Europe’s neglected infections of poverty

International Journal of Infectious Diseases
http://www.sciencedirect.com/science/journal/12019712

[In Press]
Europe’s neglected infections of poverty
In Press, Corrected Proof, Available online 16 July 2011
Peter J. Hotez, Meredith Gurwith

Summary
Objectives
To review the prevalence, incidence, and geographic distribution of the major neglected infections of poverty in Europe as a basis for future policy recommendations.

Methods
We reviewed the literature from 1999 to 2010 for neglected tropical diseases listed by PLoS Neglected Tropical Diseases (http://www.plosntds.org/static/scope.action) and the geographic regions and countries of (continental) Europe. Reference lists of identified articles and reviews were also hand searched, as were World Health Organization databases.

Results
In Eastern Europe, the soil-transmitted helminth infections (especially ascariasis, trichuriasis, and toxocariasis), giardiasis, and toxoplasmosis remain endemic. High incidence rates of selected food-borne helminthiases including trichinellosis, opisthorchiasis, taeniasis, and echinococcosis also occur, while brucellosis and leptospirosis represent important bacterial zoonoses. Turmoil and economic collapse following the war in the Balkans, the fall of Communism, and Europe’s recent recession have helped to promote their high prevalence and incidence rates. In Southern Europe, vector-borne zoonoses have emerged, including leishmaniasis and Chagas disease, and key arboviral infections. Additional vulnerable populations include the Roma, orphans destined for international adoption, and some immigrant groups.

Conclusions
Among the policy recommendations are increased efforts to determine the prevalence, incidence, and geographic distribution of Europe’s neglected infections, epidemiological studies to understand the ecology and mechanisms of disease transmission, and research and development for new control tools.