Introdução
Capítulo A.9
Edição em Português
Editor: Flávio Dias Silva.
Tradutores: Letícia Tomaz Oliveira, Luciano da Silva Quadros
Carlos Chagas discovered American trypanosomiasis, also named Chagas disease (CD) in his honor, just over a century ago. He described the clinical aspects of the disease, characterized by its etiological agent (Trypanosoma cruzi) and identified its insect vector. Initially, CD occurred only in Latin... America and was considered a silent and poorly visible disease. More recently, CD became a neglected worldwide disease with a high morbimortality rate and substantial social impact, emerging as a significant public health threat. In this context, it is crucial to better understand better the epidemiological scenarios of CD and its transmission dynamics, involving people infected and at risk of infection, diversity of the parasite, vector species, and T. cruzi reservoirs. Although efforts have been made by endemic and non-endemic countries to control, treat, and interrupt disease transmission, the cure or complete eradication of CD are still topics of great concern and require global attention. Considering the current scenario of CD, also affecting non-endemic places such as Canada, USA, Europe, Australia, and Japan, in this review we aim to describe the spread of CD cases worldwide since its discovery until it has become a global public health concern.
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The Indigenous tribe called the Wiwa lives retracted in the Sierra Nevada de Santa Marta, Colombia. Little is known about their health status and whether the health care system in place covers their needs.
Front. Public Health, 02 July 2019 Sec. Infectious Diseases: Epidemiology and Prevention
Volume 7 - 2019 | https://doi.org/10.3389/fpubh.2019.00166
Chagas disease (CD) is an anthropozoonosis caused by the protozoan parasite Trypanosoma cruzi, that affects about 6–8 million people worldwide (1) a...nd causes approximately 50,000 deaths per year. Another 65–100 million people are living in areas at risk for infection worldwide (2–4). Even though over a century has passed since its discovery, CD remains one of the leading public health problems for most Latin American countries
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WHO's 2020 milestones for Chagas disease include having all endemic Latin American countries certified with no intradomiciliary Trypanosoma cruzi transmission, and infected patients under care. Evaluating the variation in historical exposure to infection is crucial for assessing progress and for und...erstanding the priorities to achieve these milestones.
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Human African Trypanosomiasis (HAT, sleeping sickness) and Animal African Trypanosomiasis (AAT) are neglected tropical diseases generally caused by the same etiological agent, Trypanosoma brucei. Despite important advances in the reduction or disappearance of HAT cases, AAT represents a risky reserv...oir of the infections. There is a strong need to control AAT, as is claimed by the European Commission in a recent document on the reservation of antimicrobials for human use. Control of AAT is considered part of the One Health approach established by the FAO program against African Trypanosomiasis. Under the umbrella of the One Health concepts, in this work, by analyzing the pharmacological properties of the therapeutic options against Trypanosoma brucei spp., we underline the need for clearer and more defined guidelines in the employment of drugs designed for HAT and AAT. Essential requirements are addressed to meet the challenge of drug use and drug resistance development. This approach shall avoid inter-species cross-resistance phenomena and retain drugs therapeutic activity.
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Chagas disease (CD) is a neglected tropical disease, endemic in Latin America, but due to migration and environmental changes it has become a global public health issue.
Chagas disease constitutes a public health problem, and Spain is the non-endemic country with the highest burden of disease outside the Americas. It represents a model for non-endemic countries regarding health policies to control the disease. This study is aimed to generate estimates of the T.cruzi... prevalence and the number of undetected and untreated individuals with the infection in Spain and to compare them with the actual number of cases reported by official sources.
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Objective
To estimate the prevalence of Chagas disease in pregnant women and the vertical transmission of the disease.
Methods
Observational studies were identified from eight electronic databases, and details on study design, population and prevalence of Chagas disease were extracted. The data... were pooled using a random-effects model, and choropleth maps were created based on geopolitical regions and countries.
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Cutaneous leishmaniasis (CL) is a neglected infectious endemic disease that is transmitted through the bite of a vector insect (sandfly) of the Lutzomyia genus,typical of rural geographical territories, and causes disfiguring skin ulcers and disabilities. It is estimated that CL affects between 600...000 and 1 000 000 people a year around the world, mainly in the America s, the Mediterranean basin, the Middle East and Central Asia. Eighteen of the 21 countries that make up the Latin American (LA) region are considered endemic areas for this neglected tropical disease. Colombia is one of the countries that reports the majority of global cases with 6161 in 2020 and has the second highest number of cases in the Americas, after Brazil.
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Taenia saginata is a zoonotic tapeworm that is of economic importance in countries where cattle are kept. The parasite is transmitted from human tapeworm carriers (taeniosis) to bovines (cysticercosis) by excretion of eggs or proglottids containing eggs into the environment via the stool. Bovines ca...n then ingest the eggs through contaminated feed or water. After ingestion, the eggs hatch and release oncospheres in the small intestines, where the oncospheres penetrate the intestinal wall to reach the blood circulation. This distributes them throughout the body, but primarily to muscle tissue, where they develop into cysticerci. For humans to become infected with T. saginata, raw or undercooked bovine meat or offal containing infective cysts must be consumed. Bovine cysticercosis has been associated with various environmental factors related to water sources, such as animals having access to surface water, flooding of pastures and proximity to wastewater sources.
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Human African trypanosomiasis (HAT) is a lethal neglected tropical disease (NTD) transmitted by the bite of infected tsetse flies. The disease is also known as “sleeping sickness”. During the 20th century it caused enormous suffering in the endemic areas in sub-Saharan Africa. HAT transmission l...ast soared in the late 1990s, triggering a renewed, coordinated and very successful control effort. In this paper, we present achievements towards HAT elimination, with a focus on the WHO road map targets for 2020. In particular, reported cases continue to decline, from over 30,000 cases per year at the turn of the century to 663 cases in 2020. Despite the impact of the COVID-19 pandemic, HAT surveillance was largely sustained, and the network of health facilities able to diagnose and treat the disease further expanded. Looking to the future, the World Health Organization (WHO) set bold new targets for HAT in its 2021–2030 road map for NTDs, namely: the elimination of transmission of gambiense HAT, which occurs in western and central Africa, and the elimination as a public health problem of rhodesiense HAT, which is found in eastern and southern Africa. The strong commitment of national health authorities and the international community will be essential if these goals are to be achieved.
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Leishmaniasis is a vector-borne disease with a broad global distribution and an increasing number of recorded cases worldwide. However, it is still one of the world's most neglected diseases. Over the last decades, the disease has been found to expand geographically with a global increase of cases o...f visceral and cutaneous leishmaniasis increasing the public health problems associated with the disease epidemics. The reported range expansion of the diseases has been associated with range expansions of vector populations in response to climate change. Leishmaniasis is caused by protozoan parasites of the genus Leishmania. The transmission can either be zoonotic and/or anthroponotic through the bite of an infected female phlebotomine sandfly. In Eurasia and Africa, all vector-competent sandfly species belong to the genus Phlebotomus. Cutaneous leishmaniasis (CL) is the most common form of leishmaniasis. In the ‘old world’, it is caused by five currently recognized Leishmania species: L. major, L. tropica and L. aethiopica (being main causative parasites) as well as L. infantum and L. donovani. Visceral leishmaniasis (VL), another common and more severe form of leishmaniasis, is only associated with the Leishmania species L. infantum and L. donovani. The specific Leishmania species cause different clinical symptoms in humans.
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Chagas disease or American trypanosomiasis is, together with geohelminths, the neglected disease that causes more loss of years of healthy life due to disability in Latin America. Chagas disease, as determined by the factors and determinants, shows that different contexts require different actions, ...preventing new cases or reducing the burden of disease. Control strategies must combine two general courses of action including prevention of transmission to prevent the occurrence of new cases (these measures are cost effective), as well as opportune diagnosis and treatment of infected individuals in order to prevent the clinical evolution of the disease and to allow them to recuperate their health. All actions should be implemented as fully as possible and with an integrated way, to maximise the impact. Chagas disease cannot be eradicated due because of the demonstrated existence of infected wild triatomines
in permanent contact with domestic cycles and it contributes to the occurrence of at least few new cases. However, it is possible to interrupt the transmission of Trypanosoma cruzi in a large territory and to eliminate Chagas disease
as a public health problem with a dramatic reduction of burden of the disease.
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Background: The last decade has seen a dramatic increase in international and domestic funding for malaria control, coupled with important declines in malaria incidence and mortality in some regions of the world. As the ongoing climate of financial uncertainty places strains on investment in global ...health, there is an increasing need to audit the origin, recipients and geographical distribution of funding for malaria control relative to populations at risk of the disease. Methods: A comprehensive review of malaria control funding from international donors, bilateral sources and national governments was undertaken to reconstruct total funding by country for each year 2006 to 2010. Regions at risk from Plasmodium falciparum and/or Plasmodium vivax transmission were identified using global risk maps for 2010 and funding was assessed relative to populations at risk. Those nations with unequal funding relative to a regional average were identified and potential explanations highlighted, such as differences in national policies, government inaction or donor neglect.
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The International Conference on Population and Development in 1994 set targets for donor funding to support family planning programmes, and recent initiatives such as FP2020 have renewed focus on the need for adequate funding to rights-based family planning. Disbursements supporting family planning ...disaggregated by donor, recipient country and year are not available for recent years. We estimate international donor funding for family planning in 2003–13, the period covering the introduction of reproductive health targets to the Millennium Development Goals and up to the beginning of FP2020, and compare funding to unmet need for family planning in recipient countries. We used the dataset of donor disbursements to support reproductive, maternal, newborn and child health developed by the Countdown to 2015 based on the Organization for Economic Cooperation and Development Creditor Reporting System.
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BACKGROUND. Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The burden of asthma in children is increasing in low- and middle-income countries and remains under-recognised and poorly managed.
OBJE...CTIVES. To quantify the burden of asthma in the South African (SA) population and identify the risk factors associated with disease severity in the local context.
METHODS. The SA Childhood Asthma Working Group (SACAWG) convened in January 2017 with task groups, each headed by a section leader, constituting the editorial committee on assessment of asthma epidemiology, diagnosis, control, treatments, novel treatments and self-management plans. The epidemiology task group reviewed the available scientific literature and assigned evidence according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system.
CONCLUSIONS. Asthma in children remains a common condition, which has shown an increasing prevalence in urban and rural populations of SA. Of concern is that almost half of children in urban communities experience severe asthma symptoms, and many asthmatics lack a formal diagnosis and thus access to treatment. Exposure to tobacco smoke and living in highly polluted areas increase the severity of wheezing in young children.
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The goal of asthma treatment is to obtain clinical control and reduce future risks to the patient. To reach this goal in children with asthma, ongoing monitoring is essential. While all components of asthma, such as symptoms, lung function, bronchial hyperresponsiveness and inflammation, may exist i...n various combinations in different individuals, to date there is limited evidence on how to integrate these for optimal monitoring of children with asthma. The aims of this ERS Task Force were to describe the current practise and give an overview of the best available evidence on how to monitor children with asthma.
22 clinical and research experts reviewed the literature. A modified Delphi method and four Task Force meetings were used to reach a consensus.
This statement summarises the literature on monitoring children with asthma. Available tools for monitoring children with asthma, such as clinical tools, lung function, bronchial responsiveness and inflammatory markers, are described as are the ways in which they may be used in children with asthma. Management-related issues, comorbidities and environmental factors are summarised.
Despite considerable interest in monitoring asthma in children, for many aspects of monitoring asthma in children there is a substantial lack of evidence.
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Urbanisation has been associated with temporal and geographical differences in asthma prevalence in low-income and middle-income countries (lMics). however, little is known of the mechanisms by which urbanisation and asthma are associated, perhaps explained by the methodological approaches used to a...ssess the urbanisation-asthma relationship.
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