The Neglected Tropical Diseases

29 Oct 2015

Vanessa Yarwood,
DTMH 2015


The past couple of weeks at LSTM have been focusing on the so called 'Neglected Tropical Diseases', or, as Professor David Molyneux put it, all the rest of the tropical diseases that exclude Malaria, HIV and TB. These include various worms, causing diseases such as elephantiasis and river blindness, as well as dengue fever, rabies, African sleeping sickness (African trypanosomiasis), and snake bites, to name a few. These conditions afflict over 1 billion people across the globe, yet receive less than 0.6% of developmental assistance for health.  They have a huge knock-on effect in causing loss of livelihood and productivity, and are now considered to be indicators of poverty.

However, there have been some incredible success stories for a few of these neglected diseases. The first is the Guinea Worm Eradication Program which was headed up by ex-President Jimmy Carter in 1986 and has reduced those affected by a disabling condition from 3.5 million cases per year in 21 countries to just 146 cases in 2014.2

The second is the widespread administration of the anti-parasitic drug Ivermectin, donated free via pharmaceutical companies, and has been essential in reducing the disease burden.

The beginning of this week was highlighted by a morning on haemorrhagic fevers, focusing specifically on Ebola. Ebola is a virus transmitted to humans by fruit bats, it is thought, and is subsequently spread from human to human due to its highly infectious nature via direct contact or through bodily fluids. The outbreak in West Africa since March 2014 has captured the world’s attention, infecting 28,000 people and causing 11,000 deaths.3 This has led to a catastrophic break down of already weak health systems and infrastructure in Guinea, Sierra Leone and Liberia. During the morning we were privileged to have seminars with Dr Tom Fletcher (Research Training Fellow at LSTM and ID Registrar with an interest in viral haemorrhagic fevers who was seconded to the WHO and deployed several times as a clinician in the Ebola outbreak), Dr Stephen Mepham (Consultant in Infectious Diseases at The Royal Free who updated us with the management of Ebola in the UK and experimental therapies), Will Pooley (a nurse who contracted Ebola whilst working in Sierra Leone), as well as two members of our cohort who have worked in Sierra Leone as part of the response to the epidemic.

Another important mention over the past week with regards to neglected diseases is mental health, a day that was delivered and taught by Dr Maureen Wilkinson, a Consultant Psychiatrist with extensive experience of managing mental health within Africa, and clearly a passion for teaching about it. Her encouragement to us was to act as advocates for mental health in a world where 450 million people are affected adversely by mental disorders. Physical needs come first in areas where resources are extremely limited, but simple measures can be taken in order to avoid severe disabling effects these illnesses can have on people’s lives.

With the prospect of exams beginning to appear quite clearly on the horizon, mock tests and the realisation that we will have to learn the names of all of those mosquitos, more time is spent in the well-resourced library, and sneaking off to the lab to harass Maria at lunchtime.

Fear not, there has still been time to continue to explore and admire our surroundings, be it enjoying a beautiful walk to the school everyday from one cathedral to the next, experiencing the 'Razzle Dazzle Mersey Ferry' (where a cool October breeze blew away the cobwebs), or enjoying a night of dancing ultimately ending with sticky feet in the Raz...