They are a group of 20 diseases.
Very diverse from each other, but with common characteristics: in the world,
they affect more than one billion people
and have
“devastating consequences”
for health, the economy and society, warns the
World Health Organization (WHO)
.
The WHO established January 30 as
Neglected Tropical Diseases (NTD) Day
.
In the adjectives that accompany the noun, is its definition.
Tropical because they are prevalent in those climates, but with the impact of global warming, several
are expanding to regions where they did not exist before
.
And neglected because they barely appear in global health programs and a tiny percentage of health and research investment is dedicated to their approach.
13 of them are in Argentina
.
Their impact is dissimilar and ranges from some with very low prevalence (such as helminthiasis) to dengue known to everyone, to other historical ones that still have an impact to be considered, such as leprosy or Chagas.
Many of these diseases, the WHO points out,
are transmitted by vectors
, are associated with complex biological cycles and the pathogenic agent that causes them is hosted in an animal reservoir, factors that "
make their control difficult
from a public health point of view."
This is the case, for example, of
rabies
.
“We have controlled the rabies issue, we eliminate it in dogs and cats in the country.
The problem today is a rabies that is difficult to control, which is associated with bats, since 3% of these animals carry rabies virus," warns Tomás Orduna, former head of Tropical Medicine and Travel Medicine at the Muñiz Hospital and member of the Committee. Scientist at the Mundo Sano Foundation.
The tropical infectious disease specialist remembers that in 2021, and after 13 years, there was a death from rabies: a policewoman died in Coronel Suárez from the bite of a stray cat that had in turn been bitten by a bat.
She says that bats cannot be controlled because there are millions of individuals, but it is possible
to control dogs and cats
: "That is why we aim at the responsible ownership of animals and continue supporting the vaccination" of pets.
Dengue and climate change
Given the simplification that all tropical diseases spread due to climate change, Orduna clarifies the points.
“Not everything is so easily linked to climate change.
Yes, there may be an influence, but we cannot know with certainty what the real weight of that potential impact will be.
The clearest thing is the expansion of the presence of insect vectors
.
“We are seeing
Aedes aegypti
on route 2 arriving in Mar del Plata or on route 3 in Bahía Blanca, which
clearly changed in 20 or 25 years
when we had to start evaluating dengue areas,” he points out.
Aedes aegypti mosquitoes in a laboratory.
It is the vector of dengue.
Photo EFE/Thais Llorca
Dengue
is probably the disease of this heterogeneous group that we have talked about and heard about the most in recent times
.
After a record season of cases in 2023, this summer
Aedes aegypti
was also an issue due to the lack of repellents.
“Between the last two weeks of 2023 and the first two weeks of 2024,
we already have 11,000 cases in the NEA
, almost half of them in Chaco and the rest distributed between Formosa, Corrientes and Misiones,” Orduna counted.
This is the first season in which the vaccine is available in the private sector: a representative has just presented a project to include it in the National Vaccination Calendar for all those who have previously contracted the virus.
Chagas and leprosy
Orduna points out that some of these diseases "are biblical", such as
leprosy
, which is caused by infection with a bacteria and affects the skin, but also the eyes and the peripheral nervous system.
“We have endemic areas, mainly in the Northeast, where
active patient search work
is necessary to detect cases and offer treatment because it can be cured,” he says.
scabies
,
_
Also a historical disease, it is part of the group of ectoparasitosis, skin infestations caused by mites, fleas or lice that cause intense itching and rashes.
However, the specialist places special emphasis on
Chagas
, because he affirms that it is a disease in which the course could be changed for thousands of patients.
Vinchucas, the transmitting agent of Chagas, a disease that could be eliminated.
Photo Archive
“I thought that one day I would practically see Chagas as a marginal pathology, but unfortunately not.
Since 1969 we have had a treatment with the possibility of a cure and the fact that around 1,300 babies a year are born positive
breaks my head
," he gets angry.
"We have to treat all children under 19 years of age and offer treatment to all Chagas positive women of fertile and pre-fertile age, because if they are treated they will not give birth to children with Chagas," emphasizes the doctor. , who demands to continue generating
commitment from health teams
to think about the disease and treat it appropriately, and
empower patients
to demand treatment.
NTD and development
Several of the NTDs that exist in Argentina have a lower incidence, but their impact on the patients who suffer from them is not.
Mycetoma
and other deep mycoses produce chronic inflammations that cause the progressive destruction of the skin and subcutaneous tissues
;
Taeniasis is caused by
the
presence of an adult tapeworm in the human intestine;
and
cysticercosis
is contracted by ingesting tapeworm eggs that then produce larvae lodged in the tissues.
Helminthiases
are transmitted from soil contaminated by human feces and cause anemia, lack of vitamin A, malnutrition and growth delays, among other problems
.
Food-borne trematodiasis encompasses a group of infections that are contracted by consuming
fish
, crustaceans or vegetables contaminated with parasite larvae.
Hydatidosis (or echinococcosis) is caused by the “dog tapeworm” parasite, which forms cysts in human organs:
it
is endemic in places in Patagonia where there is a particular ecosystem in which sheep, dogs and humans interact.
Another example is
leishmaniasis
, transmitted by the bite of infected female sandfly mosquitoes, which in its most severe form attacks internal organs, while in its most frequent form it causes skin ulcerations, disfiguring scars and disability.
The visceral form, emerging in the country since 2006, has a low statistical rate but a very high fatality rate (close to 90%) if it is not diagnosed and treated in a timely manner.
Regarding
snake bites
, also considered NTDs, Orduna says that the record stopped at about 600/700 cases annually, of which 97% correspond to the yarará and that the possibility of encountering this snake today, with a rattlesnake or coral, which are at risk for humans, decreased by 50% compared to two decades ago because the ecosystem of these animals was reduced by “the expansion of all crops, the soy frontier and clearing.”
The yarará, one of the dangerous snakes in the country.
Photo Shutterstock
In Argentina, 99% of people who suffer a bite quickly access antivenom serum, produced by ANLIS-Malbrán.
“In Southeast Asia many die from not receiving it,” he says.
The key to
avoiding all these pathologies
, Orduna points out, is
human development
.
“That is the basis.
With adequate socioeconomic development, many of these pathologies begin to numerically decrease their incidence and many of them
are controlled and become a rarity
associated with the wild but without any weight in public health, as has happened with many of these diseases. in Europe and the United States,” he concludes.
ACE