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High prevalence of 'poor man's diseases' in India: WHO report

India continues to rank very high in the prevalence of neglected tropical diseases like dengue, rabies and soil-transmitted helminthiases, according to a report released by the World Health Organisation.

"Of the world's poorest 2.7 billion people (defined as those who live on less than USD 2.00 a day), more than 1 billion are affected by one or more neglected tropical diseases (NTDs), says the report.

Though country-wide estimates are not provided, India is expected to have a majority of the 1 billion NTD-patients given the high incidence of poverty coupled with poor sanitary and hygine conditions.

The diseases which are prevalent in rural areas and urban slums include leishmaniasis, lymphatic filariasis, and trachoma.

Of the 17 NTDs, nine are caused by microparasites which have simple life-cycles and a tendency to replicate within the host.The remaining eight NTDs are caused by macroparasites which have complex life-cycles involving intermediate and reservoir hosts and a tendency not to replicate in the definitive human host.

Today, neglected tropical diseases have their breeding grounds in the places left furthest behind by socio-economic progress, where substandard housing, lack of access to safe water and sanitation, filthy environments, and abundant insects and other vectors contribute to efficient transmission of infection.

"Close companions of poverty, these diseases also anchor large populations in poverty," Margaret Chan, WHO's DG argued, suggesting that they cause not only long-term disabilities but result in economic misery.

"Leprosy and lymphatic filariasis deform in the ways that hinder economic productivity and cancel out chances for a normal social life," while trachoma causes blindness.

The so-called poor man's diseases "include a range of diseases caused by individual pathogens, and groups of conditions caused by related microbial species".

They are spread by animal hosts such as dogs, fish or by vectors such as mosquitoes, blackflies, snails, bugs and common house flies.The report calls for five public-health strategies on a war footing.

They include provision of safe water, sanitation and hygiene which are often absent in India's rural and crowded urban slums.

In addition, a sustained effort is needed for the "expansion of preventive chemotherapy," "intensified case-detection and case-management," "improved vector control" and "appropriate veterinary public health measures".

Though the government has stepped up its health-related activities to prevent and control neglected tropical diseases, the continued poor sanitation and hygiene conditions are a cause for concern.

"The need for continuing surveillance and sustained response capacity is exemplified by the recent spread of dengue," the report says, suggesting that India and other countries in the Asian region account for most deaths.

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