Table 1.
The neglected tropical disease and their control in Africa
| Disease | Etiologic Agent | Distribution | Control strategy | Drugs | International programmes |
|---|---|---|---|---|---|
|
Helminth
| |||||
| Soil-transmitted helminths | Ascaris lumbricoides Trichuris trichiura Hookworm | A. lumbricoides and T. trichiura restricted to equatorial regions; hookworm is widespread | Annual mass treatment of schoolchildren and of whole communities in high prevalence areas | Benzimidazole anthelmintics, albendazole and mebendazole | Mebendazole Donation Initiative supported by Johnson and Johnson (see: www.taskforce.org) |
| Schistosomiasis (Bilharziasis) | Schistosoma haematobium, S. mansoni | Africa-wide | Annual mass treatment of schoolchildren and of whole communities in high prevalence areas | Praziquantel | Schistosomiasis Control Initiative (www.schisto.org) |
| Lymphatic filariasis (Elephantiasis) | Wuchereria bancrofti | Endemic in 39African countries | Annual MDA to treatment entire population for a (currently undefined) long period to interrupt transmission. | Albendazole and ivermectin | Global Alliance for the Elimination of Lymphatic Filariasis (www.filariasis.org) |
| Onchocerciasis (River Blindness) | Onchocerca volvulus | Endemic in 30 African countries | Vector control through spraying of larvicides and annual community-directed-treatment (CDT) with ivermectin | Ivermectin | African Programme for Onchocerciasis Control (www.apoc.bf/en/) |
| Dracunculiasis (Guinea Worm) | Dracunculus medinensis | Eliminated as public health problem | Active case detection and provision of water supply and use of cloth filters | Guinea Worm Eradication Program (www.cartercenter.org/health/guinea_worm/index.html) | |
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Protozoan
| |||||
| Cutaneous Leishmaniasis | Leishmania tropica, L. major, L. infantum | Scattered foci throughout Africa | Case detection and treatment. Personal protection through use of mosquito nets | Pentavalent antimonials; second line drug is amphotericin | |
| Visceral Leishmaniasis (kala-azar) | L. donovani | Scattered foci in Horn of Africa, Sudan, Ethiopia, Somalia, Kenya and Uganda | Case detection and treatment. Personal protection through use of mosquito nets | Pentavalent antimonials; second line drug is amphotericin | Drugs for Neglected Diseases initiative (www.dndi.org/) |
| Human African Trypanosomiasis | Trypanosoma gambiense T. rhodesiense | Endemic in 37 African countries | Case detection and treatment, and vector control through spraying, traps and targets. | T. rhodesiense: suramin or melarsoprol in early- or late stage disease, respectively T. gambiense: pentamidine or suramin for early- or late-stage disease, respectively. Alternative for melarsoprol refractory late stage T. gambiense treatment is eflornithine | Programme Against African Trypanosomiasis (www.fao.org/ag/againfo/programmes/en/paat/home.html) |
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Bacterial
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| Trachoma | Chlamydia trachomitis | Widespread throughout the continent | SAFE strategy: surgery, antibiotic therapy, facial cleanliness, and environmental improvement | Zithromax | International Trachoma Initiative (www.trachoma.org) |
| Buruli ulcer | Mycobacterium ulcerans | Reported cases from 8 west African countries, 7 central Africa countries and Malawi and Uganda | Case detection and treatment and surgery | Rifampicin and streptomycin/amikacin | |
| Leprosy | Mycobacterium leprae | Close to elimination (defined as prevalence of <1 cases/10,000 population) though pockets of high endemicity remain in some areas of Angola, Central African Republic, Democratic Republic of Congo, Madagascar and Tanzania | Multi-drug therapy (MDT) | Dapsone and rifampicin | |