation | Bergquist R.,Ingerod | And 2 more authors.
Geospatial Health | Year: 2013

Large-scale control and progressive elimination of a wide variety of parasitic diseases is moving to the fore. Indeed, there is good pace and broad political commitment. Yet, there are some worrying signs ahead, particularly the anticipated declines in funding and coverage of key interventions, and the paucity of novel tools and strategies. Further and intensified research and development is thus urgently required. We discuss advances in epidemiological sampling, diagnostic tools and geospatial methodologies. We emphasise the need for integrating sound epidemiological designs (e.g. cluster-randomised sampling) with innovative diagnostic tools and strategies (e.g. Mini-FLOTAC for detection of parasitic elements and pooling of biological samples) and high-resolution geospatial tools. Recognising these challenges, standardisation of quality procedures, and innovating, validating and applying new tools and strategies will foster and sustain long-term control and eventual elimination of human and veterinary public health issues.


Bergquist R.,Ingerod | Tanner M.,Swiss Tropical and Public Health Institute | Tanner M.,University of Basel
Advances in Parasitology | Year: 2010

An overview of schistosomiasis control in the People's Republic of China and the Philippines is presented. Whilst the Chinese have managed to reduce the number of Schistosoma japonicum infections from an estimated 11.6 million to well below 1 million since 1950, the corresponding drop in the Philippines is less pronounced: from 700,000 in 1975 to currently 560,000. However, these figures should be seen in the context of the population growth, which approximately doubled the Chinese population over the past 60. years (from 557 million to 1.3 billion) whereas the number of Filipinos during the same time more than quadrupled (from 21 to 93 million). The Philippine progress should also be judged against the backdrop of regional political instability combined with strong socio-ecological dynamics. Although substantial improvements have been achieved in both countries, compliance is waning in people repeatedly given praziquantel with or without prior diagnosis and this problem will not be reversed without sustained vigilance. In addition, the lower rates of excreted eggs per gram of stool in the new endemic situation characterised by widespread, low-intensity infections influence the accuracy of prevalence assessments negatively. Remaining pockets of high transmission further complicate the situation. Maintaining that advances in schistosomiasis control critically depend on technical progress, we discuss the problems currently facing control programmes from the viewpoint of what research can actually contribute at this stage of disease control. The need for flexible control approaches is emphasised and more sensitive diagnostics is highlighted. Above all, it is argued that strengthened, innovative surveillance approaches are called for if elimination of the disease is to succeed. © 2010 Elsevier Ltd.


Bergquist R.,Ingerod | Lustigman S.,Lindsley F Kimball Research Institute
Advances in Parasitology | Year: 2010

Among the tools available for the control of helminth infections, chemotherapy has come to totally dominate the field. In the veterinary field, development of drug resistance has appeared but this is not (yet) a problem in the control of human diseases. Although there is no vaccine commercially available for any human parasitic infection yet, recent progress in vaccine development is making this a future possibility for several diseases. The goal of chemotherapy is to alleviate infection and morbidity in the definitive host, or reduce transmission, while the effect of available vaccine candidates would mainly be to influence transmission through targeting the intermediate or reservoir host, when the infection is zoonotic. Apart from this general scheme, there are also vaccine candidates targeting the parasites in the definitive host, in particular the early developmental stages, which should reduce the risk of drug failure. Since the biological targets in most cases are different, vaccination would be synergistic with drug therapy. This review covers diseases caused by helminthes in both humans and animals and includes examples of diseases caused by cestodes, nematodes and trematodes. The focus is on infections for which vaccine development has been undertaken for a long time, resulting in products that could realistically become integrated into control strategies in the near future. © 2010 Elsevier Ltd.


Bergquist R.,Ingerod | Rinaldi L.,University of Naples Federico II
Journal of Helminthology | Year: 2010

The possibilities of disease prediction based on the environmental characteristics of geographical areas and specific requirements of the causative infectious agents are reviewed and, in the case of parasites whose life cycles involve more than one host, the needs of the intermediate hosts are also referred to. The geographical information systems framework includes epidemiological data, visualization (in the form of maps), modelling and exploratory analysis using spatial statistics. Examples include climate-based forecast systems, based on the concept of growing degree days, which now exist for several parasitic helminths such as fasciolosis, schistosomiasis, dirofilariasis and also for malaria. The paper discusses the limits of data collection by remote sensing in terms of resolution capabilities (spatial, temporal and spectral) of sensors on-board satellites. Although the data gained from the observation of oceans, land, elevations, land cover, land use, surface temperatures, rainfall, etc. are primarily for weather forecasting, military and commercial use, some of this information, particularly that from the climate research satellites, is of direct epidemiological utility. Disease surveillance systems and early-warning systems (EWS) are prime examples of academic approaches of practical importance. However, even commercial activities such as the construction of virtual globes, i.e. computer-based models of the Earth, have been used in this respect. Compared to conventional world maps, they do not only show geographical and man-made features, but can also be spatially annotated with data on disease distribution, demography, economy and other measures of particular interest. Copyright © Cambridge University Press 2009.

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