Background Scabies is an under-recognized global health problem with an unacceptably high prevalence in many settings worldwide. Fortunately, the World Health Organization (WHO) has formally designated scabies as a neglected tropical disease in 2017, in the hope of increasing awareness and encouraging efforts to eradicate it. Also, scabies has recently been included as part of the WHO roadmap for neglected tropical diseases 2021–2030, aimed at ending the neglect to attain the Sustainable Development Goals. Main abstract body This review article places scabies in focus. The literature was reviewed to explore discussions on controversial issues in scabies control, with the aim of clarifying whether global control of scabies is a feasible and worthwhile objective. The existing status of scabies and its burden are discussed along with future prospects for its global control. The article investigates the feasibility of scabies control and provides updates on the various impediments to this goal, such as challenges related to transmission, diagnosis, treatment, and vaccine development. Also examined are relevant research needs, success factors, and reasons for failure. This article aims to increase the global awareness of scabies and promote discussion, enhance coordinated international efforts, and ultimately, enact change at the national and worldwide levels toward the control of this preventable disease of the poor. Conclusion Despite the current challenges, scabies control is now within reach. With sustained interventions, continuous resources, and sincere commitment and support, scabies global control appears to be a worthwhile, realistic goal that is potentially achievable in the not so distant future.
Visceral leishmaniasis (VL) is one of the neglected tropical diseases that require a global policy for integrated control programs. The disease is fatal if untreated, affects ∼500,000 persons/year, and is most prevalent in poor countries. Treatment is expensive and carries a risk of toxicity. Therefore, sensitive and specific diagnosis of VL is crucial to avoid under- or overdiagnosis. Selecting an appropriate serological diagnostic test is an issue of controversy and depends on geographic location. The study aimed to evaluate the performance of two serological techniques: recombinant antigen K39 (rK39)-immunochromatographic (IC) lateral flow assay (InBios, USA) that uses a recombinant Leishmania antigen K39 and the specific IgG detection by direct agglutination test (DAT, for the diagnosis of imported VL in non-endemic region (Saudi Arabia). The diagnostic accuracy of the two assays was assessed using bone marrow aspiration, direct microscopic examination, and culture on NNN agar as the "gold standard". The bone marrow specimens from Indian, Sudanese, and Bengali patients (n = 98) with suspected VL features were cultured. Thirty-five specimens were positive (36%). The sensitivity and specificity of rK39-IC test were 89% (95% CI 78-99) and 92% (95% CI 85-99), respectively. DAT (with cutoff ≥1:1,600) showed comparable results (sensitivity 94%; 95% CI 87-101 and specificity 95%; 95% CI 90-100). To conclude, the performance of rK39-IC test and DAT is comparable. Both tests are moderately sensitive and specific and could be used to facilitate the global drive to eliminate this disease. The rK39-IC test is a rapid, easy-to-perform test and can be used as a point-of-care diagnostic method.
When the World Health Organization announced the goal of global eradication of malaria in 2007, questions were raised about the naivety of this proposition. Since then, experts have been divided about this goal. Some scientists suggest that when defeating malaria, elimination is a worthy and challenging aim, but this has to be done with modesty and thorough analysis. Others believe that it is time to repeat the experience of smallpox eradication and to open a whole new era for public health, the eradication of many diseases. The opposing view suggests that raising expectations and failing again may set malaria control back, rather than advance its cause. This literature review focuses on malaria elimination. It summarizes the history of malaria elimination, its success factors and reasons for failure, and the controversial issues in malaria elimination. The collected articles on the challenges of elimination, and the technical and financial feasibility that countries must appreciate before proceeding, are identified. Also, this review discusses the current global strategy to eliminate malaria and highlights the main concerns for future plans aimed at elimination. These plans foresee improving currently available diagnostic methods, therapeutic and prophylactic agents and protocols, vector control procedures, vaccine development progress, and other operational tools and approaches. Finally, this review addresses a number of research priorities in the present stage of the fight against malaria.
Background The world has made great strides towards beating malaria, although about half of the world population is still exposed to the risk of contracting malaria. Developing an effective malaria vaccine was a huge challenge for medical science. In 2021 the World Health Organization (WHO) approved the first malaria vaccine, RTS,S/AS01 vaccine (Mosquirix™), for widespread use. Main abstract body This review highlights the history of development, and the different approaches and types of malaria vaccines, and the literature to date. It covers the developmental stages of RTS,S/AS01 and recommends steps for its deployment. The review explores other potential vaccine candidates and their status, and suggests options for their further development. It also recommends future roles for vaccines in eradicating malaria. Questions remain on how RTS,S vaccine will work in widespread use and how it can best be utilized to benefit vulnerable communities. Conclusion Malaria vaccines have been in development for almost 60 years. The RTS,S/AS01 vaccine has now been approved, but cannot be a stand-alone solution. Development should continue on promising candidates such as R21, PfSPZ and P. vivax vaccines. Multi-component vaccines may be a useful addition to other malaria control techniques in achieving eradication of malaria.
Cryptosporidium species infect humans and a wide range of animals worldwide; outbreaks of cryptosporidiosis have been reported in several countries. Routine diagnostic methods may be insufficient to demonstrate the presence of these organisms. The study assessed the diagnostic accuracy of the antigen detection immuno-cartridge test, ImmunoCard STAT! (Meridian Bioscience Inc., Cincinnati, OH, USA), compared to the combined gold standard: modified Kinyoun's acid-fast technique confirmed with the microplate enzyme immunoassay (EIA) for the detection of Cryptosporidium in fecal specimens. Three hundred fifteen formalin-fixed stool specimens were submitted for testing. The Kinyoun's acid-fast-stained smear revealed 24 positive samples for Cryptosporidium (of which 23 specimens were confirmed by the EIA) and 291 negative samples (of which 289 were negative by EIA). Agreement between the three used tests was shown in 22 positive and 288 negative samples for Cryptosporidium. Kappa score of agreement between the immuno-cartridge test and EIA was 0.957, p = 0.000. The sensitivity of the immuno-cartridge test was 96% (95% confidence interval (CI), 87% to 104%) and the total accuracy of the test was 97% (95% CI, 93-103). The ImmunoCard STAT! Cryptosporidium cartridge assay is easy to use and does not require specialized training or equipment and is useful in routine diagnosis and screening for Cryptosporidium especially where rapid, point of care testing is needed or where other reliable tests are unfeasible with a performance comparable to the EIA and acid-fast technique.
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