Expanding the coverage of preventive chemotherapy for the prevention and control of neglected tropical diseases

Dear Sir,

Neglected tropical diseases (NTDs) have been recognized as a major public health concern affecting the lives of millions of poor and vulnerable people each year.^[1] They comprise of 17 different infectious diseases, resulting because of different microorganisms with variable vectors or intermediate hosts, and even modes of transmission.^[1] Regardless of all the epidemiological determinants, these diseases have been reported from wide geographical areas, and a strong association has been observed between poverty and the incidence of them.^[1],[2],[3] Owing to this very basic fact that these groups of diseases predominantly affect poor individuals, in most of the nation, they are still not been prioritized by the policy makers, and at the same time, different lacunae have been observed in health care delivery as well as community awareness about them.^[1],[3]

However, acknowledging the magnitude of the disease, the tendency of the diseases to result in serious complications–disfigurement–disability, impact on quality of life, and the availability of effective drugs to counter them, the global stakeholders have started to divert their attention toward these infections.^[1],[2] In fact, specific strategies have been implemented and measures have been taken to reduce the magnitude of them.^[1],[2],[3] The World Health Organization has recommended five key interventions to ensure adequate prevention and control of these diseases, namely preventive chemotherapy, appropriate case management, measures to control vector, to provide safe water, sanitation and hygiene facilities, and strengthening of the veterinary public health services.^[2],[4]

Preventive chemotherapy has been implemented to treat populations that are at the risk of some of the helminthic infections, through mass drug administration or large-scale treatment, in order to prevent their transmission in the community with the help of drugs either alone or in combination.^[2],[5] Currently, it has been recommended for the infections such as lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminthiases, and trachoma.^[2] From the program manager perspective, the good thing is that the drugs needed for these infections are safe, cheap, and are mostly donated by the pharmaceutical companies.^[4] In fact, in the year 2015, more than 1.5 billion tablets have been supplied to various nations based on their requisitions.^[2]

Owing to their high effectiveness, not only they have been successful in reducing the incidence of diseases, but they have also given a hope to aim for the elimination of the diseases in future.^[6] The recently released data suggested that more than 975 million individuals have been benefited from the preventive chemotherapy strategy in the year 2015 itself.^[2] It is a remarkable achievement considering the fact that the reach of health care services has improved significantly in a single year, and the entire credit goes to the systematic planning and coordination of the existing services.^[2],[4]

However, still there is an extensive need to scale up the ongoing preventive chemotherapy activities as a lot needs to be done, and thus to counter the drug shortage, steps have been taken to facilitate the supply and delivery of medicines to the nations free of cost.^[4],[5],[6] This can only happen if there is a better forecasting, planning, reporting, and inflow of data to streamline the coordination and integration of activities.^[4] In fact, a joint application package has also been introduced to keep a track of the progress of the ongoing activities aimed at the prevention and control of these diseases.^[2],[4]

In conclusion, owing to the extensive distribution of the NTDs, there is a great need to strengthen and expand preventive chemotherapy activities, and at the same time focus on other interventions.

Acknowledgment

SRS contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work

PSS contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work

JR contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.222705