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  • List the neglected tropical diseases (NTDs) of the developing world and the factors contributing to their being “neglected”
  • Discuss the many links between NTDs and poverty and how the Millennium Development Goals might break these links
  • Review the symptoms, diagnosis, treatment, and control measures for 13 chronic NTDs and one acute NTD (dengue)
  • Discuss the application of various disease control strategies (vector control, mass drug administration, vaccination, reservoir elimination, etc.) to NTDs

The neglected tropical diseases (NTDs) are chronic infections affecting the poorest people of the world, living in sub-Saharan Africa, Asia, and Latin America (Table 11-1). Because most health care workers in developed countries are unfamiliar with NTD diagnosis and treatment, these are summarized in Tables 11-2 and 11-3. The term neglected tropical diseases was first introduced in the 1980s as the “great neglected diseases of mankind” by the late Dr. Ken Warren. These chronic, disabling but rarely fatal diseases not only afflict the poor, but they also keep them in poverty. Many NTD victims are stigmatized by their illness and unable to find employment. These are the diseases with the horrific photos in the tropical medicine texts, and in many cultures the stigma is intensified by the condition being attributed to witchcraft or a curse. Although none are as deadly as the three most important tropical diseases, malaria, tuberculosis (TB), and acquired immune deficiency syndrome (AIDS), if taken together the total disability of just 13 of these “lesser” diseases approaches that of HIV/AIDS and exceeds that of malaria and TB.1 NTDs are “neglected” only because the suffering from these ancient scourges is largely confined to the so-called third world, effectively veiling their existence from wealthier nations. Many Americans are amazed to learn that they still exist. In the words of the World Health Organization (WHO), they are “not adequately addressed either nationally or internationally.” There is also little financial incentive for pharmaceutical firms to develop or distribute new drugs or vaccines in the absence of a ready market for them, especially because most NTDs occur in the 2.7 billion people making less than $2 US per day.2 Before philanthropic interests made them priorities, NTDs were literally “out of sight and out of mind.”

Table 11-1. The 13 Chronic Neglected Tropical Diseases and Dengue.

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