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Tropical diseases

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Tropical diseases

Tropical diseases are diseases that are prevalent in or unique to tropical and subtropical regions. The diseases are less prevalent in temperate climates, due in part to the occurrence of a cold season, which controls the insect population by forcing hibernation.[1] Insects such as mosquitoes and flies are by far the most common disease carrier, or vector. These insects may carry a parasite, bacterium or virus that is infectious to humans and animals. Most often disease is transmitted by an insect "bite", which causes transmission of the infectious agent through subcutaneous blood exchange. Vaccines are not available for any of the diseases listed here, and many do not have cures.[2]

Human exploration of tropical rainforests, deforestation, rising immigration and increased international air travel and other tourism to tropical regions has led to an increased incidence of such diseases.[3][4]

Special Programme for Research and Training in Tropical Diseases (TDR)

In 1975 the Special Programme for Research and Training in Tropical Diseases (TDR) was established to focus on neglected infectious diseases which disproportionately affect poor and marginalized populations in developing regions of World Health Organization.

TDR's vision is to foster an effective global research effort on infectious diseases of poverty in which disease endemic countries play a pivotal role. It has a dual mission of developing new tools and strategies against these diseases, and to develop the research and leadership capacity in the countries where the diseases occur. The TDR secretariat is based in Geneva, Switzerland, but the work is conducted throughout the world through many partners and funded grants.

Some examples of work include helping to develop new treatments for diseases, such as ivermectin for onchocerciasis (river blindness); showing how packaging can improve use of artemesinin-combination treatment (ACT) for malaria; demonstrating the effectiveness of bednets to prevent mosquito bites and malaria; and documenting how community-based and community-led programmes increases distribution of multiple treatments. TDR history

The current TDR disease portfolio includes the following entries:[5]

Although leprosy and tuberculosis are not exclusively tropical diseases, their high incidence in the tropics justifies their inclusion.

Other neglected tropical diseases

Additional neglected tropical diseases include:[16]

Disease Causative Agent Comments
Hookworm Ancylostoma duodenale and Necator americanus
Trichuriasis Trichuris trichiura
Treponematoses Treponema pallidum pertenue, Treponema pallidum endemicum, Treponema pallidum carateum, Treponema pallidum pallidum
Buruli ulcer Mycobacterium ulcerans
Human African trypanosomiasis Trypanosoma brucei, Trypanosoma gambiense
Dracunculiasis Dracunculus medinensis
Leptospirosis Leptospira
Strongyloidiasis Strongyloides stercoralis
Foodborne trematodiases Trematoda
Neurocysticercosis Taenia solium
Scabies Sarcoptes scabiei
Flavivirus Infections Yellow fever virus, West Nile virus, dengue virus, Tick-borne encephalitis virus

Some tropical diseases are very rare, but may occur in sudden epidemics, such as the Ebola hemorrhagic fever, Lassa fever and the Marburg virus. There are hundreds of different tropical diseases which are less known or rarer, but that, nonetheless, have importance for public health.

Relation of climate to tropical diseases

The so-called "exotic" diseases in the tropics have long been noted both by travelers, explorers, etc., as well as by physicians. One obvious reason is that the hot climate present during all the year and the larger volume of rains directly affect the formation of breeding grounds, the larger number and variety of natural reservoirs and animal diseases that can be transmitted to humans (zoonosis), the largest number of possible insect vectors of diseases. It is possible also that higher temperatures may favor the replication of pathogenic agents both inside and outside biological organisms. Socio-economic factors may be also in operation, since most of the poorest nations of the world are in the tropics. Tropical countries like Brazil, which have improved their socio-economic situation and invested in hygiene, public health and the combat of transmissible diseases have achieved dramatic results in relation to the elimination or decrease of many endemic tropical diseases in their territory.

Climate change, global warming caused by the greenhouse effect, and the resulting increase in global temperatures, are possibly causing tropical diseases and vectors to spread to higher altitudes in mountainous regions, and to higher latitudes that were previously spared, such as the Southern United States, the Mediterranean area, etc.[17][18] For example, in the Monteverde cloud forest of Costa Rica, global warming enabled Chytridiomycosis, a tropical disease, to flourish and thus force into decline amphibian populations of the Monteverde Harlequin frog.[19] Here, global warming raised the heights of orographic cloud formation, and thus produced cloud cover that would facilitate optimum growth conditions for the implicated pathogen, B. dendrobatidis.

Prevention and treatment of tropical diseases

Some of the strategies for controlling tropical diseases include:

  • Draining wetlands to reduce populations of insects and other vectors.
  • The application of insecticides and/or insect repellents) to strategic surfaces such as: clothing, skin, buildings, insect habitats, and bed nets.
  • The use of a mosquito net over a bed (also known as a "bed net") to reduce nighttime transmission, since certain species of tropical mosquitoes feed mainly at night.
  • Use of water wells, and/or water filtration, water filters, or water treatment with water tablets to produce drinking water free of parasites.
  • Sanitation to prevent transmission through human waste
  • Development and use of vaccines to promote disease immunity.
  • Pharmacologic pre-exposure prophylaxis (to prevent disease before exposure to the environment and/or vector).
  • Pharmacologic post-exposure prophylaxis (to prevent disease after exposure to the environment and/or vector).
  • Pharmacologic treatment (to treat disease after infection or infestation).
  • Assisting with economic development in endemic regions. For example by providing microloans to enable investments in more efficient and productive agriculture. This in turn can help subsistence farming to become more profitable, and these profits can be used by local populations for disease prevention and treatment, with the added benefit of reducing the poverty rate.


See also

References

Further reading

Books

  • TDR at a glance - fostering an effective global research effort on diseases of poverty
  • Le TDR en un coup d’oeilLe TDR en un coup d’oeil - favoriser un eff ort mondial de recherche eff icace sur les maladies liées à la pauvreté
  • TDR annual report - 2009
  • Monitoring and evaluation tool kit for indoor residual spraying
  • Indicators for monitoring and evaluation of the kala-azar elimination programme
  • Malaria Rapid Diagnostic Test Performance - results of WHO product testing of malaria RDTs: Round 2- 2009
  • Quality Practices in Basic Biomedical Research (QPBR) training manual: Trainer
  • Quality Practices in Basic Biomedical Research (QPBR) training manual: Trainee
  • Progress and prospects for the use of genetically modified mosquitoes to inhibit disease transmission
  • Manson's Tropical Diseases
  • this site

Journals

  • American Journal of Tropical Medicine and Hygiene
  • Japanese Journal of Tropical Medicine and Hygiene
  • Tropical Medicine and International Health
  • The Southeast Asian Journal of Tropical Medicine and Public Health
  • Revista do Instituto de Medicina Tropical de São Paulo
  • Revista da Sociedade Brasileira de Medicina Tropical
  • Journal of Venomous Animals and Toxins including Tropical Diseases

Websites

External links

  • WHO Neglected Tropical Diseases
  • WHO Operational research in tropical and other communicable diseases
  • open sourse drug discovery
  • Drugs for Neglected Diseases Initiative
  • Tropical diseases from Maya Paradise, The Guatemala Information Web Site
  • American Society for Tropical Medicine and Hygiene
  • Food and Drug Administration
  • Centers for Disease Control and Prevention
  • Professor Andrew Speilman, Harvard School of Tropical Medicine Freeview Malaria video by the Vega Science Trust.
  • Rob Hutchingson, Entomolgoist, London School of Tropical Medicine, Mosquitoes Freeview 'Snapshot' video by the Vega Science Trust.
  • Links to pictures of tropical diseases (Hardin MD/Univ of Iowa)
  • Tulane University School of Public Health and Tropical Medicine - New Orleans, Louisiana, USA
  • Tropical Diseases Web Ring
  • Tropicology Library. In Portuguese.
  • Institute for Tropical Medicine - Antwerp - Belgium
  • Lecture Notes ITM - Antwerp - Belgium
  • Faculty of Tropical Medicine, Mahidol University - Bangkok - Thailand
  • Gresham College, 17 September 2007 (available for download as video and audio files, as well as a text file).
  • Colombian Institute of Tropical Medicine ICMT-CES University
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