Elimination of parasitic infections
The idea that elimination of parasites and vectors in certain settings is achievable is gaining momentum. This is being driven, in part, by an increasing awareness that much can be done to reduce the morbidity and mortality caused by parasite infections by deploying existing tools, often based on drug donations from the pharmaceutical industry. In the past, targeted local elimination in isolated or island populations has been achieved, for example, hydatid disease (echinococcosis) in Iceland, Cyprus and New Zealand or sleeping sickness in São Tomé and Principe.
Encouraging examples of successful control and elimination of parasites and their vectors are now being reported in other settings and at a larger scale, including filariasis in China, Sri Lanka and the Republic of Korea and onchocerciasis in the Americas and in some settings in West Africa. Whilst successful control may be restricted initially to isolated pockets within an endemic area, or to the boundaries of a parasite’s range, where the life cycle may be more easily disrupted and where the prospect of reintroduction is limited, epidemiological evidence suggests that local elimination can be achieved. The role of animal reservoir hosts can be a critical factor for the prospects of elimination of some diseases and reservoir hosts may severely limit the chances of success.
In some cases, as with dracunculiasis, global eradication is the goal, that is the permanent certified reduction of incidence to zero globally. Dracunculiasis is now only endemic in 5 countries in Africa, transmission having been eliminated from Asia. Most importantly, there is a commitment from national health authorities in endemic countries to subscribe to World Health Assembly Resolutions for elimination of parasitic infections. This commitment, together with improved methods of vector and transmission control, wider availability of existing treatments, better health education, improved water quality and sanitation, increased knowledge of parasite and vector interactions, are all contributing to driving down prevalence and incidence of many parasitic infections and thus reducing disease morbidity and mortality.
In this Series, we aim to feature articles that highlight some of the important steps that need to be taken to eliminate both parasites and vectors in different regions of the world, and by bringing together these important contributions, we hope to illustrate how much can be achieved in reducing the burden of parasitic diseases.
Edited by Professor David Rollinson
Collection published: 10 February 2011
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