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      Prevention, control, and elimination of neglected diseases in the Americas: Pathways to integrated, inter-programmatic, inter-sectoral action for health and development

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          Abstract

          Background

          In the Latin America and Caribbean region over 210 million people live below the poverty line. These impoverished and marginalized populations are heavily burdened with neglected communicable diseases. These diseases continue to enact a toll, not only on families and communities, but on the economically constrained countries themselves.

          Discussion

          As national public health priorities, neglected communicable diseases typically maintain a low profile and are often left out when public health agendas are formulated. While many of the neglected diseases do not directly cause high rates of mortality, they contribute to an enormous rate of morbidity and a drastic reduction in income for the most poverty-stricken families and communities. The persistence of this "vicious cycle" between poverty and poor health demonstrates the importance of linking the activities of the health sector with those of other sectors such as education, housing, water and sanitation, labor, public works, transportation, agriculture, industry, and economic development.

          Summary

          The purpose of this paper is three fold. First, it focuses on a need for integrated "pro-poor" approaches and policies to be developed in order to more adequately address the multi-faceted nature of neglected diseases. This represents a move away from traditional disease-centered approaches to a holistic approach that looks at the overarching causes and mechanisms that influence the health and well being of communities. The second objective of the paper outlines the need for a specific strategy for addressing these diseases and offers several programmatic entry points in the context of broad public health measures involving multiple sectors. Finally, the paper presents several current Pan American Health Organization and other institutional initiatives that already document the importance of integrated, inter-programmatic, and inter-sectoral approaches. They provide the framework for a renewed effort toward the efficient use of resources and the development of a comprehensive integrated solution to neglected communicable diseases found in the context of poverty, and tailored to the needs of local communities.

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          Most cited references91

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          Schistosomiasis and water resources development: systematic review, meta-analysis, and estimates of people at risk.

          An estimated 779 million people are at risk of schistosomiasis, of whom 106 million (13.6%) live in irrigation schemes or in close proximity to large dam reservoirs. We identified 58 studies that examined the relation between water resources development projects and schistosomiasis, primarily in African settings. We present a systematic literature review and meta-analysis with the following objectives: (1) to update at-risk populations of schistosomiasis and number of people infected in endemic countries, and (2) to quantify the risk of water resources development and management on schistosomiasis. Using 35 datasets from 24 African studies, our meta-analysis showed pooled random risk ratios of 2.4 and 2.6 for urinary and intestinal schistosomiasis, respectively, among people living adjacent to dam reservoirs. The risk ratio estimate for studies evaluating the effect of irrigation on urinary schistosomiasis was in the range 0.02-7.3 (summary estimate 1.1) and that on intestinal schistosomiasis in the range 0.49-23.0 (summary estimate 4.7). Geographic stratification showed important spatial differences, idiosyncratic to the type of water resources development. We conclude that the development and management of water resources is an important risk factor for schistosomiasis, and hence strategies to mitigate negative effects should become integral parts in the planning, implementation, and operation of future water projects.
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            Incorporating a Rapid-Impact Package for Neglected Tropical Diseases with Programs for HIV/AIDS, Tuberculosis, and Malaria

            Hotez et al. argue that achieving success in the global fight against HIV/AIDS, tuberculosis, and malaria may well require a concurrent attack on the neglected tropical diseases.
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              The world health report 2000 - Health systems: improving performance

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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                2007
                17 January 2007
                : 7
                : 6
                Affiliations
                [1 ]Area of Health Surveillance and Disease Management, Pan American Health Organization/World Health Organization (PAHO/WHO), 525 23 rd Street NW, Washington D.C. 20037, USA
                [2 ]Area of Technology and Health Services Delivery, Pan American Health Organization/World Health Organization (PAHO/WHO), Av. Amazonas 2889 y Mariana de Jesús, Quito, Ecuador
                [3 ]Area of Technology and Health Services Delivery/Area of Legal Affairs, Pan American Health Organization/World Health Organization (PAHO/WHO), 525 23 rd Street NW, Washington D.C. 20037, USA
                [4 ]Field Office, US-Mexico Border, Pan American Health Organization/World Health Organization (PAHO/WHO), El Paso, Texas 79912, USA
                [5 ]Area of Sustainable Development and Environmental Health, Pan American Health Organization/World Health Organization (PAHO/WHO), 525 23 rd Street NW, Washington D.C. 20037, USA
                [6 ]Veterinary Public Health, Pan American Foot and Mouth Disease Center (PANAFTOSA), Avenida Presidente Kennedy 7778, Sao Bento, Duque de Caxias, 25040-004, Rio de Janeiro, Brasil
                [7 ]Pan American Health Organization/World Health Organization (PAHO/WHO), 525 23 rd Street NW, Washington D.C. 20037, USA
                Article
                1471-2458-7-6
                10.1186/1471-2458-7-6
                1797008
                17229324
                ec1bcf70-20cc-4925-92b3-3927e8b187b3
                Copyright © 2007 Holveck et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 31 March 2006
                : 17 January 2007
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