Historical Profiles in Neglected Tropical Disease Control
This week PLOS Neglected Tropical Diseases publishes the first paper in its new Historical Profiles and Perspectives section
There is a rich history linked to the control of neglected tropical diseases (NTDs). Because many NTDs are disfiguring or produce characteristic signs and symptoms they were often easily identified – even in ancient times – as unique. Therefore, attempts to treat or control these conditions sometimes go back thousands of years. For instance, the ancients devised methods for slowly removing guinea worms from the subcutaneous tissues of the lower extremities and even devised a method to immunize people against leishmaniasis by inoculating children on the extremities or buttocks with live Leishmania parasites in order to prevent disfiguring ulcers on the face following the bites of sandflies. “Leishmanization” conducted in the Middle East and Central Asia likely predates by centuries the first Jennerian attempts at vaccination in the late 1700s.
The twentieth century witnessed some extraordinary efforts, many of which were successful, at NTD control. Beginning in the early 1900s both the London and Liverpool schools of tropical medicine pioneered approaches to disease treatment and prevention. Shortly thereafter the French physician and scientist Eugene Jamot promoted an innovative approach for sleeping sickness that relied on mobile teams to diagnose and treat human African trypanosomiasis in Cameroon and elsewhere in West Africa. The Jamot method led to the near elimination of the disease in many areas, only to see such public health gains reversed during the conflicts in Angola, Democratic Republic of Congo, Sudan, and elsewhere in the last half of the 20th century.
During the Great Leap Forward in the late 1950s in China, millions of peasants were mobilized to bury snails along the tributaries of the Yangtze River resulting to a log-fold reduction in the prevalence of Asian schistosomiasis. The concepts of mass drug administration for controlling or eliminating helminth infections began in the 1960s when populations were first treated with diethylcarbamazine citrate as a means to interrupt the transmission of lymphatic filariasis (LF). Subsequently, China became one of the first nations to eliminate LF. Egypt will soon follow. Today programs of MDA are underway in dozens of developing countries, leading to the control or elimination of at least seven NTDs, including six helminth infections and trachoma. Simultaneously global leprosy elimination efforts are in progress through programs of multi-drug therapy, and guinea worm is near eradication.
Each of these NTD control, elimination, or eradication efforts brings with them rich stories of triumph and failure. They often involve charismatic or larger-than-life personalities. In an effort to chronicle and record these stories PLOS Neglected Tropical Diseases is launching a new Historical Profiles and Perspectives section. Our first paper is be a report on the 10 years of podoconiosis research in Ethiopia.
Ultimately, we look forward to hearing from the community of NTD scientists and public health experts about other stories of NTD control and elimination. Our history represents an extraordinary legacy, which unfortunately is not well known but most certainly needs to be told!