China's sustained drive to eliminate neglected tropical diseases.

Non-communicable diseases dominate the public health arena in China, yet neglected tropical diseases (NTDs) are still widespread and create a substantial burden. We review the geographical distribution, prevalence, and epidemic characteristics of NTDs identified in China caused by helminths, protozoa, bacteria, and viruses. Lymphatic filariasis was eliminated in 2007, but schistosomiasis still affects up to 5% of local village residents in some endemic counties with around 300 000 people infected. China harbours more than 90% of the world's burden of alveolar echinococcosis and food-borne zoonoses are emerging. In 2010, the overall prevalence of soil-transmitted helminth infections caused by Ascaris lumbricoides, Trichuris trichiura, and hookworm was 11·4%, with 6·8% of these infections caused by A lumbricoides. Corresponding figures for food-borne trematodiasis, echinococcosis, and cysticercosis are more than 5%. Dengue, leishmaniasis, leprosy, rabies, and trachoma exist in many areas and should not be overlooked. Transmission of vector-borne diseases can be interrupted; nevertheless, epidemics occur in remote areas, creating a challenge for surveillance and control. Rigorous surveillance, followed by immediate and integrated response packages tailored to specific social and ecological systems, is essential for progress towards the elimination of NTDs in China.

Motives and determinants for residence change after leprosy diagnosis, central Brazil.

OBJECTIVE: To determine the extent of population movement after diagnosis with leprosy and to describe the underlying motives and determinants for relocation. DESIGN: A cross-sectional study was conducted among those newly diagnosed with leprosy in 79 endemic municipalities in the state of Tocantins, central Brazil. Individuals were identified through the National Information System for Notifiable Diseases (SINAN) database and interviewed with structured questionnaires. RESULTS: In total, 224 (20.9%) out of 1070 individuals relocated after their diagnosis with leprosy. Respondents moved to another neighbourhood in the same municipality (n = 178, 79.5%), followed by another municipality in Tocantins state (n = 26, 11.6%) and in another state (n = 11, 4.9%). The primary motives and/or determinants for relocation were: home ownership (n = 55, 28.4%), familial reasons (n = 43, 19.2%), to seek better living conditions (n = 27, 13.9%), employment (n = 26, 11.6%), and better neighbourhood (n = 22, 9.8%). Other motives were related to better access to leprosy diagnosis/treatment (n = 11, 4.9%), owner-terminated rental (n = 5, 2.2%), personal finances/could not afford housing (n = 4, 1.8%). Perceived stigma due to leprosy was mentioned by one participant (0.5%). CONCLUSION: In Tocantins state, population movement is lower among individuals recently diagnosed with leprosy, as compared to the overall population. The primary motives for relocation after leprosy diagnosis were related to lifestyle changes. Stigma and treatment-related reasons did not appear to be common motives for population movement. These results may reflect policy changes instituted from the Brazilian Program of Leprosy Control to decentralise leprosy services and intensify health education campaigns within a broader concept of Information, Education and Communication.