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Published in: Seminars in Immunopathology 3/2020

Open Access 01-06-2020 | Leishmania | Review

Implications of asymptomatic infection for the natural history of selected parasitic tropical diseases

Authors: Jorge Alvar, Fabiana Alves, Bruno Bucheton, Louise Burrows, Philippe Büscher, Eugenia Carrillo, Ingrid Felger, Marc P. Hübner, Javier Moreno, Maria-Jesus Pinazo, Isabela Ribeiro, Sergio Sosa-Estani, Sabine Specht, Antoine Tarral, Nathalie Strub Wourgaft, Graeme Bilbe

Published in: Seminars in Immunopathology | Issue 3/2020

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Abstract

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.
Footnotes
1
In Ancient Greece, offerings and sacrifices to the gods were performed by the priest at an altar, next to it rich and prominent citizens sat around eating the remaining food; they were called ‘parasites’.
 
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Metadata
Title
Implications of asymptomatic infection for the natural history of selected parasitic tropical diseases
Authors
Jorge Alvar
Fabiana Alves
Bruno Bucheton
Louise Burrows
Philippe Büscher
Eugenia Carrillo
Ingrid Felger
Marc P. Hübner
Javier Moreno
Maria-Jesus Pinazo
Isabela Ribeiro
Sergio Sosa-Estani
Sabine Specht
Antoine Tarral
Nathalie Strub Wourgaft
Graeme Bilbe
Publication date
01-06-2020
Publisher
Springer Berlin Heidelberg
Published in
Seminars in Immunopathology / Issue 3/2020
Print ISSN: 1863-2297
Electronic ISSN: 1863-2300
DOI
https://doi.org/10.1007/s00281-020-00796-y

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