Integrated Control and Management of Neglected Tropical Skin Diseases

Mitjà, Oriol; Marks, Michael; Bertran, Laia; Kollie, Karsor; Argaw, Daniel; Fahal, Ahmed H.; Fitzpatrick, Christopher; Fuller, L.C.; Izquierdo, Bernardo Garcia; Hay, Roderick J.; Ishii, Norihisa; Johnson, Christian; Lazarus, Jeffrey V.; Meka, Anthony O.; Murdoch, Michele E.; Ohene, Sally-Ann; Small, Pam; Steer, Andrew C.; Tabah, Earnest Njih; Tiendrébéogo, Alexandre; Waller, Lance A.; Yotsu, Rie Roselyne; Walker, Stephen L.; Asiedu, Kingsley

doi:10.1371/journal.pntd.0005136

Cited by 141 publications

(190 citation statements)

References 31 publications

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“…In addition, the WHO is giving support for countries to develop master plans and to adapt regional strategies and guidelines. The WHO is providing manuals to help health workers recognize NTDs through changes on the skin …”

Section: The Who Position On the African Region (Afro) Neglected Tropmentioning

confidence: 99%

“…The WHO is providing manuals to help health workers recognize NTDs through changes on the skin. [4][5][6] For other non-NTD chronic skin conditions such as AD, the lack of dermatologists and dermatology clinics, the probable underestimated low burden of disease and low mortality in this group precludes WHO prioritization. For AD as well as asthma and allergic rhinitis, the available data indicate prevalence rates for some countries similar to European Union countries.…”

Section: Introductionmentioning

confidence: 99%

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Position Statement on Atopic Dermatitis in Sub‐Saharan Africa: current status and roadmap

Schmid‐Grendelmeier

Takaoka

Ahogo

et al. 2019

Acad Dermatol Venereol

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Background The first International Society of Atopic Dermatitis (ISAD) global meeting dedicated to atopic dermatitis (AD) in Sub‐Saharan Africa (SSA) was held in Geneva, Switzerland in April 2019. A total of 30 participants were present at the meeting, including those from 17 SSA countries, representatives of the World Health Organization (WHO), the International Foundation for Dermatology (IFD) (a committee of the International League of Dermatological Societies, ILDS http://www.ilds.org), the Fondation pour la Dermatite Atopique, as well as specialists in telemedicine, artificial intelligence and therapeutic patient education (TPE). Results AD is one of the most prevalent chronic inflammatory skin diseases in SSA. Besides neglected tropical diseases (NTDs) with a dermatological presentation, AD requires closer attention from the WHO and national Departments of Health. Conclusions A roadmap has been defined with top priorities such as access to essential medicines and devices for AD care, in particular emollients, better education of primary healthcare workers for adequate triage (e.g. better educational materials for skin diseases in pigmented skin generally and AD in particular, especially targeted to Africa), involvement of traditional healers and to a certain extent also patient education, bearing in mind the barriers to effective healthcare faced in SSA countries such as travel distances to health facilities, limited resources and the lack of dermatological expertise. In addition, several initiatives concerning AD research in SSA were discussed and should be implemented in close collaboration with the WHO and assessed at follow‐up meetings, in particular, at the next ISAD meeting in Seoul, South Korea and African Society of Dermatology and Venereology (ASDV) meeting in Nairobi, Kenya, both in 2020.

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Section: The Who Position On the African Region (Afro) Neglected Tropmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Position Statement on Atopic Dermatitis in Sub‐Saharan Africa: current status and roadmap

Schmid‐Grendelmeier

Takaoka

Ahogo

et al. 2019

Acad Dermatol Venereol

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“…Consequently, less frequent TTT may be less attractive than our results suggest. Finally, we do not consider synergies that may arise from integrated skin NTD control programs [15]: If health systems were to commit to ongoing high-quality dermatologic screening in order to combat diseases other than yaws, then a TTT-based yaws eradication strategy might be preferable. On the other hand, integration of yaws programs with other 7/9 NTD programs that implement recurrent cycles of preventive chemotherapy would favor the MDA approach.…”

Section: Changing the Frequency Of Tttmentioning

confidence: 99%

Programmatic goals and spatial epidemiology influence the merit of targeted versus of population-wide interventions for yaws eradication

Mooring

Marks

Mitjà

et al. 2019

Preprint

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Infectious disease eradication programs often pursue spatially targeted interventions, but how well they perform might depend on the underlying spatial epidemiology and the specific goal of the program. We use a stochastic compartmental metapopulation model of yaws transmission to investigate how total targeted treatment (TTT) performs compared to mass drug administration (MDA) in different settings. While TTT can efficiently control the prevalence of active yaws disease, we consistently found that multiple rounds of TTT are required to match the impact of 1 round of MDA on the prevalence of latent yaws infection. When complete eradication of yaws is the goal, MDA can achieve the same result as TTT more quickly and probably at lower cost. We found that the performance of TTT is improved when there is little mixing between subpopulations and when there is spatial heterogeneity in transmissibility, but even in these settings, our model suggests that MDA will still outperform TTT. Significance StatementYaws is a neglected tropical disease that causes skin lesions. Eradicating yaws is challenging because people can be infected but not show any signs or symptoms for years. Using simulations, we found that targeting antibiotics to people with active yaws and to their neighbors is a good way to combat active yaws, but treating entire populations is a better way to get rid of all infections, including the hidden ones. Also, targeted treatment works better in populations in which people do not move around much and in which how easily the disease is transmitted varies from place to place. Overall, a targeted treatment strategy uses fewer antibiotics but takes longer than mass treatment to achieve results.

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“…In a histopathological examination, it is easy to discriminate between fungal and bacterial causative agents [16,17]. However, identification to the species level is more challenging and considered far from reliable [18 19…”

Section: Introductionmentioning

confidence: 99%

The Accuracy of Histopathological and Cytopathological Techniques in the Identification of the Mycetoma Causative Agents

Fahal

Siddig

Mhmoud

et al. 2018

Preprint

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24Mycetoma is a devastating neglected tropical disease, caused by various fungal 25 and bacterial pathogens. Correct diagnosis to the species level is mandatory for 26 proper treatment. In endemic areas, various diagnostic tests and techniques are 27 in use to achieve that, and that includes grain culture, surgical biopsy 28 histopathological examination, fine needle aspiration cytological (FNAC) 29 examination and in certain centres molecular diagnosis such as PCR. 30 In this retrospective study, the sensitivity, specificity and diagnostic accuracy of 31 grain culture, surgical biopsy histopathological examination and FNAC to identify 32 the mycetoma causative organisms were determined. The histopathological 33 examination appeared to have better sensitivity and specificity. 34The histological examination results were correct in 714 (97.5%) out of 750 35 patients infected with Madurella mycetomatis, in 133 (93.6%) out of 142 patients 36 infected with Streptomyces somaliensis, in 53 (74.6%) out of 71 patients infected 37 with Actinomadura madurae and in 12 (75%) out of 16 patients infected with 38 Actinomadura pelletierii. 39 FNAC results were correct in 604 (80.5%) out of 750 patients with Madurella 40 mycetomatis eumycetoma, in 50 (37.5%) out of 133 Streptomyces somaliensis 41 patients, 43 (60.5%) out of 71 Actinomadura madurae patients and 11 (68.7%) out 42 of 16 Actinomadura pelletierii. The mean time required to obtain the FNAC result 43was one day, and for the histopathological examinations results it was 3.5 days, 44 and for grain, it was a mean of 16 days. 45In conclusion, histopathological examination and FNAC are more practical 46 techniques for rapid species identification than grain culture in many endemic 47 regions. 48 49 50 Author summary 51 In mycetoma endemic regions, the medical and health settings are commonly 52 suboptimal, and only a few diagnostic tests and techniques are available. That had 53 badly affected the patients' proper diagnosis and management and thus the late 54presentation of patients with advanced disease. In this retrospective study, the 55 experience of the MRC on the common in use diagnostic tests in the period 56 between 1991 and 2018 is presented. 57In this study, the sensitivity, specificity rates and diagnostic accuracy of grain 58 culture, surgical biopsy histopathological examination and FNAC to identify the 59 mycetoma causative organisms were determined. The histopathological 60 examination appeared to have better sensitivity and specificity. Furthermore, the 61 grain culture identification needs high experience, it is the tedious procedure, and 62 cross-contamination is common hence misdiagnosis is frequent. It can be 63 concluded that histopathological examination and FNAC are more practical 64 techniques for rapid species identification than grain culture in many endemic 65 regions with poor diagnostic setting. 66 67 68 Introduction: 69 Mycetoma is a chronic granulomatous subcutaneous inflammatory infection 70 endemic in subtropical and tropical re...

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Integrated Control and Management of Neglected Tropical Skin Diseases

Cited by 141 publications

References 31 publications

Position Statement on Atopic Dermatitis in Sub‐Saharan Africa: current status and roadmap

Position Statement on Atopic Dermatitis in Sub‐Saharan Africa: current status and roadmap

Programmatic goals and spatial epidemiology influence the merit of targeted versus of population-wide interventions for yaws eradication

The Accuracy of Histopathological and Cytopathological Techniques in the Identification of the Mycetoma Causative Agents

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