Neglected Tropical Diseases
Neglected tropical diseases (NTDs) are defined as a group of infectious, mainly chronic, debilitating and often stigmatizing diseases that primarily afflict the poorest of the poor, living in remote rural and deprived urban settings of tropical and sub-tropical countries. The cognition of the NTDs has greatly increased in recent years, particularly since the first report on NTDs by the World Health Organization in 2010.
NTDs are the most prevalent infections of the world's poorest people who live on no money in developing regions of sub-Saharan Africa, Asia, and tropical regions of the Americas. The most common NTDs include ascariasis, trichuriasis, and hookworm infection (600-800 million cases), schistosomiasis, lymphatic filariasis and onchocerciasis (>300 millions), and trachoma (100-200 million), food-borne trematodiases including opisthorchiasis (50 million), and leishmaniasis and Chagas disease (20-40 million). In terms of disability adjusted life years lost (DALYs), these NTDs exhibit a global disease burden that exceeds tuberculosis and is almost equivalent to HIV/AIDS. The NTDs also cause poverty and entrap people and communities into poverty, because they affect child development, pregnancy, and productivity and often are stigmatizing (Hotez et al, 2009 Lancet 373,1570; The London Declaration on Neglected Tropical Diseases 2012, http://unitingtocombatntds.org; World Health Organization, 2014, http://www.who.int/neglected_diseases/about/en/
Neglected Infections of Poverty
There is a second important group of non-tropical neglected infections of poverty (NIPs) that occur in the United States. Recent analyses indicate that unexpectedly high rates of NIPs occur in areas of poverty, especially in the Mississippi Delta and post-Hurricane Katrina Louisiana, the U.S. border with Mexico, Appalachia, and U.S. inner cities. Although not well known, there is increasing evidence that like the NTDs, the NIPs are trapping African American and Hispanic American minorities in poverty, as well as poor whites living in Appalachia and the Mississippi Valley, and Native Americans living on reservations in the West. The major NIPs include:
- congenital cytomegalovirus and syphilis
- Chagas disease
In the United States, HIV/AIDS can also be considered a neglected infection of poverty.
GW has launched a multi-faceted assault on these two groups of neglected infections. First, a unique Department of Microbiology, Immunology, and Tropical Medicine (MITM) is in place in the GW School of Medicine and Health Sciences, with about 10 faculty members conducting fundamental NIH-sponsored research on hookworm, schistosomiasis, opisthorchiasis, and hookworm disease and vaccinology, while additional epidemiological investigations take place within relevant departments in the GW Milken Institute School of Public Health.
Specific to the NIPs, GW has a broad program in HIV/AIDS, molecular- and immuno-pathogenesis, clinical translational research, epidemiology, and health policy located in the departments of MITM, Pathology, Medicine, and Epidemiology & Biostatistics. Extensive research is also underway to study lesser-known NIPs including toxoplasmosis, and Chagas disease. A health policy initiative for both the NTDs and NIPs is also in progress at GW and we originally hosted the first open-access journal on these conditions, PLoS Neglected Tropical Diseases.