Tropical Medicine

Neglected Tropical Diseases and Climate Change

Tropical Diseases and climate

Environment has a direct impact on the diseases prevalent in a particular region. Public health professionals refer to tropical diseases as the list of diseases found in tropical countries. These include malaria, HIV, dengue, schistosomiasis, trypanosomiasis, cholera, leprosy, leishmaniasis and others. These diseases may be contagious or spread by vectors and mostly affect the economically backward class.

Neglected Tropical Diseases

Globally, attention is focused on big three infectious disease i.e. HIV/AIDS, tuberculosis and malaria responsible for highest death rates. Unfortunately, other lesser known diseases are overlooked, thus called neglected tropical diseases (NTDs). The attention is not extended to these diseases due to lower mortality rate and lower income of the patient or poverty of the sufferers. Unavailability of food and clean water has resulted in malnutrition, poor sanitary conditions and abundant insect vectors. Poor sanitation is responsible for patients being infected with a parasite that transmits disease called schistosomiasis; poverty and unavailability of healthcare has resulted in deaths due to devastating hemorrhagic fever in Dengue patients. NTDs result from a variety of causative pathogens like bacteria (Buruli ulcer, trachoma and leprosy); viruses (rabies and dengue); protozoa (Human African trypanosomiasis, Chagas disease, and the leishmaniases); helminths (cysticercosis, taeniasis and soil-transmitted helminthiases) and others. WHO has revealed deaths due to NTDs is increasing which is responsible for social and health consequences, but attracts minimum research and funding activities.

Impact of climate change on public health

Every domain of society is impacted by climate change across the globe, including health. Life cycles of pathological and infectious disease are sensitive to environmental factors that include different physical phases of water, air and soil. Long (decadal), medium (annual) and short (seasonal) term effects of climate change determines the geographical transmission patterns of different infectious diseases. Among majority of infections occurring in the vast population, environmental factors are found responsible for parasitic, zoonotic and vector borne diseases.

Majority of the population across the world is susceptible to NTDs. With the exception of vector borne diseases that has been researched and published for the potential effects of climatic change, there is paucity on reports for other diseases. Scientific organisations and communities have overlooked the potential impact of climate change on NTDs.

Measures Control and Prevention

By 2020 WHO has expected elimination or eradication of some of the regional or global neglected tropical diseases. The strategies employed to achieve these goals are implementing integrated therapy, intensified disease management and preventive chemotherapy with repeated community based MDA (mass drug administration). NTDs treated by MDA include Schistosomiasis, Lymphatic filariasis, Trachoma, Onchocerciasis and caused by guinea worm or soil transmitted helminths; diseases needing individual treatment are Leprosy, Buruli Ulcer, Chagas disease, Human African Trypanosomiasis, Cutaneous or Visceral Leishmaniasis and Dengue; and other diseases are Neuro-Cysticercosis, Echinococcus, Brucellosis and rabies. Certain countries have focused intensified control efforts on soil transmitted helminths (STH).

Climate change and migration challenges NTDs elimination efforts, MDA strategies and campaigns. The climatic change based health impacts like vegetation phenology, changes in temperature or precipitation and identifying arbovirus vectors is researched intensively, but impact of climate change on NTDs and migration challenges have been overlooked. Emphasis has been put on developing strategies across various disease control and elimination programs, public health surveillance and outbreak responses towards mobile population to improve health impacts of climate change, better universal health coverage and sustainable development.

Research and development of simplified approaches and new strategies of novel interventions like vaccines, drug, diagnostics and vector control methods must be pursued. Key to success involves targeting more than one disease for preventive chemotherapy, coordinated and integrated therapy for diseases, safe co-administration of drugs, strategic and operational planning. Some of the attempts to accelerate control, elimination, eradication and prevention of NTDs include employing intensified innovative disease management strategies; funding research and development of preventive chemotherapy and vaccines; employing effective surveillance and reporting systems; improving veterinary health services; enhancing provisions of sanitation and hygiene; understanding vector ecology and management; and creating awareness on NTDS like zoonotic, helminths, vector borne diseases, etc.

Online Course in Tropical Medicine / Online Course in Environmental Health

James Lind Institute (JLI) provides an online program – Advanced PG Diploma in Tropical medicine, surveillance and immunization that can help in better understanding of neglected Tropical diseases. JLI also provides an advanced course in Environmental Health which aims to develop professionals with updated knowledge and skills for implementing programs and policies for safeguard of the environment in different regions of the world.

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