TY - JOUR
T1 - Implications of asymptomatic infection for the natural history of selected parasitic tropical diseases
AU - Alvar, Jorge
AU - Alves, Fabiana
AU - Bucheton, Bruno
AU - Burrows, Louise
AU - Büscher, Philippe
AU - Carrillo, Eugenia
AU - Felger, Ingrid
AU - Hübner, Marc P
AU - Moreno, Javier
AU - Pinazo, Maria-Jesus
AU - Ribeiro, Isabela
AU - Sosa-Estani, Sergio
AU - Specht, Sabine
AU - Tarral, Antoine
AU - Wourgaft, Nathalie Strub
AU - Bilbe, Graeme
N1 - OGOA; FTX; (CC BY 4.0)
PY - 2020
Y1 - 2020
N2 - Progress has been made in the control or elimination of tropical diseases, with a significant reduction of incidence. However, there is a risk of re-emergence if the factors fueling transmission are not dealt with. Although it is essential to understand these underlying factors for each disease, asymptomatic carriers are a common element that may promote resurgence; their impact in terms of proportion in the population and role in transmission needs to be determined. In this paper, we review the current evidence on whether or not to treat asymptomatic carriers given the relevance of their role in the transmission of a specific disease, the efficacy and toxicity of existing drugs, the Public Health interest, and the benefit at an individual level, for example, in Chagas disease, to prevent irreversible organ damage. In the absence of other control tools such as vaccines, there is a need for safer drugs with good risk/benefit profiles in order to change the paradigm so that it addresses the complete infectious process beyond manifest disease to include treatment of non-symptomatic infected persons.
AB - Progress has been made in the control or elimination of tropical diseases, with a significant reduction of incidence. However, there is a risk of re-emergence if the factors fueling transmission are not dealt with. Although it is essential to understand these underlying factors for each disease, asymptomatic carriers are a common element that may promote resurgence; their impact in terms of proportion in the population and role in transmission needs to be determined. In this paper, we review the current evidence on whether or not to treat asymptomatic carriers given the relevance of their role in the transmission of a specific disease, the efficacy and toxicity of existing drugs, the Public Health interest, and the benefit at an individual level, for example, in Chagas disease, to prevent irreversible organ damage. In the absence of other control tools such as vaccines, there is a need for safer drugs with good risk/benefit profiles in order to change the paradigm so that it addresses the complete infectious process beyond manifest disease to include treatment of non-symptomatic infected persons.
U2 - 10.1007/s00281-020-00796-y
DO - 10.1007/s00281-020-00796-y
M3 - A1: Web of Science-article
C2 - 32189034
SN - 1863-2297
VL - 42
SP - 231
EP - 246
JO - Seminars in Immunopathology
JF - Seminars in Immunopathology
IS - 3
ER -