Tropical disease

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Tropical diseases are diseases that are prevalent in or unique to tropical and subtropical regions. These diseases are less prevalent in temperate climates, due in part to the occurrence of a cold season, which controls the insect population by forcing hibernation during the cold season.[1] Insects such as mosquitoes and flies are by far the most common disease carrier or "vector". These insects may carry a parasite, bacterium or virus that is infectious to humans and animals. Most often disease is transmitted by an insect "bite", which causes transmission of the infectious agent through subcutaneous blood exchange. Vaccines are not available for any of the diseases listed here.[2]

Some of the strategies for controlling tropical diseases include:

  • Draining wetlands to reduce insect populations
  • The application of insecticides (or to a lesser extent, perhaps insect repellents) to strategic surfaces such as: clothing, skin, buildings, insect habitats, and bed nets.
  • The use of a mosquito net over a bed (also known as a "bed net"), to reduce nighttime transmission, since tropical mosquitoes often feed only at night.
  • Use of water wells, and/or water filtration, water filters, or water treatment with water tablets to produce drinking water free of parasites.
  • Development and use of vaccines to promote disease immunity
  • Funding and subsidizing the use of medicinal treatments to treat disease after infection
  • Assisting with economic development in endemic regions. For example by providing microloans to enable investments in more efficient and productive agriculture. This in turn can help subsistence farming to become more profitable, and these profits can be used by local populations for disease prevention and treatment, with the added benefit of reducing the poverty rate.[3]

Human exploration of tropical rainforests, deforestation, raising immigration and increased international air travel and other tourism to tropical regions has led to an increased incidence of such diseases.[4][5]

Contents

[edit] Diseases

In 1975 the United Nations Children's Fund, the United Nations Development Programme, the World Bank and the World Health Organization established the Special Programme for Research and Training in Tropical Diseases (TDR) to focus on neglected infectious diseases which disproportionately affect poor and marginalized populations in developing regions of Africa, Asia, Central America and South America. The current TDR disease portfolio includes the following ten entries:[6]

Caused by a Protozoan parasites transmitted by Anopheles mosquitoes. It infects 300-500 million people each year, killing more than 1 million.[7]
or sleeping sickness, is a parasitic disease, caused by protozoa and transmitted by the tsetse fly
a virus transmitted by mosquitoes
caused by protozoan parasites, and transmitted by the bite of certain species of sand fly.
also known as snail fever, is a parasitic disease caused by several species of flatworm in areas with freshwater snails, which may carry the parasite. The most common form of transmission is by wading or swimming in lakes, ponds and other bodies of water containing the snails and the parasite. More than 200 million people worldwide are infected by schistosomiasis.[8]
(abbreviated as TB), is a bacterial infection of the lungs or other tissues, which is highly prevalent in the world, with mortality over 50% if untreated. It is a communicable disease, transmitted by aerosol expectorant from a cough, sneeze, speak, kiss, or spit. Over one-third of the world's population has been infected by the TB bacterium.[9]
(also called American trypanosomiasis) is a parasitic disease which occurs in the Americas, particularly in South America. Its pathogenic agent is a flagellate protozoan named Trypanosoma cruzi, which is transmitted mostly by blood-sucking assassin bugs, however other methods of transmission are possible, such as ingestion of food contaminated with parasites, blood transfusion and fetal transmission. Between 16 and 18 million people are currently infected.[10]
(or Hansen's disease) is a chronic infectious disease caused by a bacterium. Leprosy is primarily a granulomatous disease of the peripheral nerves and mucosa of the upper respiratory tract; skin lesions are the primary external symptom.[11] Left untreated, leprosy can be progressive, causing permanent damage to the skin, nerves, limbs, and eyes. Contrary to popular conception, leprosy does not cause body parts to simply fall off, and it differs from tzaraath, the malady described in the Hebrew scriptures and previously translated into English as leprosy.[12]
Worldwide, two to three million people are estimated to be permanently disabled because of Hansen's disease.[13] India has the greatest number of cases, with Brazil second and Myanmar third.[13]
The exact mechanism of transmission of leprosy is not known: prolonged close contact and transmission by nasal droplet have both been proposed.[14] It is treated with multidrug therapy (MDT).
incidence is spread throughout the world, and fluctuates between 640,000 - 767,000 new cases detected per year. It is endemic to 91 countries.
According to the WHO, new cases detected worldwide decreased by approximately 20% per year from 2001 to 2004. The global registered prevalence of HD was 286,063 cases; 407,791 new cases were detected during 2004.
is a parasitic disease caused by thread-like parasitic filarial worms called nematode worms, all transmitted by mosquitoes. Loa loa is another filarial parasite transmitted by the deer fly. 120 million people are infected worldwide. It is carried by over half the population in the most severe endemic areas. [15]
The most noticeable symptom is elephantiasis: a thickening of the skin and underlying tissues.
(pronounced [ɒn.kəʊ.sɜːˈkaɪə.sɪs]) or river blindness is the world's second leading infectious cause of blindness. It is caused by Onchocerca volvulus, a parasitic worm.[16] It is transmitted through the bite of a black fly. The worms spread throughout the body, and when they die, they cause intense itching and a strong immune system response that can destroy nearby tissue, such as the eye.[17]
About 18 million people are currently infected with this parasite. Approximately 300,000 have been irreversibly blinded by it.[18]
is an infectious eye disease, and the leading cause of the world's infectious blindness.[19] Globally, 84 million people suffer from active infection and nearly 8 million people are visually impaired as a result of this disease.[20]
is a human disease caused by the parasitic roundworm Ascaris lumbricoides. Nearly 25% of the global population - an estimated 1.4 billion persons - are infected with this worm, primarily in Africa and Asia.[21]


† Although leprosy and tuberculosis are not exclusively tropical diseases, their high incidence in the tropics justifies their inclusion.

Additional neglected tropical diseases include:[22]

Some tropical diseases are very rare, but may occur in sudden epidemics, such as the Ebola hemorrhagic fever, Lassa fever and the Marburg virus. There are hundreds of different tropical diseases which are less known or rarer, but that, nonetheless, have importance for public health.

[edit] Relation of climate to tropical diseases

The so-called "exotic" diseases in the tropics has long been noted both by travelers, explorers, etc., as well as by physicians. One obvious reason is that the hot climate present during all the year and the larger volume of rains directly affect the formation of breeding grounds, the larger number and variety of natural reservoirs and animal diseases that can be transmitted to humans (zoonosis), the largest number of possible insect vectors of diseases. It is possible also that higher temperatures may favor the replication of pathogenic agents both inside and outside biological organisms. Socio-economic factors may be also in operation, since most of the poorest nations of the world are in the tropics. Tropical countries like Brazil, which have improved their socio-economic situation and invested in hygiene, public health and the combat of transmissible diseases have achieved dramatic results in relation to the elimination or decrease of many endemic tropical diseases in their territory.[citation needed]

Climate change, and global warming caused by the greenhouse effect, and the resulting increase in global temperatures, are causing tropical diseases and vectors to spread to higher altitudes in mountainous regions, and to higher latitudes that were previously spared, such as the Southern United States, the Mediterranean area, etc.[23][24] For example, in the Monteverde cloud forest of Costa Rica, global warming enabled Chytridiomycosis, a tropical disease, to flourish and thus force into decline amphibian populations of the Monteverde Harlequin frog [25]. Here, global warming raised the heights of orographic cloud formation, and thus produced cloud cover that would facilitate optimum growth conditions for the implicated pathogen, B. dendrobatidis.

[edit] References

  1. ^ "Guns, Germs, and Steel" by Jared Diamond
  2. ^ See the Wikipedia articles for the respective diseases
  3. ^ Jeffrey Sachs
  4. ^ Deforestation Boosts Malaria Rates, Study Finds
  5. ^ UK 'faces tropical disease threat', BBC News
  6. ^ "Disease portfolio". Special Programme for Research and Training in Tropical Diseases. Retrieved on 2008-01-21.
  7. ^ Frequently Asked Questions | CDC Malaria
  8. ^ WHO | Schistosomiasis
  9. ^ World Health Organization (WHO). Tuberculosis Fact sheet N°104 - Global and regional incidence. March 2006, Retrieved on 6 October 2006.
  10. ^ Chagas Disease After Organ Transplantation --- United States, 2001
  11. ^ Kenneth J. Ryan and C. George Ray, Sherris Medical Microbiology Fourth Edition McGraw Hill 2004.
  12. ^ Leviticus 13:59, Artscroll Tanakh and Metsudah Chumash translations, 1996 and 1994, respectively.
  13. ^ a b WHO (1995). "Leprosy disabilities: magnitude of the problem". Weekly Epidemiological Record 70 (38): 269–75. PMID 7577430. 
  14. ^ Reich CV (1987). "Leprosy: cause, transmission, and a new theory of pathogenesis". Rev. Infect. Dis. 9 (3): 590–4. PMID 3299638. 
  15. ^ Aupali T, Ismid IS, Wibowo H, et al. (2006). "Estimation of the prevalence of lymphatic filariasis by a pool screen PCR assay using blood spots collected on filter paper". Tran R Soc Trop Med Hyg 100 (8): 753–9. doi:10.1016/j.trstmh.2005.10.005. 
  16. ^ http://www.worldbank.org/afr/gper/disease.htm The World Bank | Global Partnership to Eliminate Riverblindness. Accessed November 04, 2007.
  17. ^ "Causes of river blindness". Retrieved on 2008-01-28.
  18. ^ "What is river blindness?". Retrieved on 2008-01-28.
  19. ^ About Neglected Tropical Diseases (NTDs)
  20. ^ WHO | Trachoma
  21. ^ Ascariasis, NIAID, NIH
  22. ^ Hotez, P. J. (September 2007). "Control of Neglected Tropical Diseases". The New England Journal of Medicine 357 (10): 1018–1027. doi:10.1056/NEJMra064142. 17804846. PMID 17804846. http://content.nejm.org/cgi/content/full/357/10/1018. Retrieved on 21 January 2008. 
  23. ^ Climate change brings malaria back to Italy The Guardian 6 January 2007
  24. ^ BBC Climate link to African malaria 20 March 2006
  25. ^ Pounds, J. Alan et al. "Widespread Amphibian Extinctions from Epidemic Deisease Driven by Global Warming." Nature 439.12 (2006) 161-67

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