Implications of asymptomatic infection for the natural history of selected parasitic tropical diseases

Progress has been made in the control or elimination of tropical diseases, with a significant reduction of incidence. However, there is a risk of re-emergence if the factors fueling transmission are not dealt with. Although it is essential to understand these underlying factors for each disease, asy...

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Detalhes bibliográficos
Autores: Alvar, Jorge, Alves, Fabiana, Bucheton, Bruno, Burrows, Louise, Büscher, Philippe, Carrillo, Eugenia, Felger, Ingrid, Hübner, Marc P., Moreno Blanc, Javier, Pinazo, Maria-Jesus, Ribeiro, Isabela, Sosa Estani, Sergio, Specht, Sabine, Tarral, Antoine, Wourgaft, Nathalie Strub, Bilbe, Graeme
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Recursos:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/159639
Acesso em linha:https://hdl.handle.net/2445/159639
Access Level:acceso abierto
Palavra-chave:Medicina tropical
Malaltia de Chagas
Tropical medicine
Chagas' disease
Descrição
Resumo:Progress has been made in the control or elimination of tropical diseases, with a significant reduction of incidence. However, there is a risk of re-emergence if the factors fueling transmission are not dealt with. Although it is essential to understand these underlying factors for each disease, asymptomatic carriers are a common element that may promote resurgence; their impact in terms of proportion in the population and role in transmission needs to be determined. In this paper, we review the current evidence on whether or not to treat asymptomatic carriers given the relevance of their role in the transmission of a specific disease, the efficacy and toxicity of existing drugs, the Public Health interest, and the benefit at an individual level, for example, in Chagas disease, to prevent irreversible organ damage. In the absence of other control tools such as vaccines, there is a need for safer drugs with good risk/benefit profiles in order to change the paradigm so that it addresses the complete infectious process beyond manifest disease to include treatment of non-symptomatic infected persons.