Syndromic approach to neglected infectious diseases (NID) at primary health care level: an international collaboration on integrated diagnosis-treatment platforms
Keywords: neglected infectious diseases, diagnosis, rapid diagnostic tests, algorithms, cost-effectiveness
Treatment options for neglected infectious diseases (NID) (box 1) are generally few and the problem is exacerbated by a critical lack of appropriate diagnostic tools to guide treatment. A major challenge in the clinical management of NID is the weakness of health systems of disease-endemic countries. People affected by NID mostly present to primary health care, which are generally under-staffed and ill-equipped, resulting in a low quality of care. Misdiagnosis is frequent, as the clinical presentation of many NID is non-specific and may be confounded with that of other common conditions. NIDIAG will develop and validate upgraded, evidence-based, widely applicable and cost-effective algorithms for diagnosis and treatment that incorporate key clinical symptoms and signs, as well as existing or newly developed rapid diagnostic tests (RDT) for each of three clinical syndromes that are major clinical presentations of many NID, namely the persistent fever, intestinal and neurological syndromes.
Neglected infectious diseasesThey include a range of acute or chronic lethal or disabling infections such as Buruli ulcer, Chagas disease, cysticercosis, dengue, dracunculiasis, endemic treponematoses, enteric fever, human African trypanosomiasis (sleeping sickness), leishmaniasis, leprosy, lymphatic filariasis, onchocerciasis, rabies, schistosomiasis, soil-transmitted helminthiasis, trachoma, food-borne trematodiasis.
Globally an estimated 1.2 billion people are affected by one or more NID that thrive among impoverished populations of developing countries, in remote rural areas, urban slums and conflict zones.
[+] Read More
The aim of the NIDIAG project is to develop an improved system for delivering primary health care in resource-poor settings.
The major objectives of the NIDIAG consortium are:
NIDIAG is unique in the sense that it places the patient living in NID-endemic areas at the centre of the research effort. The project will provide clinicians working in the frontline of the primary health care setting with new or improved diagnostic algorithms for the better clinical management of NID. It is expected that the study findings will be translated into policy recommendations at national and regional levels.
The development of improved diagnosis-treament algorithms will primarly serve health care workers at primary health care level, but patients consulting physicians or nurses at secondary (e.g. district hospital) or tertiary care level will also benefit from these new tools. Improved algorithms will also facilitate disease burden estimates at country level, may contribute to disease control and be used is sick travellers returning from NID-endemic areas.