Clinical Research on Neglected Tropical Diseases: Challenges and Solutions

Boelaert, Marleen

doi:10.1371/journal.pntd.0004853

Cited by 10 publications

(9 citation statements)

References 37 publications

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“…Unfortunately, many NTDs affect remote and rural areas of low-and middle income countries (LMICs) with limited resources, infrastructures, and medical personnel. In these areas it is challenging to follow the Good Clinical Practices (GCPs) outlined by WHO and International Conference of Harmonization (ICH) to conduct meaningful clinical trials ( Boelaert and Consortium, 2016 ; Ravinetto et al, 2016 ). We hope that raising awareness about NTDs and their burden will fuel the already ongoing mobilization of resources on a global scale to aid the development of more infrastructures to conduct clinical trials as well as screening and treatment in endemic areas.…”

Section: Discussionmentioning

confidence: 99%

Host-Directed Drug Therapies for Neglected Tropical Diseases Caused by Protozoan Parasites

et al. 2018

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The neglected tropical diseases (NTDs) caused by protozoan parasites are responsible for significant morbidity and mortality worldwide. Current treatments using anti-parasitic drugs are toxic and prolonged with poor patient compliance. In addition, emergence of drug-resistant parasites is increasing worldwide. Hence, there is a need for safer and better therapeutics for these infections. Host-directed therapy using drugs that target host pathways required for pathogen survival or its clearance is a promising approach for treating infections. This review will give a summary of the current status and advances of host-targeted therapies for treating NTDs caused by protozoa.

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Section: Discussionmentioning

confidence: 99%

Host-Directed Drug Therapies for Neglected Tropical Diseases Caused by Protozoan Parasites

et al. 2018

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“…From 2011 to 2016, the project “Better Diagnosis for Neglected Infectious Diseases” (NIDIAG, www.nidiag.org ) was conducted in four African and three Asian countries. 17 Its main objective was to improve the field diagnosis of major neglected tropical/infectious diseases that are part of the differential diagnoses of three challenging clinical syndromes in low-resource settings (neurological disorders, persistent fever, and chronic abdominal pain/diarrhea). At each site, prospective clinical and diagnostic studies were carried out using an extensive set of reference tests targeting the priority (e.g., severe and treatable) conditions.…”

Section: Introductionmentioning

confidence: 99%

Clinical Spectrum, Etiology, and Outcome of Neurological Disorders in the Rural Hospital of Mosango, the Democratic Republic of Congo

Mukendi

Kalo

Mpanya

et al. 2017

The American Journal of Tropical Medicine and Hygiene

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Abstract.There is little published information on the epidemiology of neurological disorders in rural Central Africa, although the burden is considered to be substantial. This study aimed to investigate the pattern, etiology, and outcome of neurological disorders in children > 5 years and adults admitted to the rural hospital of Mosango, province of Kwilu, Democratic Republic of Congo, with a focus on severe and treatable infections of the central nervous system (CNS). From September 2012 to January 2015, 351 consecutive patients hospitalized for recent and/or ongoing neurological disorder were prospectively evaluated by a neurologist, subjected to a set of reference diagnostic tests in blood or cerebrospinal fluid, and followed-up for 3–6 months after discharge. No neuroimaging was available. Severe headache (199, 56.7%), gait/walking disorders (97, 27.6%), epileptic seizure (87, 24.8%), and focal neurological deficit (86, 24.5%) were the predominant presentations, often in combination. Infections of the CNS were documented in 63 (17.9%) patients and mainly included bacterial meningitis and unspecified meningoencephalitis (33, 9.4%), second-stage human African trypanosomiasis (10, 2.8%), and human immunodeficiency virus (HIV)-related neurological disorders (10, 2.8%). Other focal/systemic infections with neurological manifestations were diagnosed in an additional 60 (17.1%) cases. The leading noncommunicable conditions were epilepsy (61, 17.3%), psychiatric disorders (56, 16.0%), and cerebrovascular accident (23, 6.6%). Overall fatality rate was 8.2% (29/351), but up to 23.8% for CNS infections. Sequelae were observed in 76 (21.6%) patients. Clinical presentations and etiologies of neurological disorders were very diverse in this rural Central African setting and caused considerable mortality and morbidity.

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“…Integrated interventions in diagnosis with other disease groups can also be explored, such as the development of a standardised approach to the diagnosis of persistent fevers at the primary health-care level. 23 In this strategy, the diagnosis and treatment of visceral leishmaniasis and post kala-azar dermal leishmaniasis should be provided free of charge at the primary health-care level; and a referral system including free transport, waiving hospital bed fees, provision of meals, and management of malnutrition and concomitant infections needs to be provided for complex cases. Regular training and mentoring of health workers should be in place, using innovative approaches, which can include telemedicine (mainly for post kala-azar dermal leishmaniasis), a visceral leishmaniasis person as a point of contact, or a helpline.…”

Section: A Prospective Approach: Towards Elimination Of Visceral Leishmaniasis In East Africamentioning

confidence: 99%

Towards the elimination of visceral leishmaniasis as a public health problem in east Africa: reflections on an enhanced control strategy and a call for action

Alvar

Boer

Dagne

2021

The Lancet Global Health

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Clinical Research on Neglected Tropical Diseases: Challenges and Solutions

Cited by 10 publications

References 37 publications

Host-Directed Drug Therapies for Neglected Tropical Diseases Caused by Protozoan Parasites

Host-Directed Drug Therapies for Neglected Tropical Diseases Caused by Protozoan Parasites

Clinical Spectrum, Etiology, and Outcome of Neurological Disorders in the Rural Hospital of Mosango, the Democratic Republic of Congo

Towards the elimination of visceral leishmaniasis as a public health problem in east Africa: reflections on an enhanced control strategy and a call for action

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