Authors: Martha Powell, Future Science Group
The end of January saw the London Centre for Neglected Tropical Disease Research’s (LCNTDR; UK) annual anniversary event, this year commemorating the sixth anniversary of the London Declaration on Neglected Tropical Diseases (NTDs).The evening focused on quality research for effective policies, highlighting some of the best work from 2017.
To begin, Director of the LCNTDR, Sir Roy Anderson, introduced the evening’s keynote speaker, Simon Brooker, Senior Program Officer at the Bill & Melinda Gates Foundation (WA, USA) who spoke about taking proof-of-concept studies through policy to implementation. He discussed the example of triple drug therapy for lymphatic filariasis, which saw a particularly fast timeline from research to implantation, with guidelines for non-onchocerciasis endemic areas published in November 2017.
Brooker highlighted the factors that made this timeline a success – including a close relationship with grantees, use of modeling and rapid funding – before urging the researchers in the room to think about how the data they produce can have relevance to large-scale implementation, and how they might make that leap.
Hear more from Roy in our video interviews on the London Centre for Neglected Tropical Disease Research, his career and his current undertakings.
Following this was the first session, which focused on tools and strategies for control. This started with Chrissy Roberts from the London School of Hygiene & Tropical Medicine (LSHTM; UK) who introduced a zero-cost electronic data capture system he has been working on termed ‘Open Data Kit’. Roberts highlighted that digital technology is of great value for working in the field and is becoming increasingly sophisticated, with this open-source project allowing global health researchers to capture a variety of data that can be shared and analyzed in real time.
Starting discussion around schistosomiasis, a major focus of the evening, was Carlos Torres Vitolas from Imperial College London (UK). Torres Vitolas spoke on the social determinants of preventive chemotherapy uptake during mass-drug administration interventions for schistosomiasis in sub-Saharan Africa. He presented results that suggested strategies to tackle food scarcity and poverty are necessary, in addition to wider community involvement and a careful understanding of the historical and cultural context of these communities. However, he stated there is a need for more evidence, and more regional diversity in this topic.
Continuing on schistosomiasis, Anna Phillips (Imperial College London) summarized findings from a large-scale trial in Mozambique and Niger, which aimed to assess alternative approaches to treat urogenital schistosomiasis. She specifically highlighted that results from studies such as this will be necessary to determine the correct strategy in the progress towards elimination.
Joe Timothy from LSHTM followed, introducing his research mapping case-management NTDs in Liberia. These diseases present a challenge as they are rare, affect remote communities and are often detected late – a quantified burden is therefore required. Timothy reported on the proof-of-principle study currently underway in Maryland, Liberia using a two-stage cluster-randomized mapping protocol, hopefully with potential to be further expanded.
Moving back to schistosomiasis, Elsa Leger (Royal Veterinary College, London, UK) discussed the burden of zoonotic schistosomiasis in sub-Saharan Africa, highlighting that the level of livestock infection is frequently overlooked and that praziquantel is often misappropriated to treat animals. She concluded that a One Health, multi-host framework for policy will be necessary to tackle this disease.
The final speaker in this session was Susanne Franssen (Wellcome Trust Sanger Institute, Cambridge, UK), who spoke on her research into the global genome-diversity and hybridization in the Leishmania donovani complex. This was followed by an opportunity to question the speakers before the second session was introduced, focusing on achieving and maintaining elimination.
Starting this session was Steffi Knopp (Swiss Tropical and Public Health Institute, Basel, Switzerland) who discussed the schistosomiasis elimination program in Zanzibar thus far, including successes such as a decreased prevalence and the majority of infections now being low intensity. However, she highlighted that in a low-prevalence setting better diagnostics will be required, leading Bonnie Webster (Natural History Museum, London, UK to introduce a recombinase
DNA-polymerase amplification-based diagnostic, and the potential this holds. Webster highlighted that molecular diagnostics have great potential, with pilot studies highlighting that this is an accurate measurem and a simple, reliable and portable tool.
Obiora Eneanya (Imperial College London) followed, speaking on his work developing a model to assess the climate and environmental suitability of lymphatiac filariasis in Nigeria. Eneanya spoke on his future plans to model spatial prevalence and evaluate the impact of bed nets in preventing this NTD.
The focus then shifted to India, with a presentation from Shannon McIntrye (LSHTM) on visceral leishmaniasis transmission, and whether xenomonitoring could be a useful tool for this. She highlighted that xenomonitoring is non-invasive, more cost effective and can indicate transmission, stating her hopes for a pilot study currently underway in India.
Moving on to soil transmitted helminths (STH), Katherine Halliday (LSHTM) presented the Deworm3 study, which aims to demonstrate the feasibility of interrupting STH transmission across three study sites – Benin, Malawi and India. She presented the initial census data from each site, which will establish a baseline for the trial, and explained the further steps, which will compare 3 years of community-wide intervention with the standard-of-care and 2 years of surveillance.
Want to learn more about Deworm3? Discover more in this overview of the project.
In the final presentation of this session Charlie Whittaker (Imperial College London) introduced his research modeling the epidemiology of loa loa, a disease infecting an estimated 10 million individuals across Africa. He reported that recent research has suggested loa loa may be linked to excess mortality, potentially presenting a significant public health threat, and that a model could help to estimate the burden, assess if elimination is feasible and evaluate interventions.
This session was followed by a quick question-and-answer discussion, where issues were raised around water, hygiene and sanitation, and the use of biometric technology.
The conference concluded with closing remarks from Warren Lancaster, from the END Fund (NY, USA), who spoke on why research is important to advocacy and policy. Lancaster spoke about early NTD funding from the Gates Foundation and the first steps that were taken in approaching politicians about the issue, highlighting that many of the successes seen in the field can be attributed to the advocacy efforts of individual researchers.
With all the fantastic research presented during the evening, Lancaster emphasized the need to maintain focus on NTDs and translate research to language of policy makers, finally urging the researchers in the room to also consider their work from an advocacy perspective.