Comprehensive Report: Neglected Tropical Diseases in Europe

This report provides an in-depth analysis of Neglected Tropical Diseases (NTDs) in Europe, examining their impact on public health. It begins with an executive summary and an introduction to NTDs, highlighting their prevalence in developing countries and their causes. The discussion section offers a general overview of NTDs, focusing on the various treatments, including mass drug administration, and the role of WASH initiatives. The report then addresses changes in the epidemiology of NTDs, including the emergence of new diseases and the influence of climate change and poverty. The report emphasizes the negative effects of NTDs on public health, particularly in Southern and Eastern Europe, where poverty and lack of sanitation are major factors. It also explores the interventions and strategies being implemented to curb the spread of diseases, including the development of new diagnostic tools and vector control measures. The report includes figures on the prevalence of NTDs and death rates, and concludes by emphasizing the need for improved technologies and approaches to control the diseases. The report is contributed by a student to be published on Desklib, a platform which provides all the necessary AI based study tools for students.

Running head: NEGLECTED TROPICAL DISEASES IN EUROPE
Neglected Tropical Diseases in Europe
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Executive summary:
The report aims to analyze the impact of Neglected Tropical Diseases in Europe that
has been a major public health issue for the past few years. The Neglected Tropical
Diseases have been prominent in all the parts of the world, especially in the developing
countries. Due to the effects of climate changes and the standard of living of the
poverty-stricken people, the impact of the diseases has been wider in these regions of
the world. The report studies the public health condition of people all over the world to
understand the global consequences of the diseases. It further emphasizes the various
treatments and measures that are being integrated to curb the diseases. It also
incorporates the condition of people in Europe in the report chiefly, to assess the
situation of the people suffering from the rapid influence of the tropical diseases. The
report finds that in spite of the precautions that are being implemented, a widespread of
the disease has been considerably high in various areas and Europe is not an
exception. It has been negatively affecting the health of the people as a whole and
records to contribute to the high death rate of the population.

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Table of Contents
Introduction:.......................................................................................................................3
Discussion:.........................................................................................................................3
General overview-..........................................................................................................3
Treatments-....................................................................................................................5
Changes in epidemiology of NTDS-...............................................................................8
Influence of the changes on public health-....................................................................9
Conclusion-......................................................................................................................10
References-.....................................................................................................................11

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Introduction:
Neglected Tropical Diseases, commonly referred as NTDs are tropical infections
and communicable diseases that are mostly prevalent in the low-income population
manifested in the developing countries. NTDs are caused by pathogens such as virus,
helminthes, bacteria and such other vectors that affect a large number of people
worldwide. In developed countries, the tropical diseases mostly affect the poorer
sections of the society who live in close proximity with the infectious vectors, lack
adequate housing, and fail to access proper sanitation. Various public health
approaches work to improve the situation of people affected by the NTDs. A number of
diseases fall under the criteria of the NTDs starting from ulcer, dengue, forborne
diseases, leprosy, rabies and various others that accelerate from a minimum effect to
seriously affecting a person. It often causes death to the affected people. Thus, it serves
to be a major concern on which various researches are going on since years. The report
deals with the major concern of the NTDs and its prevalence in Europe, focusing on the
methods being adapted to eliminate the diseases and the treatments that are employed
to heal the affected patients. It also records the changes that have been made in the
treatment methods, which has been very much influencing in the public health.
Discussion:
General overview-
NTDs have been recorded to have caused harmful consequences to over one
billion people in 149 countries (Hotez et al. 2014). Various research and developmental
measures are being introduced and developed in order to improve the treatments
offered to people who are affected with NTDs. Initiatives by the NGOs, biotechnology
companies, and multiple other organizations work collaboratively to eradicate the
diseases. The wide influence of the NTDs on public health has led to the initiation of the
London Declaration on Neglected Tropical Diseases who work in collaboration with
World Health Organization, the World Bank, leading pharmaceutical companies and
representatives of various companies to prevent the spread and cause of the diseases

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(Savioli and Daumerie 2013). They work together to provide more effective medicines
and methods to terminate the diseases. The Water, Sanitation and Hygiene, referred to
as WASH is also an initiation that works effectively to prevent NTDs with drug
administration methods and spreading public awareness in the areas that are generally
affected by the deadly diseases.
Due to rapid human mobility and migration, climatic changes, economic falls in
the North African regions and Middle East areas, there has been a wide spread of the
Neglected Tropical Diseases in the European countries. The major diseases include
leishmaniasis, dengue, chagas disease, and schistosomiasis in addition to the multiple
other diseases are highly occurring in the countries. Emergence of arbovirus and
parasitic infections has also been very rapid in these regions. Europe has become the
“ground zero” for vector borne diseases that has affected the public health in Europe
drastically (Boissier et al. 2015). A number of initiatives are taken by the nations to curb
the diseases that are leading to high mortality rate in the countries. NTDs are mostly
found to be concentrated in the eastern and southern Europe where people live below
poverty level. The low standard of living of the people with lack of sanitation and proper
knowledge of health has led to the widespread of the NTDs in these regions. The
European Centre for Disease Prevention and Control has laid to an initiation of health
guidelines to prevent the spread of the disease and make people aware of them.
Knowledge of medicines, mass drug administrations, developing minority healthcare
workforces are some of the major concerns in European nations that are striving hard to
reduce the number of people being affected by NTDs and help them to recover from
those. From the given figure below, figure 2, the prevalence of the diseases in parts of
Europe has been represented, which is highest in Glasgow where poverty is a major
cause of the occurrence and lowest in Switzerland that is more conscious and
advanced compared to the other states.

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Fig. 1: Prevalence Rates of NTD in Europe
Source. (Boissier et al. 2015)
Treatments-
Mass Drug Administration strategies help to treat a huge population affected by
NTDs (Keenan et al. 2013). Proper medicines with the right dose help to heal the
diseases. NTDs weaken the entire body of the affected person. Thus, medicines play
the primary role to regain back ones potential. Annual and semi-annual distribution of
drugs lowers down the occurrence of the diseases to a certain extent. The basic need to
restrict the diseases is to have an access to safe drinking water, proper sanitary
facilities and proper hygiene. The use of drugs, vaccines, controlling agents, diagnostics
and various similar methods help to eliminate the NTDs (Bergquist et al. 2015).
However, these methods contain high toxicities and do not prevent future infections.
Thus, they have a limited usage. This results to an urgent need of improvised
technologies to control the diseases. Ivernectin preventive chemotherapy is one such
method that indicates a reduction of the diseases in future. Research and studies have
helped to develop more NTD drugs such as drugs for Kinetoplastid infections, for
onchocerciasis, bacterial and viral NTDs and others (Bockarie et al. 2013). Production
of newer vaccines like anthelminthic, and for hookworm and other soil-transmitted

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helmith infections, or vaccines linked chemotherapy are also being effective in
preventing reinfection that is a major problem that comes along the NTDs.
Fig.2: Prevalence of NTDs in the countries of the world.
Source: (World Health Organization 2015)
The figure represents the spread of the NTDs all over the world that indicates
that the diseases are more prominent in the developing countries.
Intervention strategies to develop better NTD diagnostic tools to monitor the
infected patients and confirm cure of the diseases are being promoted. Mass treatment
programs are focusing on reaching to people of all strata fighting with the diseases. The
various organizations and programs working with NTDs are striving hard to make the
diagnostic centers easily reachable and available for the people. Simultaneously, it
focuses on the minimum cost of these treatments so that it can be afforded by the poor
section of the societies who are mainly affected by the diseases. The researchers are
also stressing on the reliability of the measures undertaken to curb the diseases. The
countries and researchers are trying to define and prioritize NTD diagnostic needs and
emphasizing to educate people about the basic preventive measures that they can take
by themselves. Vector control measures, source reduction strategies and various
chemical agents used as insecticides are being studied upon with greater concern to
develop more preventive option for the diseases. Development in functional genomics

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research, molecular mechanisms that act as insect resistance against pathogens that
lead to serious diseases are being examined and put to use. Along with the various
methods, approaches based on transgenic are also proving beneficial. The intervention
of transgenic approach reduces the insect population densities, which helps in the
reduction of the transmitted diseases. Input of greater knowledge on functional biology
and genomics with modified technology are being applied to have a modification in host
preferences and olfaction that would aid to fight the NTDs (Hopkins 2013).
Fig.3: Death occurances due to NTDs and the production of new drugs
Source. (Pedrique et al. 2013)
The figure depicts the massive death rates caused by NTDs globally and the
approval and introduction of new drugs that would help to eradicate the diseases. About
1,535 new drugs were produced in a year gap of 25 years to curb tuberculosis and
tropical diseases in the world (Pedrique et al. 2013). This suggests that greater and

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faster initiatives need to be taken to prevent the emerging diseases to reduce the
massive death rates globally.
Changes in epidemiology of NTDS-
Many precautions are being taken by different organizations to control the spread
of NTDs, and eliminating them. However, it has failed to meet the changes aimed at to
stop the spread. Rather, in recent times, there has been a rapid change in the spread of
the diseases. A number of NTDs are specific to certain regions only. This prevents the
diseases to have a global concern. Thus, investigations and recommendations to fight
these diseases remain out-numbered. Another major issue acting as social determinant
of NTDs is conflict. Poverty-stricken people rising in conflicts have been found to suffer
from coetaneous as well as visceral Leishmaniasis, majorly found in the countries of
East Africa and Sudan (Freeman et al. 2013). Thus, political destabilization has been
accelerating NTDs in these regions. Malaria is also reemerging in the Western regions
with the prevalence of arthropod borne infections. Venezuela has also been threatening
the Latin American countries that are causing serious health crisis (Requena et al.
2015). A continuous spread and occurrence of dengue, chikungunya, and Zika virus has
been constant in Europe (Murray, Quam and Wilder-Smith 2013). Climate changes are
accelerating zoonotic, snail-borne, and mosquito transmitted diseases in various parts
of Europe (Esch and Petersen 2013). Poverty and population movements have
accelerated the spread of NTDs enormously. Various global measures are being
undertaken and worked upon to deal with the climate changes; however, there is a need
to manifest global interest and greater interventions in areas seriously affected by the
diseases. Chagas disease has been causing havoc, affecting about 90% of the people
in Latin America, who barely have any proper medical aid to fight the disease (Hotez et
al. 2014). The Chagas disease is a global concern that has been spreading in Southern
Europe and some other regions as well. It has been observed that despite various
measures are being taken to fight the NTDs in recent years; there is still a huge rate of
deaths occurring all over. Figure 4 represents the rate of death caused by the prominent
NTDs in the year 2010 in Europe.

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Fig.4: Death rates caused by NTDs in Europe in 2010
Source. (World Health Organization 2015)
Reports suggest that there is still a huge requirement to improve technologies
and adopt new approaches to curb diseases such as tuberculosis, malaria, AIDS,
trachoma and others. However, reduction of the number of people affected by leprosy
by expert methods of scientists and public health organizations has been incredibly
successful, preventing it from further spread and effects.
Influence of the changes on public health-
Encouraging investment and proper research in NTDs has led to various interventions
that has positively influenced public health. However, multiple vector borne diseases
have emerged and re-emerged in Southern Europe. Dengue, Chagas disease,
schistosomiasis, opisthorchiasis and leishmaniasis are the major NTDs highly occurring
in the Southern Europe (Molyneux 2013). Malaria and various other infections have also
been prevalent in the countries. West Nile Virus infection caused by the Culex
mosquitoes is also emerging in these regions. Due to rapid immigration from people
from various countries and lower standard of living of the people of these regions, there
has been an accelerated transmission of the NTDs. Public health has been seriously
affected by diseases such as dengue, chikungunya, malaria and multiple others in
recent times, which have emerged and re-emerged for the past few years (McMichael
2013). NTDs flourish more in the impoverished areas but they reinforce poverty through

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their tremendous negative effects on the workers and women and growing children.
People often remain out of reach of medicinal aid, which lead to a total collapse of their
health systems. The high increase in heat waves in Europe that facilitates the growth of
more insects and snails simultaneously promotes vector-borne diseases in Northern
Europe, ill affecting the health of the people. The entire population is under the threat of
the rapid growth and re-emergence of NTDs that seeks greater attention by the
European Union and other organizations of the country to help the people in dealing
with the diseases, if not eradicating them altogether.
Conclusion-
From the report, it can be concluded that though there are various measures
being undertaken in the Global sphere as well as in various parts of the European
territory, a greater portion of the entire population of the country is yet under the threats
of the Neglected Tropical Diseases. Diseases such as dengue, schistosomiasis,
opisthorchiasis and leishmaniasis are widely affecting the poverty-stricken people of
Europe who lack proper sanitation and basic requisites of a healthy living. Various other
transmitted diseases have been prevalent in recent times. Climatic changes turn out to
be the major cause of the NTDs occurring in Europe. The rapid movement of population
from the various regions to Europe has also added to the number of diseases causing
serious consequences to the people. With greater initiatives and advanced technology
and researches, it is believed that European people along with the people of other
developing countries who are fighting with the NTDs would be able to eliminate them
and live a life free of such threats in the future.

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References-
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Bockarie, M.J., Kelly-Hope, L.A., Rebollo, M. and Molyneux, D.H., 2013. Preventive
chemotherapy as a strategy for elimination of neglected tropical parasitic diseases:
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Boissier, J., Moné, H., Mitta, G., Bargues, M.D., Molyneux, D. and Mas-Coma, S., 2015.
Schistosomiasis reaches Europe. The Lancet Infectious Diseases, 15(7), pp.757-758.
Esch, K.J. and Petersen, C.A., 2013. Transmission and epidemiology of zoonotic
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