Prospects for the control of neglected tropical diseases by mass drug administration

Abstract

The prospects for the control of neglected tropical diseases, including soil-transmitted helminthiasis, shistosomiasis, lymphatic filariasis, onchocerciasis and trachoma, through mass drug administration, are exemplified by the elimination of the trachoma as a public-health problem in Morocco. In spite of this and other striking successes, mass drug administration programs are faced with major challenges resulting from suboptimal coverage and lack of efficacy. At current suboptimal coverage rates, programs may need prolongation for an extended period, increasing costs and undermining sustainability. Community participation through health education and information appears to be crucial to improve coverage and to achieve sustainability. Implementation of complementary measures, such as vector control, improved hygiene and environmental sanitation, are important to further control transmission and to prevent re-emergence of the infection and, again, may only be achieved effectively through community-based initiatives. To reduce costs and to relieve pressure on the health system, combining neglected tropical disease programs in areas where diseases coexist and integration with existing control programs for malaria, tuberculosis and HIV/AIDS is advocated. The risk of developing drug resistance is of particular concern in view of the lack of alternative drugs, and reduced treatment efficacy due to emerging resistance is evident for the soil-transmitted helminths and onchocerciasis. Given the risk for the development of drug resistance and the need for a high degree of participation, close attention should be paid to the monitoring of the coverage and efficacy of the different program components.

The Prevalence of Parasitic Human Intestinal Helminthes and the Efficacy of Anthelmintic Drug in Children in Uzo-Uwani Local Government Area, Enugu State, Nigeria

“…This is similar to works carried out by [15][16][17]19,20]. The study also revealed two cases of multiple or poly-parasitism of which Hookworm and Trichuris occurred in both.…”

Cost-effectiveness of triple drug administration (TDA) with praziquantel, ivermectin and albendazole for the prevention of neglected tropical diseases in Nigeria

“…The control or elimination of the 'tool ready' neglected tropical diseases (NTDs) onchocerciasis, lymphatic filariasis (LF), soil transmitted helminthiasis (STH) and schistosomiasis has been a topic of renewed interest in recent years since all may be controlled or eliminated by mass drug administration (MDA) of safe and effective medicines, many of which are donated by large pharmaceutical companies (Brady et al, 2006;Musgrove and Hotez, 2009;Smits, 2009;Bernhard et al, 2010). Onchocerciasis is a leading cause of visual impairment and blindness in many developing countries.…”

Rationale for the Coadministration of Albendazole and Ivermectin to Humans for Malaria Parasite Transmission Control

“…2,3 Numerous publications call for the integration of control measures that target malaria and neglected tropical diseases (NTDs) with the same platform. [4][5][6][7][8][9] The NTDs are a diverse group of infectious diseases including STH infections, lymphatic filariasis (LF), schistosomiasis, onchocerciasis, and at least 13 others, prioritized by the World Health Organization as such, because they promote poverty and have a negative impact on pregnancy, child health and development, and adult worker productivity. Examples of synergism between malaria and NTD control programs include a reduction in LF transmission by the large-scale rollout of long-lasting insecticide-treated nets (LLINs) and indoor residual spraying (IRS) with insecticides for malaria control 10,11 and the distribution of LLINs and sulfadoxine-pyrimethamine for intermittent preventive therapy for pregnant women by Community-Directed Treatment (CDT) platforms that have been mobilized by the African Program for Onchocerciasis Control (APOC) 12,13 and the Global Program to Eliminate Lymphatic Filariasis (GPELF) 14 in Africa.…”