BackgroundNeglected tropical diseases (NTDs) are an important cause of death and disability in Africa. This study estimates the monetary value of human lives lost due to NTDs in the continent in 2015.MethodsThe lost output or human capital approach was used to evaluate the years of life lost due to premature deaths from NTDs among 10 high/upper-middle-income (Group 1), 17 middle-income (Group 2) and 27 low-income (Group 3) countries in Africa. The future losses were discounted to their present values at a 3% discount rate. The model was re-analysed using 5% and 10% discount rates to assess the impact on the estimated total value of human lives lost.ResultsThe estimated value of 67 860 human lives lost in 2015 due to NTDs was Int$ 5 112 472 607. Out of that, 14.6% was borne by Group 1, 57.7% by Group 2 and 27.7% by Group 3 countries. The mean value of human life lost per NTD death was Int$ 231 278, Int$ 109 771 and Int$ 37 489 for Group 1, Group 2 and Group 3 countries, respectively. The estimated value of human lives lost in 2015 due to NTDs was equivalent to 0.1% of the cumulative gross domestic product of the 53 continental African countries.ConclusionsEven though NTDs are not a major cause of death, they impact negatively on the productivity of those affected throughout their life-course. Thus, the case for investing in NTDs control should also be influenced by the value of NTD morbidity, availability of effective donated medicines, human rights arguments, and need to achieve the NTD-related target 3.3 of the United Nations Sustainable Development Goal 3 (on health) by 2030.Electronic supplementary materialThe online version of this article (10.1186/s40249-017-0379-y) contains supplementary material, which is available to authorized users.

Background: As Kenya accelerates the momentum to attain the Sustainable Development Goals (SDG) 3 on health and 13 on combatting impacts of climate change, it is critically important not to overlook their impacts on the elderly, i.e. people aged 60 years and above (elderly). The objective of this study was to estimate the indirect cost (productivity losses) of disability-adjusted life years (DALYs) lost among the elderly in Kenya in 2015. Methods:The indirect cost associated with j th disease (or health condition) DALYs lost among the elderly is the product of the per capita non-health GDP in purchasing power parity (PPP) and the total j th disease (or health condition) DALYs lost in a specific age group. Per capita non-health GDP equals Kenya's per capita GDP minus total health expenditure in 2015. The study covers all the diseases and health conditions reported in WHO Global Health Observatory (GHO). The data on DALYs and per capita total health expenditure were obtained from WHO GHO; while per capita GDP data was from IMF World Economic Outlook database. Results BackgroundKenya is one of the five East African Community (EAC) countries. In 2015 it had an estimated population of 46,034,000 people; which was about 4% of Africa's population. About 1,921,000 (4%) of Kenya's population was 60 years and above, i.e. the elderly [1]. Sixty-five percent of the elderly were aged 60 to 69 years and the remaining 35% were aged 70 years and above. Sixty-seven and 33% of the elderly were female and male respectively. The World Health Organization (WHO) projects that the number of people aged 60 years (or over) in Africa will increase by 3.2 fold between 2015 and 2050; meaning that Kenya will have approximately 6.2 million elderly people by 2050.During the same year there occurred a total of 317,173 deaths from all causes in Kenya; which was 3% of deaths borne by Africa [2]. Approximately 93,693 (30%) of Kenya's deaths were among the elderly; 33% among 60-60 year olds and 67% among 70 years and above. Fifty-one percent of the deaths were female.Kenya incurred a total loss of 21,854,898 disability-adjusted life years (DALYs) from all causes in 2015, i.e. 3.1% of Africa's loss [1]. About 2,238,004 (10.2%) of the DALY loss occurred among the elderly; of which half were among those aged 60-69 years and other half among 70 years and above. Again almost 51% of the DALY loss was incurred by females.The disability-adjusted life years (DALYs) losses are attributable to three very broad causes [1]. First, 656,637 (29.3%) of the DALY lost in 2015 were caused by communicable, maternal, perinatal and nutritional conditions. Second, 1,434,494 (64.1%) were from non-communicable diseases. Lastly, 146,873 (6.6%) were from intentional and unintentional injuries. Thus, it is clear that majority of health problems of elderly persons are inextricably linked to chronic non-communicable diseases.According to WHO most of the chronic NCD conditions can be prevented or delayed by healthy behaviours, including physical activity, stoppage of s...

Background. Cryptosporidium is a protozoan parasite and a major cause of diarrhea in children and immunocompromised patients. Current diagnostic methods for cryptosporidiosis such as microscopy have low sensitivity while techniques such as PCR indicate higher sensitivity levels but are seldom used in developing countries due to their associated cost. A loop-mediated isothermal amplification (LAMP) technique, a method with shorter time to result and with equal or higher sensitivity compared to PCR, has been developed and applied in the detection of Cryptosporidium species. The test has a detection limit of 10 pg/µl (~100 oocysts/ml) indicating a need for more sensitive diagnostic tools. This study developed a more sensitive lateral flow dipstick (LFD) LAMP test based on SAM-1 gene and with the addition of a second set of reaction accelerating primers (stem primers). Results. The stem LFD LAMP test showed analytical sensitivity of 10 oocysts/ml compared to 100 oocysts/ml (10 pg/ul) for each of the SAM-1 LAMP test and nested PCR. The stem LFD LAMP and nested PCR detected 29/39 and 25/39 positive samples of previously identified C. parvum and C. hominis DNA, respectively. The SAM-1 LAMP detected 27/39. On detection of Cryptosporidium DNA in 67 clinical samples, the stem LFD LAMP detected 16 samples and SAM-2 LAMP 14 and nested PCR identified 11. Preheating the templates increased detection by stem LFD LAMP to 19 samples. Time to results from master mix preparation step took ~80 minutes. The test was specific, and no cross-amplification was recorded with nontarget DNA. Conclusion. The developed stem LFD LAMP test is an appropriate method for the detection of C. hominis, C. parvum, and C. meleagridis DNA in human stool samples. It can be used in algorithm with other diagnostic tests and may offer promise as an effective diagnostic tool in the control of cryptosporidiosis.

Background Entamoeba histolytica, the causative agent for amoebiasis is a considerable burden to population in the developing countries where it accounts for over 50 million infections. The tools for detection of amoebiasis are inadequate and diagnosis relies on microscopy which means a significant percent of cases remain undiagnosed. Moreover, tests formats that can be rapidly applied in rural endemic areas are not available.MethodsIn this study, a loop-mediated isothermal test (LAMP) based on 18S small subunit ribosomal RNA gene was designed with extra reaction accelerating primers (stem primers) and compared with the published LAMP and PCR tests in detection of E. histolytica DNA in clinical samples.ResultsThe stem LAMP test indicated shorter time to results by an average 11 min and analytical sensitivity of 10−7 (~30 pg/ml) compared to the standard LAMP and PCR which showed sensitivities levels of 10−5 (~3 ng/ml) and 10−4 (~30 ng/ml) respectively using tenfold serial dilution of DNA. In the analysis of clinical specimens positive for Entamoeba spp. trophozoites and cysts using microscopy, the stem LAMP test detected E. histolytica DNA in 36/126, standard LAMP test 20/126 and PCR 17/126 cases respectively. There was 100% agreement in detection of the stem LAMP test product using fluorescence of SYTO-9 dye in real time machine, through addition of 1/10 dilution of SYBR® Green I and electrophoresis in 2% agarose gel stained with ethidium bromide.ConclusionThe stem LAMP test developed in this study indicates potential towards detection of E. histolytica.

The World Health Organization has targeted Human African Trypanosomiasis (HAT) for elimination by 2020 with zero incidence by 2030. To achieve and sustain this goal, accurate and easy-to-deploy diagnostic tests for Gambian trypanosomiasis which accounts for over 98% of reported cases will play a crucial role. Most needed will be tools for surveillance of pathogen in vectors (xenomonitoring) since population screening tests are readily available. The development of new tests is expensive and takes a long time while incremental improvement of existing technologies that have potential for xenomonitoring may offer a shorter pathway to tools for HAT surveillance. We have investigated the effect of including a second set of reaction accelerating primers (stem primers) to the standard T. brucei gambiense LAMP test format. The new test format was analyzed with and without outer primers. Amplification was carried out using Rotorgene 6000 and the portable ESE Quant amplification unit capable of real-time data output. The stem LAMP formats indicated shorter time to results (~8 min), were 10–100-fold more sensitive, and indicated higher diagnostic sensitivity and accuracy compared to the standard LAMP test. It was possible to confirm the predicted product using ESE melt curves demonstrating the potential of combining LAMP and real-time technologies as possible tool for HAT molecular xenomonitoring.