Neglected tropical diseases in India

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Neglected tropical diseases in India are a group of bacterial, parasitic, viral, and fungal infections that are common in low income countries but receive little funding to address them. Neglected tropical diseases are common in India.

Contents

India's population is about 1.3 billion as of 2018, which is the second largest in the world. [1] However, high population does not explain the greater frequently of neglected tropical diseases in India than in other countries. [1] Neglected tropical diseases in India occur in areas of both urban and rural poverty. [1]

The neglected tropical diseases which especially affect India include ascariasis, hookworm infection, trichuriasis, dengue fever, lymphatic filariasis, trachoma, melioidosis, cysticercosis, leprosy, echinococcosis, visceral leishmaniasis, and rabies. [2]

List

Various organizations will include different diseases under the umbrella term of "neglected tropical diseases," but most diseases listed as such occur in tropical climates, lack global public attention, and have high infection rates.[ citation needed ] The World Health Organization recognizes 20 neglected tropical diseases, [3] of which 12 are present in India.

Protozoan

Visceral leishmaniasis (kala-azar)

India has a goal for the elimination of kala-azar. [4] The steps to eliminating the disease include passive and active case detection, early diagnosis and treatment, and vector control integrated into medical treatment. [4] [5]

Before the year 2000 there was hope and expectation that India could eliminate kala-azar from the country. [6] In those years there were various programs to continue usual treatments and develop new ones. [6] Around year 2000 there were reports that parasites which cause kala-azar had developed drug resistance to pentavalent antimonial, which was the popular drug for treating this disease for the last 50 years. [7] [8] The disease spread to become a problem again and now more difficult to treat. [6] In poorer areas of India underreporting of the disease was a problem, allowing the disease to spread. [9] The newer treatments of that time were expensive. [10]

The treatment of kala-azar in India since about year 2000 has been difficult. [11] In 2017 the Indian government had contained kala-azar in certain regions with the goal of providing easy access to medical treatment to eliminate it from the country. [12] The intent was that by 2020 the disease should be very uncommon and also should never spread or grow again. [13] Physicians use a drug to treat kala-azar both before and after the patient seems cured, but take care to use a safe amount. [14] The work that health agencies in India have done to reduce kala-azar are learning models for India or any other country to apply to other public health programs to eliminate infectious disease. [15]

African trypanosomiasis

African trypanosomiasis (sleeping sickness) is not a problem in India. [16] Researchers do monitor watching for the disease. [16] In 2005, an Indian farmer became ill following an unusual infection with an Indian species of this parasite called Trypanosoma evansi . [17]

Chagas disease

Chagas disease is not a problem in India. [16] Chagas disease, like African trypanosomiasis, has a Trypanosoma parasite as its cause. [16] [17] This parasite is not in India. [16] [17]

Worms

Soil-transmitted helminthiasis

Soil-transmitted helminthiasis is a group of various parasitic diseases which different roundworms cause. The large roundworm causes Ascariasis, the hookworm causes Hookworm infection, and the whipworm causes Trichuriasis. These worms are related and there are strategies for prevention which apply to all of them. [18] The World Health Organization estimated that in 2015, 75% of the children in India who had Soil-transmitted helminthiasis also got treatment. [1] [19]

Lymphatic filariasis

India has 40% of the world's lymphatic filariasis (LF) cases. [20] For the patient, one of the major costs of treating the disease is having to take a lot of time off work. [20] A year 2000 survey reported that about half of the people in India were at risk of contracting LF. [21] Men and women can get this disease equally, but in the past, there have been barriers to women accessing treatment in the normal way. [22]

In 1955 the Indian government established the National Filaria Control Programme to reduce LF. [23] In 1997 India joined a World Health Assembly resolution to eliminate LF by 2020. [23] In India to achieve this goal healthcare must be very accessible to almost everyone at risk for the disease. [24] In 2015 the Indian government launched a health campaign called Hathipaon Mukt Bharat (Filaria Free India) to encourage public participation in eliminating LF. [25]

Following some missed deadlines in 2015 and before a 2020 target date for eliminating LF, various media outlets discussed how India might meet the goal or what it should happen next if more time is required. [26] [27] [28]

The Ayurvedic text Sushruta Samhita described lymphatic filariasis. [23]

Echinococcosis

Echinococcosis is a parasitic disease of tapeworms. [29] [30] [31] [32]

Cysticercosis

Taeniasis and cysticercosis are both parasitic diseases caused by tapeworms in the family Taeniidae.[ citation needed ]

Eliminated – guinea worm

Guinea-worm disease was a neglected tropical disease in India until 2000 when it was eradicated. [33] In 2006 India announced the eradication of yaws after going since 2003 with no reported cases of the disease. [34]

Foodborne trematode infection

Foodborne trematode infection is not a problem in India.[ citation needed ]

From 1969 to 2012 there have only been a few reports of a few people in India getting fasciolosis (foodborne trematode infection). [35] The disease is endemic among cows, buffalo, sheep, and goats in India. [36] A 2012 paper which reported two human infections urged for attention that human infection might be more prevalent. [37]

Onchocerciasis

Onchocerciasis (river blindness) is not a problem in India.[ citation needed ]

Onchocerciasis has been found in India in an unusual case. [38]

Schistosomiasis

Schistosomiasis is not a problem in India.

A 2015 report described that while India has no routine reports of schistosomiasis, the disease might be present and unreported. [39] A 1952 paper described the disease present in an Indian village and how WHO investigators treated the disease and tried to identify its source. [40] [41] In retrospect, that older paper was unusual, and either this disease is uncommon in India or difficult to detect. [40]

Fungus

Mycetoma

location, cause, and number of cases of mycetoma in India in 2013 Human Mycetoma in India in 2013.png
location, cause, and number of cases of mycetoma in India in 2013

Mycetoma is an infection under the skin which in India may have either a fungus or a bacterium as cause. [42] In Rajasthan the cause is usually a fungus, but elsewhere in India a bacterium usually causes the disease. [42]

Small health surveys have shown that mycetoma is common in central India. [43]

The disease is difficult to treat. [44] The treatment for fungus will not work on the bacteria and vice versa. [44] When it is a bacterium the treatment period is long. [44]

In 1874 Henry Vandyke Carter, a British surgeon, wrote a book titled On mycetoma, or the fungus disease of India. [45]

Bacteria

Leprosy

From 1983 until 2005 India organized successful programs to eliminate leprosy as a public health problem. [46] While these programs reduced the number of people in India with leprosy from 58 in 10,000 to 1 in 10,000, they did not eliminate leprosy entirely. [46] Completely eliminating the disease is possible in the near future. [47] The National Leprosy Eradication Program is part of the government solution to ending the disease.[ citation needed ]

Without health intervention, it is possible that leprosy rates could rise and all the progress could be lost. [48]

A 2018 study reported that India does well at detecting leprosy in poor areas, but more often misses cases in places with more money. [49]

A 2019 report described how newly available technology should make detecting and treating leprosy in India more easy. [50]

Trachoma

In December 2017 the health minister of India announced that India was free of trachoma. [51] [52] This announcement included a statement that there were no children in India who had an active case of trachoma. [53]

A 2011 paper had speculated that India could eliminate trachoma within 10 years. [54]

Yaws

The Indian government began programs to eliminate yaws in the 1950s. [55] India began its Yaws Eradication Program in 1996 and identified 735 cases at its start. [56] In 2004 the Indian government announced that the health program seemed to have eliminated the disease. [56] Even after yaws seemed to be gone, the government continued monitoring and searching for cases heavily through 2006. [56] Following that, there was a program to investigate rumors of yaws through 2011. [55]

In May 2016 the World Health Organization declared India free of yaws. [57] India was the first country where yaws was endemic and which eliminated it. [58] This success in India led to excite for other countries to also try to eliminate yaws by year 2020 using techniques which India developed. [59]

Buruli ulcer

Buruli ulcer is not a problem in India.[ citation needed ]

In 2019 physicians identified a case of Buruli ulcer in India, but the patient was from Nigeria where the disease is present. [60]

Viruses

Dengue fever and chikungunya fever

The WHO groups dengue and chikungunya fever together, but these are separate conditions.[ citation needed ]

India had chikungunya cases before 1973 when the disease was nearly eliminated. In 2005 India got another case of this. [61] [62] Checkungunya cases are rising in India [63]

Rabies

Rabies has been a problem in India since ancient times. [64] Rabies often comes from dog bites. [64]

In India there are many stray dogs and many people report being bitten by them. [65] To determine whether someone requires treatment for rabies or only treatment for the bite, the physician should have information about the incidence of rabies in animals in the area. [66] In India about 2% of people who are bitten get a rabies vaccine. [65] [67] A 2012 paper argued that there was now enough information about rabies in India to plan to contain and prevent the disease nationally. [68]

For people in India who get rabies the death rate is nearly 100%. [69]

Other

Scabies

Incidence of scabies in India ranges from 13 to 59% throughout observed areas. [70] Little research exists on how much this condition affects Indian people's work, leisure, and sleep. [70]

Various epidemiological studies exist reporting the number of people in India with scabies in various times and places. [71] [72]

Topical Permethrin and oral ivermectin are commonly available in India for treatment. [73] [74]

Snakebites

Indian cobra bites are a serious problem. Indiancobra.jpg
Indian cobra bites are a serious problem.

The envenomation is the danger of the snakebite, and not the bite itself. [75] [76] The four snakes in India which account for most bites are the Indian cobra, common krait, Russell's viper, and saw-scaled viper. [77] Besides these four there are various other snakes which bite enough to require an organized medical response. [77]

In May 2018 the World Health Organization declared that responding to snake bites is a global health priority. [78]

Some places in India use traditional folk medicine with plants to treat snakebite. [79]

Designing antivenom is a challenge because different snakes require different antivenom to treat, and there are many types of snakes in India. [80]

97% of snake bites occur in rural areas. [81]

Snakes have a special place in Indian society and culture. [82] Because of this, many people who receive a snakebite treat their illness with less medical urgency than they would some other disease. [82]

A 2010 review of snake bite in India found that there is underreporting of the problem and also insufficient health care treatment available. [83]

A 1954 study tracked snake bites since 1940. This study estimated 300,000-400,000 bites a year with 10% of those being deadly. [84]

Treatment which should be available but which are sometimes hard to get includes a whole blood clotting test and a venom detection kit. [85]

Epidemiology

India and South Asia have about half of the world's cases of kala azar, lymphatic filariasis, and leprosy. [86] The region also has about a third of rabies deaths and a quarter of the South Asia, in addition to one-third of the rabies deaths, one-quarter of the intestinal helminth infections. [86] As of 2014 there was not good information about dengue and Japanese encephalitis, but these diseases are a major burden in India also. [86]

Of the 17 neglected tropical diseases which the World Health Organization recognized in 2017, six are common in India. [87] Those 6 diseases are Lymphatic filariasis, kala-azar (Visceral leishmaniasis), Leptospirosis, Rabies, Soil-transmitted helminthiasis, and Dengue fever. [87]

The Global Burden of Disease Study is a regularly updated report which attempts to describe the extent to which each major disease in the world affects individuals with those diseases. [1] This report identifies surprising problems and described them to be unknown among many health professionals. [1] One surprising finding of the 2016 Global Burden of Disease study is that India has the most and worst cases of 11 of the 16 neglected tropical diseases it considered. [1] India has the most cases of all neglected tropical diseases which occur in India. [1]

New cases of neglected tropical diseases in 2016 [1] [88] [89]
neglected tropical diseaseCases in IndiaTotal cases globallyIndia's percent
of global total		India's incidence rank
Ascariasis 222 million799 million28%1
Hookworm infection 102 million451 million23%1
Trichuriasis 68 million435 million16%1
Dengue fever * 53 million101 million53%1
Lymphatic filariasis 8.7 million29.4 million29%1
Trachoma † 1.8 million3.3 million53%1
Cysticercosis 819,5382.7 million31%1
Leprosy 187,730523,24536%1
Echinococcosis 119,320973,66212%1
Visceral leishmaniasis 13,53030,06745%1
Rabies * 4,37013,34033%1
* – only new cases
† – only cases causing visual impairment

Prevention

Elimination of as many of these diseases as possible is a goal. [90]

The government of India collaborates with the World Health Organization in making financial investments in health care for the purpose of reducing and eliminating neglected tropical diseases in India. [91]

In 2005, the Indian Health Ministry, Bangladeshi Health Ministry, and the Nepali Health Ministry shared a memorandum of understanding to eliminate kala-azar in their shared region by 2015. [92]

A 2015 study reported that India's public health programs were reducing leprosy rates but not quickly enough to eliminate the disease from the region. [93]

In 2017 the Indian government began participating in the World Health Organization's plan to eliminate 10 of the neglected tropical diseases. [87] The government strategy was to reduce poverty, promote sanitation, do vector control, and provide public health education. [87]

Society and culture

The neglected tropical diseases are diseases of poverty and poverty reduction in society will reduce them.[ citation needed ]

Some people feel embarrassed to have a disease, but a disease is not anyone's fault. [94] The government of India sometimes has organized health campaigns to teach about diseases so that people feel comfortable coming for medical help when they need it. [94]

Related Research Articles

<span class="mw-page-title-main">Leishmaniasis</span> Disease caused by parasites of the Leishmania type

Leishmaniasis is a wide array of clinical manifestations caused by protozoal parasites of the Trypanosomatida genus Leishmania. It is generally spread through the bite of phlebotomine sandflies, Phlebotomus and Lutzomyia, and occurs most frequently in the tropics and sub-tropics of Africa, Asia, the Americas, and southern Europe. The disease can present in three main ways: cutaneous, mucocutaneous, or visceral. The cutaneous form presents with skin ulcers, while the mucocutaneous form presents with ulcers of the skin, mouth, and nose. The visceral form starts with skin ulcers and later presents with fever, low red blood cell count, and enlarged spleen and liver.

<i>Wuchereria bancrofti</i> Species of parasitic worm

Wuchereria bancrofti is a filarial (arthropod-borne) nematode (roundworm) that is the major cause of lymphatic filariasis. It is one of the three parasitic worms, together with Brugia malayi and B. timori, that infect the lymphatic system to cause lymphatic filariasis. These filarial worms are spread by a variety of mosquito vector species. W. bancrofti is the most prevalent of the three and affects over 120 million people, primarily in Central Africa and the Nile delta, South and Central America, the tropical regions of Asia including southern China, and the Pacific islands. If left untreated, the infection can develop into lymphatic filariasis. In rare conditions, it also causes tropical pulmonary eosinophilia. No vaccine is commercially available, but high rates of cure have been achieved with various antifilarial regimens, and lymphatic filariasis is the target of the World Health Organization Global Program to Eliminate Lymphatic Filariasis with the aim to eradicate the disease as a public-health problem by 2020. However, this goal was not met by 2020.

<span class="mw-page-title-main">Helminthiasis</span> Any macroparasitic disease caused by helminths

Helminthiasis, also known as worm infection, is any macroparasitic disease of humans and other animals in which a part of the body is infected with parasitic worms, known as helminths. There are numerous species of these parasites, which are broadly classified into tapeworms, flukes, and roundworms. They often live in the gastrointestinal tract of their hosts, but they may also burrow into other organs, where they induce physiological damage.

<span class="mw-page-title-main">Cutaneous leishmaniasis</span> Medical condition

Cutaneous leishmaniasis is the most common form of leishmaniasis affecting humans. It is a skin infection caused by a single-celled parasite that is transmitted by the bite of a phlebotomine sand fly. There are about thirty species of Leishmania that may cause cutaneous leishmaniasis.

<span class="mw-page-title-main">Visceral leishmaniasis</span> Human disease caused by protist parasites

Visceral leishmaniasis (VL), also known as kala-azar or "black fever", is the most severe form of leishmaniasis and, without proper diagnosis and treatment, is associated with high fatality. Leishmaniasis is a disease caused by protozoan parasites of the genus Leishmania.

<span class="mw-page-title-main">Podoconiosis</span> Human disease

Podoconiosis, also known as nonfilarial elephantiasis, is a disease of the lymphatic vessels of the lower extremities that is caused by chronic exposure to irritant soils. It is the second most common cause of tropical lymphedema after lymphatic filariasis, and it is characterized by prominent swelling of the lower extremities, which leads to disfigurement and disability. Methods of prevention include wearing shoes and using floor coverings. Mainstays of treatment include daily foot hygiene, compression bandaging, and when warranted, surgery of overlying nodules.

<span class="mw-page-title-main">Lymphatic filariasis</span> Medical condition

Lymphatic filariasis is a human disease caused by parasitic worms known as filarial worms. Usually acquired in childhood, it is a leading cause of permanent disability worldwide, impacting over a hundred million people and manifesting itself in a variety of severe clinical pathologies While most cases have no symptoms, some people develop a syndrome called elephantiasis, which is marked by severe swelling in the arms, legs, breasts, or genitals. The skin may become thicker as well, and the condition may become painful. Affected people are often unable to work and are often shunned or rejected by others because of their disfigurement and disability.

<span class="mw-page-title-main">Neglected tropical diseases</span> Diverse group of tropical infectious diseases which are common in developing countries

Neglected tropical diseases (NTDs) are a diverse group of tropical infections that are common in low-income populations in developing regions of Africa, Asia, and the Americas. They are caused by a variety of pathogens, such as viruses, bacteria, protozoa, and parasitic worms (helminths). These diseases are contrasted with the "big three" infectious diseases, which generally receive greater treatment and research funding. In sub-Saharan Africa, the effect of neglected tropical diseases as a group is comparable to that of malaria and tuberculosis. NTD co-infection can also make HIV/AIDS and tuberculosis more deadly.

<span class="mw-page-title-main">Eradication of infectious diseases</span> Elimination of a disease from all hosts

The eradication of infectious diseases is the reduction of the prevalence of an infectious disease in the global host population to zero.

<span class="mw-page-title-main">Rabies</span> Deadly viral disease, transmitted through animals

Rabies is a viral disease that causes encephalitis in humans and other mammals. It was historically referred to as hydrophobia because its victims would panic when offered liquids to drink. Early symptoms can include fever and abnormal sensations at the site of exposure. These symptoms are followed by one or more of the following symptoms: nausea, vomiting, violent movements, uncontrolled excitement, fear of water, an inability to move parts of the body, confusion, and loss of consciousness. Once symptoms appear, the result is virtually always death. The time period between contracting the disease and the start of symptoms is usually one to three months but can vary from less than one week to more than one year. The time depends on the distance the virus must travel along peripheral nerves to reach the central nervous system.

<span class="mw-page-title-main">Post-kala-azar dermal leishmaniasis</span>

Post-kala-azar dermal leishmaniasis (PKDL) is a complication of visceral leishmaniasis (VL); it is characterised by a macular, maculopapular, and nodular rash in a patient who has recovered from VL and who is otherwise well. The rash usually starts around the mouth from where it spreads to other parts of the body depending on severity.

Mycetoma is a chronic infection in the skin caused by either bacteria (actinomycetoma) or fungi (eumycetoma), typically resulting in a triad of painless firm skin lumps, the formation of weeping sinuses, and a discharge that contains grains. 80% occur in feet.

Leprosy currently affects approximately a quarter of a million people throughout the world, with the majority of these cases being reported from India.

The London Declaration on Neglected Tropical Diseases was a collaborative disease eradication programme launched on 30 January 2012 in London. It was inspired by the World Health Organization roadmap to eradicate or prevent transmission for neglected tropical diseases by the year 2020. Officials from WHO, the World Bank, the Bill & Melinda Gates Foundation, the world's 13 leading pharmaceutical companies, and government representatives from US, UK, United Arab Emirates, Bangladesh, Brazil, Mozambique and Tanzania participated in a joint meeting at the Royal College of Physicians to launch this project. The meeting was spearheaded by Margaret Chan, Director-General of WHO, and Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation.

<span class="mw-page-title-main">Mission Rabies</span> Rabies prevention program

Mission Rabies is a programme of Worldwide Veterinary Service (WVS), a United Kingdom-based charity that assists animals. Mission Rabies has a One Health approach driven by research to eliminate dog bite transmitted rabies. Launched in September 2013 with a mission to vaccinate 50,000 dogs against rabies across India, Mission Rabies teams have since then vaccinated over 4,000,000 dogs and educated 8,000,000 children in dog bite prevention in rabies endemic countries.

Kala azar in India refers to the special circumstances of the disease kala azar as it exists in India. Kala azar is a major health problem in India with an estimated 146,700 new cases per year as of 2012. In the disease a parasite causes sickness after migrating to internal organs such as the liver, spleen and bone marrow. If left untreated the disease almost always results in the death. Signs and symptoms include fever, weight loss, fatigue, anemia, and substantial swelling of the liver and spleen.

The Global Programme to Eliminate Lymphatic Filariasis (GPELF) is a World Health Organization project to eradicate the Filarioidea worms which cause the disease lymphatic filariasis and also treat the people who already have the infection.

The eradication of lymphatic filariasis is the ongoing attempt to eradicate the Filarioidea worms which cause the disease lymphatic filariasis and also treat the people who already have the infection.

Lymphatic filariasis in India refers to the presence of the disease lymphatic filariasis in India and the social response to the disease. In India, 99% of infections come from a type of mosquito spreading a type of worm through a mosquito bite. The treatment plan provides 400 million people in India with medication to eliminate the parasite. About 50 million people in India were carrying the worm as of the early 2010s, which is 40% of all the cases in the world. In collaboration with other countries around the world, India is participating in a global effort to eradicate lymphatic filariasis. If the worm is eliminated from India then the disease could be permanently eradicated. In October 2019 the Union health minister Harsh Vardhan said that India's current plan is on schedule to eradicate filariasis by 2021.

The Kigali Declaration on Neglected Tropical Diseases is a global health project that aims to mobilise political and financial resources for the control and eradication of infectious diseases, the so-called neglected tropical diseases. Launched by the Uniting to Combat Neglected Tropical Diseases on 27 January 2022, it was the culmination and join commitment declared at the Kigali Summit on Malaria and Neglected Tropical Diseases (NTDs) hosted by the Government of Rwanda at Kigali on 23 June 2022.

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