Neglected tropical diseases (NTDs)
1-Feb-2023: Global Report on Neglected Tropical Diseases
Neglected Tropical Diseases (NTDs)
- Group of infections that are common in marginalized communities in developing regions
- Caused by various pathogens
- Common in tropical areas with poor sanitation
- Receives less funding than other diseases
- Examples: snakebite envenomation, scabies, yaws, trachoma, Leishmaniasis, Chagas disease, etc.
Highlights of the Report
- 16 countries account for 80% of global NTD burden
- Nearly 1.65 billion people need treatment for at least one NTD
- Covid-19 impacted community-based initiatives and healthcare access and as a result 34% fewer people received NTD treatment in 2020.
Recommendations
- More investments needed to reach NTD road map targets by 2030
- Multi-sectoral collaboration and partnerships essential
- Additional partners and funders needed
Global Initiatives
- WHO's New Roadmap for 2021-2030 in the context of the United Nations Sustainable Development Goals.
- The Blueprint recommends following measures,
- From measuring process to measuring impact.
- From disease-specific planning and programming to collaborative work across sectors.
- From externally driven agendas reliant to programmes that are country-owned and country-financed.
- London Declaration on NTDs (2012) to recognise the global burden of NTDs.
Indian Initiatives to Eliminate NTDs
- Accelerated Plan for Elimination of Lymphatic Filariasis (APELF) launched in 2018
- Regional alliance with Bangladesh and Nepal, supported by WHO in 2005 to expedite early diagnosis and treatment of the most vulnerable populations and improve disease surveillance and control of sandfly populations (Kala-azar).
- India has already eliminated guinea worm, trachoma, and yaws
- Preventive methods like Mass Drug Administration and vector control measures used to prevent sandfly breeding.
- Morbidity management and disability prevention supported for those affected by lymphoedema and hydrocele.
- Wage compensation schemes introduced for Kala-Azar and its sequela(a condition which is the consequence of a previous disease or injury) known as Post-Kala Azar Dermal Leishmaniasis.
Norovirus
24-Jan-2023: Norovirus infection was confirmed in two schoolchildren in Kerala.
Norovirus is a highly contagious virus that causes acute gastroenteritis, an inflammation of the stomach and intestines.
Norovirus is transmitted through contaminated food or water, contact with infected people or surfaces, and aerosolized vomit. Norovirus is resistant to many disinfectants and can heat up to 60°C. Therefore, merely steaming food or chlorinating water does not kill the virus. It can also survive many common hand sanitisers.
Symptoms of norovirus infection include vomiting, diarrhea, nausea, abdominal pain, headache, and fever. The symptoms of norovirus infection usually last for 1-3 days.
Causes
- Virus family: Norovirus belongs to the family Caliciviridae.
- Viral structure: Norovirus is a non-enveloped, single-stranded RNA virus.
- Genogroups: Norovirus is classified into 10 genogroups, with genogroups I, II, and IV causing human infections.
Epidemiology
- Prevalence: Norovirus is the most common cause of acute gastroenteritis worldwide, responsible for approximately 685 million cases and 200,000 deaths annually.
- Outbreaks: Norovirus outbreaks are common in closed settings such as hospitals, nursing homes, schools, and cruise ships.
- Risk factors: Norovirus infection is more common in young children, older adults, and people with weakened immune systems.
Diagnosis and Treatment
- Diagnosis: Norovirus infection is diagnosed based on symptoms, and confirmed by laboratory testing of stool samples.
- Treatment: There is no specific treatment for norovirus infection, and the focus is on managing symptoms and preventing dehydration.
- Prevention: Hand hygiene, food safety practices, and cleaning and disinfection of surfaces are key measures to prevent norovirus transmission.
Public Health Impact
- Economic impact: Norovirus outbreaks can have significant economic impact, with costs estimated to be over $60 billion globally.
- Burden on healthcare system: Norovirus outbreaks can put a strain on healthcare resources, with hospitalizations and emergency room visits increasing during outbreaks.
- Control measures: Surveillance, outbreak investigation, and implementation of control measures are critical in preventing and controlling norovirus outbreaks.
Global Trans Fat Elimination report
24-Jan-2023: WHO Report on Global Trans Fat Elimination
A new report from the World Health Organization (WHO) has found;
- 5 billion people globally remain unprotected from harmful trans fats
- Consumption of trans fats responsible for up to 500,000 premature deaths from heart disease every year
- WHO called for the global elimination of industrially produced trans fats in 2018
- Elimination target set for 2023
- 43 countries have implemented best-practice policies for tackling trans-fat in food
- 2.8 billion people protected globally
- Many countries in America and Europe have phased the substance out with bans on partially hydrogenated oils
- No low-income countries have adopted such measures
- 9 of the 16 countries with the highest estimated proportion of coronary heart disease deaths caused by trans-fat intake do not have a best-practice policy
- Best-practices in trans-fat elimination policies follow specific criteria established by WHO and limit industrially produced trans-fat in all settings
- Two best-practice policy alternatives: mandatory national limit of 2 grams of industrially produced trans-fat per 100 grams of total fat in all foods; mandatory national ban on the production or use of partially hydrogenated oils as an ingredient in all foods.
What are Trans Fats?
- Trans fat or trans-fatty acids are unsaturated fatty acids
- Naturally-occurring trans-fat come from ruminants (cows and sheep)
- Industrially-produced trans-fat is formed in an industrial process that adds hydrogen to vegetable oil converting the liquid into a solid, resulting in “partially hydrogenated” oil (PHO)
- Trans fats have been linked to an increased risk of heart disease, diabetes, and obesity
Challenges in Eliminating Trans Fat:
- Trans fats are a cheap and easy way to stabilise and extend the shelf life of food products
- Many small and medium-sized food manufacturers may not have the resources or technical expertise to reformulate their products to remove trans fats
- Trans fats are often used in food service and restaurant settings, which can be harder to regulate than retail food products
- Changing consumer habits and taste preferences can be difficult
- Some countries or regions may have limited infrastructure and resources to monitor and enforce the ban of trans fats
Initiatives to Eliminate Trans Fat:
India
- Eat Right Movement
- Swachh Bharat Yatra
- Heart Attack Rewind
- The Food Safety and Standards Authority of India (FSSAI) has stated that all food items should contain less than 2% of trans fat from Jan 2022
Global
- WHO released REPLACE, a step-by-step guide for the elimination of industrially-produced trans-fatty acids from the global food supply
- REPLACE provides six strategic actions for eliminating trans fats.
- Review dietary sources of industrially-produced trans fats and the landscape for required policy change.
- Promote the replacement of industrially-produced trans fats with healthier fats and oils.
- Legislate or enact regulatory actions to eliminate industrially-produced trans fats.
- Assess and monitor trans fats content in the food supply and changes in trans-fat consumption in the population.
- Create awareness of the negative health impact of trans fats among policymakers, producers, suppliers, and the public.
- Enforce compliance of policies and regulations.