DOENÇAS DA POBREZA, NEGLIGENCIADAS E EMERGENTES
Creators: name: Parreira, Ricardo
name: Campino, Lenea
Publisher: name: Anais do Instituto de Higiene e Medicina Tropical
Year: 2018

description: The term neglected and poverty-related diseases, despite not being clearly defined, is usually regarded as synonym of a group of illnesses that primarily occur in developing count ries, where they severely impact the morbidity and mortality of the populat ions they afflict . Notwithstanding the absence, for some of them, of adequate prophylact ic as well as therapeut ic intervent ions, their persistence is very frequent ly determined by a combinat ion of social and economic issues that allow their et iological agents, and potent ial vectors, to thrive, taking advantage of the physical environment . Nevertheless, their consequences go beyond a direct effect on human health, as they imprison the disease-st ricken populat ions in an endless loop of 43 poverty, itself consequence of the outcome these diseases have on child development , fert ility and child-birth rates, and general product ivity (Hotez et al., 2009). Frequent ly, these neglected diseases fail to at t ract the at tent ion of governmental officials and potent ial investors (pharmaceut ical companies included), and the limited funds available severely limit research and development projects that might lead to a bet ter management of these illnesses. Unt il the early 1980, an erradicat ionist perspect ive dominated the way medicine looked upon infect ious diseases (Snowden, 2008). As a result , the beginning of the aids pandemic in 1981 unified all the erradicat ionists thought as improbable: a new infect ious scourge for which no cure existed, that plagued both developing and industrialized count ries, and to which a plethora of opportunist ic pathogens was usually associated with. One of the diseases most frequently diagnosed in associat ion with HIV – tuberculosis – caused by Mycobacterium tuberculosis, has tormented mankind from immemorial t imes. Nonetheless, it is, nowadays, emerging, being responsible for thousands the deaths annually, not sparing either poor or wealthy populat ions. This example also serves to illust rate the fact that the neglected and poverty-related diseases are frequent ly associated with so-called emerging or re-emerging infect ions. This designat ion.was coined during the 1990s by the Nobel laureate Joshua Lederberg, and is intended to embrace a group of diseases with an ongoing prevalence increase, and no expected decline in the near future, among human populat ions (Davis e Lederberg, 2000). Even though some of the diseases we will come across in the coming pages thrive in environments beleaguered by social as well as polit ical conflicts, and where the most affected populat ions are, most frequent ly than not , targeted for discriminat ion, some of them have also a significant bearing in the so-called developed world, as a direct consequence one of the aspects that governs our present t ime – globalizat ion. The lat ter is a product of mass populat ion displacement (whether voluntary or not ), and extensive commercial exchanges, that not only open avenues for an almost limit less expansion of the microbial gene pool, but at the same t ime grants them access to a never-ending number of potent ial non-immune hosts. On top of the effects of globalizat ion, demographic growth also repeatedly assumes uncont rollable and chaot ic features, giving rise to physical conditions where microorganisms and their vectors prosper. These translate into the growth of megacit ies where thousands of individuals come together, a significant proport ion of whom are poor and uneducated, living under inadequate sanit ary condit ions. Furthermore, the persistent human encroachment in prist ine environments is a cont inuous source of ecological turmoil. Finally, climate change is also expected to have cont ributed in recent t imes to temporal seasonal changes, as well as the geographical variat ions of ecological boundaries. This chapter is dedicated to a very diverse group of pathogens that are et iological agents to a no less varied collect ion of poverty-related and emerging diseases. They include geohelminthosis, fascioliasis, filariasis, and schistosomiasis, protozoa-caused infect ions such as amebiasis, cryptosporidiosis, giardiasis, and other intestinal infections, leishmaniosis, malaria, and t rypanosomosis. Among bacterial related diseases, and while cholera may be the one that best reflects poverty, we will address leptospirosis, syphilis and tuberculosis. As examples of viral infect ions, we will focus on arbovirosis, diarrheas caused by enteric viruses, hepat it is delta and aids. Finally, emerging opportunist ic mycosis imported from t ropical environments will also be addressed.
description: Anais do Instituto de Higiene e Medicina Tropical, v. 11 (2012): Edição Comemorativa