The Neglected Tropical Diseases (NTD) Unit hosted at CGHR brings together different researchers working on disease specific aspects of NTDs at KEMRI. The Unit addresses the critical need to align research program with national and current global agenda.
Neglected tropical diseases (NTDs) are a group of chronic disabling infections affecting more than one billion people worldwide, mainly in Africa and mostly those living in remote rural areas, urban slums or conflict zones.
Beyond their negative impact on health, NTDs contribute to an ongoing cycle of poverty and stigma that leaves people unable to work, go to school or participate fully in family and or community life.
They range from Trypanosomal parasites (Leishmaniasis, Human African Trypanosomiasis, Chagas disease /American trypanosomiasis); Helminth parasites (Schistosomiasis, Lymphatic Filariasis, Onchocerciasis, Drancunculiasis, Echinococcosis, Taeniasis/Cysticercosis, Ascariasis, Trichuriasis, Hookworm, Strongyloidiasis); Bacterial infections (Leprosy, Buruli ulcer, Noma, Trachoma, Cholera, Yaws) and Viral infections (Yellow fever, Dengue fever, Japanese Encephalitis, Rabies).
The diseases are called neglected because, compared with malaria, HIV and TB for example, they have received relatively much less funding or attention from national governments and medical and donor communities despite the vast numbers of people affected.
Lacking a strong political voice, people affected by these tropical diseases have a low profile and status in public health priorities. Lack of reliable statistics and ‘unpronounceable’ names of diseases have all hampered efforts to bring them out of the shadows.
Neglected Tropical Diseases (NTDs) are a devastating obstacle to human settlement and socioeconomic development of already impoverished communities. A growing body of evidence demonstrates that control of these diseases can contribute directly to achievement of several Millennium Development Goals (MDGs).
Interventions against NTDs mostly in the form of mass distribution of medicines donated by pharmaceutical companies have already benefited millions of people, protecting them from physical pain, disability and poverty. Over the past decades, the World Health Organization (WHO), together with its partners, has formulated an innovative strategy to ensure cost-effective, ethical and sustainable control towards elimination or eradication of several NTDs.
In general, the major challenges for controlling NTDs and zoonoses are:
- Sensitivity of current copromicroscopy methods is sufficient for informing early stages of control (mapping and monitoring impact of Mass Drug Administration - MDA), but is inadequate when infections are reduced to low levels by MDA to inform late stages of control (decision to reduce or stop MDA and post-elimination surveillance), underscoring the urgent need to develop more sensitive alternative diagnostic tools
- Need for effective alternative medicines and pesticides to mitigate against any potential resistance to monotherapies such as Praziquantel (PZQ) used against schistosomes.
- Provision of treatment and other interventions free of charge to communities in need
- A system for delivery of medicines to cover the entire at-risk population
- Lack of a suitable PZQ pediatric formulation
- Promotion of integrated vector management
- Advocating an intersectoral, interprogrammatic approach to control of NTDs
- Early protection of children
- Post-implementation surveillance and monitoring
- Need for capacity building for increasing pool of researchers in NTDs
Our research in western Kenya region has mainly focused on Schistosomiasis and Soil-Transmitted Helminths (STH), addressing some of the pressing challenges outlined above.