Streptococcus: An organism causing diseases beyond neglect

Abstract

The neglected tropical diseases (NTDs) are a heterogeneous group of diseases that affect some of the poorest people on the planet. They occur predominantly in low- and middle-income tropical countries (LMIC) and amongst indigenous and very poor people living in developed countries. The concept of NTDs was developed by Peter Hotez and colleagues to draw attention to a large group of diseases that carry significant morbidity but were largely ignored when the Millennium Development Goals were established [1]. The NTDs are now recognized by WHO, and the organization has set targets for their control and elimination. Different organizations have slightly different lists of diseases that make up the NTDs, but approximately 20 diseases are considered NTDs. All but one (snake bite envenomation) are of infectious origin, and some are transmitted by vectors. While NTDs must obviously be neglected and tropical, the Strategic and Technical Advisory Group committee of WHO also mandated that for diseases to be classified as NTDs, they must disproportionately affect people living in poverty and must be amenable to control or elimination (Table 1). The magnitude of the disease burden, in terms of mortality or morbidity, was not a consideration for inclusion or exclusion. However, the burden of individual NTDs is not large in comparison to diseases such as pneumonia, HIV/AIDS, tuberculosis, malaria, and diarrhoeal diseases, for which the annual disability-adjusted life years (DALYs) each exceed 40 million years [2]. Nevertheless, the societal burden of NTDs is extensive as the total annual burden of life lost is estimated to be in excess of 25 million years [3].