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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. Source

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. Source

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. Source

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. Source

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. Source

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