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3.
Artículo en Inglés | MEDLINE | ID: mdl-33671293

RESUMEN

Monitoring the safety of medicines used in public health programs (PHPs), including the neglected tropical diseases (NTD) program, is a WHO recommendation, and requires a well-established and robust pharmacovigilance system. The objective of this study was to assess the pharmacovigilance systems within the NTD programs in Ethiopia, Kenya, Rwanda, and Tanzania. The East African Community Harmonized Pharmacovigilance Indicators tool for PHPs was used to interview the staff of the national NTD programs. Data on four components, (i) systems, structures, and stakeholder coordination; (ii) data management and signal generation; (iii) risk assessment and evaluation; and (iv) risk management and communication, were collected and analyzed. The NTD programs in the four countries had a strategic master plan, with pharmacovigilance components and mechanisms to disseminate pharmacovigilance information. However, zero individual case safety reports were received in the last 12 months (2017/2018). There was either limited or no collaboration between the NTD programs and their respective national pharmacovigilance centers. None of the NTD programs had a specific budget for pharmacovigilance. The NTD program in all four countries had some safety monitoring elements. However, key elements, such as the reporting of adverse events, collaboration with national pharmacovigilance centers, and budget for pharmacovigilance activity, were limited/missing.


Asunto(s)
Enfermedades Desatendidas , Farmacovigilancia , Etiopía , Humanos , Kenia/epidemiología , Enfermedades Desatendidas/tratamiento farmacológico , Enfermedades Desatendidas/epidemiología , Rwanda/epidemiología , Tanzanía/epidemiología
4.
Artículo en Inglés | MEDLINE | ID: mdl-33672237

RESUMEN

Neglected Tropical Diseases (NTDs) trap individuals in a cycle of poverty through their devastating effects on health, wellbeing and social-economic capabilities that extend to other axes of inequity such as gender and/or ethnicity. Despite NTDs being regarded as equity tracers, little attention has been paid toward gender dynamics and relationships for gender-equitable access to NTD programs in sub-Saharan Africa (SSA). This paper examines the impact of NTDs on women's health and wellbeing in SSA using Kenya as a case study. This research is part of a larger research program designed to examine the impact of NTDs on the health and wellbeing of populations in Kenya. Thematic analysis of key informants' interviews (n = 21) and focus groups (n = 5) reveals first that NTDs disproportionately affect women and girls due to their assigned gender roles and responsibilities. Second, women face financial and time constraints when accessing health care due to diminished economic power and autonomy. Third, women suffer more from the related social consequences of NTDs (that is, stigma, discrimination and/or abandonment), which affects their health-seeking behavior. As such, we strongly suggest a gender lens when addressing NTD specific exposure, socio-economic inequities, and other gender dynamics that may hinder the successful delivery of NTD programs at the local and national levels.


Asunto(s)
Enfermedades Desatendidas , Salud de la Mujer , Prestación de Atención de Salud , Femenino , Humanos , Kenia/epidemiología , Enfermedades Desatendidas/epidemiología , Pobreza
5.
Washington, D.C.; OPS; 2021-03-09.
en Español | PAHO-IRIS | ID: phr-53335

RESUMEN

La atención concedida a la equidad en la Agenda 2030 para el Desarrollo Sostenible obliga a encontrar nuevas formas de ampliar progresivamente los servicios a las poblaciones que no los reciben. Las alianzas satisfactorias entre el sector encargado del suministro de agua, el saneamiento y la higiene (WASH, por su sigla en inglés) y los programas de lucha contra las enfermedades tropicales desatendidas (ETD) pueden contribuir a lograr esta aspiración. Sin embargo, colaborar para encontrar juntos esas nuevas formas, exige nuevos modos de pensar. En esta edición corregida se presenta un conjunto de herramientas para ayudar a los países y los programas de lucha contra la ETD a colaborar con la comunidad relacionada con las acciones de agua, saneamiento e higiene, y guía en la creación de alianzas, en la movilización de recursos y en el diseño, la aplicación y la evaluación de las intervenciones. Más que una guía de “buenas prácticas”, se trata de un conjunto de herramientas basadas en la experiencia adquirida en la realidad de un programa. Se espera que los interesados en usar este documento puedan elegir las herramientas y adaptarlas a sus necesidades y al contexto local. Estas herramientas ayudarán a 1) crear alianzas multisectoriales con los interesados directos clave: ministerios, agencias de WASH nacionales y locales, empresas, grupos locales activos en cuestiones de salud, expertos en cambio de comportamientos y en comunicación, etc.; 2) a formar estructuras de programa inteligentes centradas en la rendición de cuentas y en los objetivos comunes; 3) a establecer un método de programación adaptativo y flexible; 4) a garantizar la sostenibilidad mediante la creación de capacidad local a todos los niveles; y 5) a brindar apoyo y complementar las intervenciones clínicas y de salud pública en la lucha contra las EID.


Asunto(s)
Enfermedades Desatendidas , Enfermedades Transmisibles , Desarrollo Sostenible , Indicadores de Desarrollo Sostenible , Saneamiento , Agua , Higiene , Abastecimiento de Agua
6.
Washington, D.C.; PAHO; 2021-03-01.
en Inglés | PAHO-IRIS | ID: phr-53312

RESUMEN

In 2016, PAHO's Directing Council, through Resolution CD55.R9, approved the “Plan of Action for Elimination of Neglected Infectious Diseases (NID) and Post-Elimination Actions, 2016-2022.” This Resolution urges Member States to implement a set of interventions to reduce the burden of disease by NID in the Americas by 2022, including “…support promotion of treatment, rehabilitation, and related support services through an approach focused on integrated morbidity management and disability prevention for individuals and families afflicted by those neglected infectious diseases that cause disability and generate stigma.” NIDs can have devastating chronic sequelae for patients, such as disability, visible change or loss in body structure, loss of tissue, and impairment of proper tissue and organ function, among others. All of these can in turn lead to unjustified discrimination, stigmatization, mental health problems, and partial or total incapacity to work, perpetuating the vicious cycle of neglected diseases as both a consequence and a cause of poverty. Patients with chronic conditions caused by NIDs require proper health care in order to prevent further damage and improve their living and social conditions. This should be provided at the primary health care level, as patients suffering from NIDs are often unable to travel to or afford to pay for specialized care services. Care for patients suffering from chronic morbidity caused by NID should be integrated into care for other chronic conditions caused by non-communicable diseases. This manual provides a framework for morbidity management and disability prevention of patients affected by NIDs and gives specific guidance for the proper care of patients suffering from chronic conditions caused by lymphatic filariasis, leprosy, trachoma, and Chagas disease. It is intended to be used mainly by health care workers at the primary health care level, but health workers at more complex and specialized levels may also find it useful.


Asunto(s)
Enfermedad de Chagas , Lepra , Enfermedades Linfáticas , Filariasis Linfática , Tracoma , Enfermedades Desatendidas , Transmisión de Enfermedad Infecciosa
7.
PLoS Negl Trop Dis ; 15(3): e0009088, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33661903

RESUMEN

The neglected tropical diseases (NTDs) affect hundreds of millions of people, predominantly in rural, often difficult-to-access areas, poorly served by national health services. Here, we review the contributions of 4.8 million community-directed distributors (CDDs) of medicines over 2 decades in 146,000 communities in 27 sub-Saharan African countries to control or eliminate onchocerciasis and lymphatic filariasis (LF). We examine their role in the control of other NTDs, malaria, HIV/AIDS interventions, immunisation campaigns, and support to overstretched health service personnel. We are of the opinion that CDDs as community selected, trained, and experienced "foot soldiers," some of whom were involved in the Ebola outbreak responses at the community level in Liberia, if retrained, can assist community leaders and support health workers (HWs) in the ongoing Coronavirus Disease 2019 (COVID-19) crisis. The review highlights the improved treatment coverage where there are women CDDs, the benefits and lessons from the work of CDDs, their long-term engagement, and the challenges they face in healthcare delivery. It underscores the value of utilising the CDD model for strong community engagement and recommends the model, with some review, to hasten the achievement of the NTD 2030 goal and assist the health system cope with evolving epidemics and other challenges. We propose that, based on the unprecedented progress made in the control of NTDs directly linked to community engagement and contributions of CDDs "foot soldiers," they deserve regional and global recognition. We also suggest that the World Health Organization (WHO) and other international stakeholders promote policy and guidance for countries to adapt this model for the elimination of NTDs and to strengthen national health services. This will enhance the accomplishment of some Sustainable Development Goals (SDGs) by 2030 in sub-Saharan Africa.


Asunto(s)
Servicios de Salud Comunitaria/organización & administración , Filariasis Linfática/terapia , Administración Masiva de Medicamentos , Enfermedades Desatendidas/terapia , Oncocercosis/terapia , África del Sur del Sahara , Agentes Comunitarios de Salud , Filariasis Linfática/prevención & control , Femenino , Humanos , Ivermectina/administración & dosificación , Enfermedades Desatendidas/prevención & control , Oncocercosis/prevención & control
9.
Exp Parasitol ; 224: 108100, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33744229

RESUMEN

Chagas disease and leishmaniasis are neglected diseases caused by parasites of the Trypanosomatidae family and together they affect millions of people in the five continents. The treatment of Chagas disease is based on benznidazole, whereas for leishmaniasis few drugs are available, such as amphotericin B and miltefosine. In both cases, the current treatment is not entirely efficient due to toxicity or side effects. Encouraged by the need to discover valid targets and new treatment options, we evaluated 8 furan compounds against Trypanosoma cruzi and Leishmania amazonensis, considering their effects against proliferation, infection, and ultrastructure. Many of them were able to impair T. cruzi and L. amazonensis proliferation, as well as cause ultrastructural alterations, such as Golgi apparatus disorganization, autophagosome formation, and mitochondrial swelling. Taken together, the results obtained so far make these compounds eligible for further steps of chemotherapy study.


Asunto(s)
Furanos/farmacología , Leishmania mexicana/efectos de los fármacos , Trypanosoma cruzi/efectos de los fármacos , Línea Celular , Enfermedad de Chagas/tratamiento farmacológico , Enfermedad de Chagas/parasitología , Cromatografía en Capa Delgada , Enfermedades Endémicas , Furanos/química , Humanos , Concentración 50 Inhibidora , Leishmania mexicana/crecimiento & desarrollo , Leishmania mexicana/ultraestructura , Leishmaniasis Cutánea/tratamiento farmacológico , Leishmaniasis Cutánea/parasitología , Macrófagos , Espectroscopía de Resonancia Magnética , Microscopía Electrónica de Rastreo , Simulación del Acoplamiento Molecular , Enfermedades Desatendidas/tratamiento farmacológico , Enfermedades Desatendidas/parasitología , Trypanosoma cruzi/crecimiento & desarrollo , Trypanosoma cruzi/ultraestructura
10.
Trans R Soc Trop Med Hyg ; 115(3): 229-235, 2021 03 06.
Artículo en Inglés | MEDLINE | ID: mdl-33580952

RESUMEN

BACKGROUND: In March 2020, India declared a nationwide lockdown to control the spread of coronavirus disease 2019. As a result, control efforts against visceral leishmaniasis (VL) were interrupted. METHODS: Using an established age-structured deterministic VL transmission model, we predicted the impact of a 6- to 24-month programme interruption on the timeline towards achieving the VL elimination target as well as on the increase of VL cases. We also explored the potential impact of a mitigation strategy after the interruption. RESULTS: Delays towards the elimination target are estimated to range between 0 and 9 y. Highly endemic settings where control efforts have been ongoing for 5-8 y are most affected by an interruption, for which we identified a mitigation strategy to be most relevant. However, more importantly, all settings can expect an increase in the number of VL cases. This increase is substantial even for settings with a limited expected delay in achieving the elimination target. CONCLUSIONS: Besides implementing mitigation strategies, it is of great importance to try and keep the duration of the interruption as short as possible to prevent new individuals from becoming infected with VL and continue the efforts towards VL elimination as a public health problem in India.


Asunto(s)
/epidemiología , Control de Enfermedades Transmisibles/organización & administración , Leishmaniasis Visceral/epidemiología , Leishmaniasis Visceral/prevención & control , Humanos , India/epidemiología , Enfermedades Desatendidas/epidemiología , Enfermedades Desatendidas/prevención & control , Pandemias
11.
Trans R Soc Trop Med Hyg ; 115(3): 213-221, 2021 03 06.
Artículo en Inglés | MEDLINE | ID: mdl-33596317

RESUMEN

BACKGROUND: The COVID-19 pandemic has disrupted planned annual antibiotic mass drug administration (MDA) activities that have formed the cornerstone of the largely successful global efforts to eliminate trachoma as a public health problem. METHODS: Using a mathematical model we investigate the impact of interruption to MDA in trachoma-endemic settings. We evaluate potential measures to mitigate this impact and consider alternative strategies for accelerating progress in those areas where the trachoma elimination targets may not be achievable otherwise. RESULTS: We demonstrate that for districts that were hyperendemic at baseline, or where the trachoma elimination thresholds have not already been achieved after three rounds of MDA, the interruption to planned MDA could lead to a delay to reaching elimination targets greater than the duration of interruption. We also show that an additional round of MDA in the year following MDA resumption could effectively mitigate this delay. For districts where the probability of elimination under annual MDA was already very low, we demonstrate that more intensive MDA schedules are needed to achieve agreed targets. CONCLUSION: Through appropriate use of additional MDA, the impact of COVID-19 in terms of delay to reaching trachoma elimination targets can be effectively mitigated. Additionally, more frequent MDA may accelerate progress towards 2030 goals.


Asunto(s)
/epidemiología , Control de Enfermedades Transmisibles/organización & administración , Tracoma/epidemiología , Tracoma/prevención & control , Antibacterianos/uso terapéutico , Humanos , Administración Masiva de Medicamentos , Modelos Teóricos , Enfermedades Desatendidas/epidemiología , Enfermedades Desatendidas/prevención & control , Pandemias
12.
Trans R Soc Trop Med Hyg ; 115(3): 245-252, 2021 03 06.
Artículo en Inglés | MEDLINE | ID: mdl-33611586

RESUMEN

Many control programmes against neglected tropical diseases have been interrupted due to the coronavirus disease 2019 (COVID-19) pandemic, including those that rely on active case finding. In this study we focus on gambiense human African trypanosomiasis (gHAT), where active screening was suspended in the Democratic Republic of Congo (DRC) due to the pandemic. We use two independent mathematical models to predict the impact of COVID-19 interruptions on transmission and reporting and achievement of the 2030 elimination of transmission (EOT) goal for gHAT in two moderate-risk regions of the DRC. We consider different interruption scenarios, including reduced passive surveillance in fixed health facilities, and whether this suspension lasts until the end of 2020 or 2021. Our models predict an increase in the number of new infections in the interruption period only if both active screening and passive surveillance were suspended, and with a slowed reduction-but no increase-if passive surveillance remains fully functional. In all scenarios, the EOT may be slightly pushed back if no mitigation, such as increased screening coverage, is put in place. However, we emphasise that the biggest challenge will remain in the higher-prevalence regions where EOT is already predicted to be behind schedule without interruptions unless interventions are bolstered.


Asunto(s)
/epidemiología , Control de Enfermedades Transmisibles/organización & administración , Tripanosomiasis Africana/epidemiología , Tripanosomiasis Africana/prevención & control , República Democrática del Congo/epidemiología , Humanos , Modelos Teóricos , Enfermedades Desatendidas/epidemiología , Enfermedades Desatendidas/prevención & control , Pandemias , Vigilancia de la Población , Trypanosoma brucei gambiense
13.
Adv Protein Chem Struct Biol ; 124: 187-223, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33632465

RESUMEN

Neglected tropical diseases (NTDs) are a group of twenty-one diseases classified by the World Health Organization that prevail in regions with tropical and subtropical climate and affect more than one billion people. There is an urgent need to develop new and safer drugs for these diseases. Protein kinases are a potential class of targets for developing new drugs against NTDs, since they play crucial role in many biological processes, such as signaling pathways, regulating cellular communication, division, metabolism and death. Bioinformatics is a field that aims to organize large amounts of biological data as well as develop and use tools for understanding and analyze them in order to produce meaningful information in a biological manner. In combination with chemogenomics, which analyzes chemical-biological interactions to screen ligands against selected targets families, these approaches can be used to stablish a rational strategy for prioritizing new drug targets for NTDs. Here, we describe how bioinformatics and chemogenomics tools can help to identify protein kinases and their potential inhibitors for the development of new drugs for NTDs. We present a review of bioinformatics tools and techniques that can be used to define an organisms kinome for drug prioritization, drug and target repurposing, multi-quinase inhibition approachs and selectivity profiling. We also present some successful examples of the application of such approaches in recent case studies.


Asunto(s)
Biología Computacional , Genómica , Enfermedades Desatendidas , Inhibidores de Proteínas Quinasas , Proteínas Quinasas , Medicina Tropical , Humanos , Enfermedades Desatendidas/tratamiento farmacológico , Enfermedades Desatendidas/enzimología , Enfermedades Desatendidas/genética , Inhibidores de Proteínas Quinasas/química , Inhibidores de Proteínas Quinasas/uso terapéutico , Proteínas Quinasas/química , Proteínas Quinasas/genética , Proteínas Quinasas/metabolismo
14.
Adv Protein Chem Struct Biol ; 124: 275-309, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33632468

RESUMEN

The discovery and development of a new drug is a complex, time consuming and costly process that typically takes over 10 years and costs around 1 billion dollars from bench to market. This scenario makes the discovery of novel drugs targeting neglected tropical diseases (NTDs), which afflict in particular people in low-income countries, prohibitive. Despite the intensive use of High-Throughput Screening (HTS) in the past decades, the speed with which new drugs come to the market has remained constant, generating doubts about the efficacy of this approach. Here we review a few of the yeast-based high-throughput approaches that can work synergistically with parasite-based, in vitro, or in silico methods to identify and optimize novel antiparasitic compounds. These yeast-based methods range from HTP screens to identify novel hits against promising parasite kinase targets to the identification of potential antiparasitic kinase inhibitors extracted from databases of yeast chemical genetic screens.


Asunto(s)
Descubrimiento de Drogas , Enfermedades Desatendidas , Inhibidores de Proteínas Quinasas , Proteínas Quinasas , Saccharomyces cerevisiae , Evaluación Preclínica de Medicamentos , Humanos , Enfermedades Desatendidas/tratamiento farmacológico , Enfermedades Desatendidas/enzimología , Enfermedades Desatendidas/genética , Inhibidores de Proteínas Quinasas/química , Inhibidores de Proteínas Quinasas/uso terapéutico , Proteínas Quinasas/genética , Proteínas Quinasas/metabolismo , Saccharomyces cerevisiae/enzimología , Saccharomyces cerevisiae/genética
17.
Washington, D.C.; OPS; 2021-02-23. (OPS/CDE/VT/20-0043).
en Español | PAHO-IRIS | ID: phr-53302

RESUMEN

Según las estimaciones, en las Américas, hay entre 6 y 8 millones de personas con enfermedad de Chagas, aproximadamente 30 000 casos nuevos anuales por transmisión vectorial y 8000 casos nuevos anuales por transmisión congénita. Es decir, cerca de 65 millones de personas viven en la Región con el riesgo de contraer la infección. Los países endémicos han desempeñado una gran labor para disminuir la prevalencia, la morbilidad, la mortalidad y el riesgo de infección por T. cruzi mediante las iniciativas subregionales de prevención, control y atención de la enfermedad de Chagas, pero aún queda mucho por hacer. En este documento se presentan las conclusiones y recomendaciones de la comisión intergubernamental de la vigésimo primera reunión anual y primera reunión virtual de la Iniciativa de los países de Centroamérica y México para la Interrupción de la Transmisión Vectorial, Transfusional y la Atención de la Enfermedad de Chagas de la Organizaión Panamericana de la Salud.


Asunto(s)
Enfermedad de Chagas , Enfermedades Desatendidas , Enfermedades Transmitidas por Vectores , Enfermedad de Chagas , Tripanosomiasis , Américas
18.
Washington, D.C.; OPS; 2021-02-22. (OPS/CDE/VT/20-0042).
No convencional en Español | PAHO-IRIS | ID: phr-53300

RESUMEN

La enfermedad de Chagas o tripanosomiasis americana es una parasitosis sistémica causada por el Trypanosoma cruzi. Su transmisión vectorial se restringe a la Región de las Américas, aunque se puede convertir en un problema de salud de alcance mundial debido a sus modalidades de transmisión transfusional y congénita, y a los movimientos de población desde zonas endémicas. Según las estimaciones, en las Américas hay entre 6 y 8 millones de personas con infección, aproximadamente 30 000 casos nuevos anuales por transmisión vectorial y 8000 casos nuevos anuales por transmisión congénita. Es decir, cerca de 65 millones de personas viven en la Región con el riesgo de contraer la infección; se calcula que esta causa alrededor de 12 000 muertes cada año. La transmisión de T. cruzi de un donante con la enfermedad de Chagas a un receptor de trasplante es poco frecuente y es resultado de la aplicación de un tratamiento quirúrgido. En este documento se proponen diez pautas para manejar y prevenir la transmisión de la enfermedad de Chagas por trasplante de órganos.


Asunto(s)
Enfermedad de Chagas , Tripanosomiasis , Enfermedad de Chagas , Enfermedades Desatendidas , Trypanosoma cruzi , Epidemiología , Américas
20.
PLoS Negl Trop Dis ; 15(2): e0009092, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33561159

RESUMEN

The World Health Organization (WHO) considers mycetoma, chromoblastomycosis, and paracoccidioidomycosis to be fungal neglected tropical diseases (FNTDs). Depending on climatic, cultural, and economic contexts, these diseases have a similar geographical distribution as many other diseases, particularly tuberculosis (TB) and malaria, but are often less targeted by the national and many international healthcare systems. Another subgroup of fungal infections, such as candidiasis, cryptococcosis, pneumocystosis, histoplasmosis, and to a lesser extent, aspergillosis, are known as AIDS-related mycoses. Although antiretroviral therapy (ART) has been able to decrease the mortality rate of these diseases, particularly cryptococcosis, the disproportionately low distribution of funds to their diagnosis and treatment remains an obstacle in saving and improving the lives of patients affected. A new wave of viral diseases dubbed the Coronavirus Disease 2019 (COVID-19) hit the world at the end of 2019. Due to progressive symptoms and high mortality rates of COVID-19 compared to fungal infections, particularly the FNTDs, funding is currently allocated predominantly for diagnostic and therapeutic research on COVID-19. As a result, advances in FNTDs and AIDS-related mycosis care are considerably reduced. This paper explores the association between COVID-19, FNTDs, and AIDS-related mycoses with a predictive perspective.


Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Micosis/epidemiología , Enfermedades Desatendidas/epidemiología , Infecciones Oportunistas Relacionadas con el SIDA/microbiología , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Humanos
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