Years of conflict and political struggle have caused massive human and animal migrations in the Middle East and North Africa. Now a new study blames these upheavals for the spread or re-emergence of a variety of tropical diseases - some previously eliminated or controlled - affecting an estimated 65 million people.
A family of illnesses called Neglected Tropical Diseases [NTDs] adds to the troubles in the Middle East and North Africa. These diseases traditionally affect poor countries, but the new study says NTDs also are prevalent in many middle-income countries, such as Egypt, Saudi Arabia, Morocco and Yemen.
“Cutaneous leishmanaisis, Dengue, Rift Valley fever, Crimean Congo hemorrhagic fever,” said Dr. Peter Hotez of the National School of Tropical Medicine, listing some of the diseases.
Hotez, lead researcher of the study, said he and his colleagues found a huge hidden burden of tropical diseases in the region.
“Neglected Tropical Diseases disproportionately affect Egypt and Yemen. So these two countries have some of the greatest number of cases of intestinal worm infections, elephantiasis, and schistosomiasis, as well as diseases such as fascioliasis. I would like to call them the most important diseases that you have never heard of,” said Hotez.
Researchers also were surprised by the reemergence and prevalence of infections like cutaneous leishmaniasis, caused by a sandfly, and infections transmitted from animals to humans, such as brucellosis - a bacterial infection originating in cattle and sheep.
They say diseases of the poor are not a priority in conflict-ridden nations where community and public health systems often have broken down.
Hotez said the immediate strategy for controlling the rising infection rate is to step up mass drug administration efforts, especially for schistosomiasis, intestinal helminthes infections, and leprosy.
Dr. Julie Jacobson is senior program officer at the Bill and Melinda Gates Foundation, a leading advocate of a global campaign to eliminate NTDs. She said the research points to a public health problem seen in many conflict-ridden countries, and it underscores the need for vigilance.
“People see most health problems as being too onerous, too difficult and unsolvable - and here we have some very solvable problems with not a huge price tag," said Jacobson. "It is very cost effective. Fifty cents per person, per year, on average will take care of seven of these diseases, and a lot of drugs are donated for the program outside of that.”
The elimination of NTDs also will require the development of new drugs, and new vaccines. Hotez said he is hopeful funds will be found to support more research in this area, especially on drugs to treat some of the deadliest and most prevalent of the tropical diseases, such as dengue fever and leishmanaisis.