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Chronic Care for Neglected Infectious Diseases: Leprosy/ Hansen's Disease, Lymphatic Filariasis, Trachoma, and Chagas Disease

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Chronic Care for Neglected Infectious Diseases: Leprosy/ Hansen's Disease, Lymphatic Filariasis, Trachoma, and Chagas Disease Chronic Care for Neglected Infectious Diseases: Leprosy/ Hansen’s Disease, Lymphatic Filariasis, Trachoma, and Chagas Disease A Guide for Morbidity Management and Disability Prevention for Primary Health Care Services p Chronic Care for Neglected Infectious Diseases: Leprosy/ Hansen’s Disease, Lymphatic Filariasis, Trachoma, and Chagas Disease A Guide for Morbidity Management and Disability Prevention for Primary Health Care Services Washington, D.C., 2021 Chronic Care for Neglected Infectious Diseases: Leprosy/Hansen’s Disease, Lymphatic Filariasis, Trachoma, and Chagas Disease © Pan American Health Organization, 2021 ISBN: 978-92-75-12250-1 eISBN: 978-92-75-12251-8 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial- ShareAlike 3.0 IGO license (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/ igo). Under the terms of this license, this work may be copied, redistributed, and adapted for non-commercial purposes, provided the new work is issued using the same or equivalent Creative Commons license and it is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that the Pan American Health Organization (PAHO) endorses any specific organization, product, or service. Use of the PAHO logo is not permitted. Adaptations: If this work is adapted, the following disclaimer should be added along with the suggested citation: “This is an adaptation of an original work by the Pan American Health Organization (PAHO). Views and opinions expressed in the adaptation are the sole responsibility of the author(s) of the adaptation and are not endorsed by PAHO.” Translation: If this work is translated, the following disclaimer should be added along with the suggested citation: “This translation was not created by the Pan American Health Organization (PAHO). PAHO is not responsible for the content or accuracy of this translation.” Suggested citation. Chronic Care for Neglected Infectious Diseases: Leprosy/Hansen’s Disease, Lymphatic Filariasis, Trachoma, and Chagas Disease. Washington, D.C.: Pan American Health Organization; 2020. License: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data. CIP data are available at http://iris.paho.org. Sales, rights, and licensing. To purchase PAHO publications, visit http://publications.paho.org. To submit requests for commercial use and queries on rights and licensing, visit http://www.paho.org/ permissions. Third-party materials. If material that is attributed to a third party, such as tables, figures, or images, is reused from this work, it is the user’s responsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder. The risk of claims resulting from infringement of any third-party-owned material or component from this work rests solely with the user. General disclaimers. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of PAHO concerning the legal status of any country, territory, city, or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by PAHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by PAHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall PAHO be liable for damages arising from its use. Photographs: © PAHO CDE/VT/2020 Table of Contents Foreword ................................................................................................. iv Acknowledgments ................................................................................ vi Acronyms .............................................................................................. viii Purpose of This Manual ........................................................................ x Chapter 1: General Overview of Neglected Infectious Diseases ......................1 Chapter 2: Care in Hansen’s Disease (Leprosy) .................................................19 Chapter 3: Care in Lymphatic Filariasis ...............................................................61 Chapter 4: Care in Trachoma .............................................................................. 109 Chapter 5: Care in Chagas Disease ................................................................... 137 iii Foreword Considerable progress has been achieved both globally and in the Region of the Americas towards the control and elimination of the neglected tropical diseases (NTD), known in the Americas as the neglected infectious diseases (NID). In 2016, for the first time in history, according to the World Health Organization (WHO), more than 1 billion people were reached globally with preventive chemotherapy interventions for NID such as lymphatic filariasis, onchocerciasis, soil-transmitted helminthiases, schistosomiasis, and trachoma; this figure was maintained in 2017. Most countries in the world have eliminated leprosy as a public health problem, 17 countries in the Americas have interrupted the domestic transmission of Chagas disease by the main vector species in whole or part of their territory, while there has been progress toward the global elimination of lymphatic filariasis, onchocerciasis, and trachoma. These are indeed very important public health achievements. However, the NID can also have devastating chronic sequelae for patients, such as disability, visible change or loss in body structure, loss of tissue, and impairment of proper tissue and organ function, among others. All of these can in turn lead to unjustified discrimination, stigmatization, mental health problems, and partial or total incapacity to work, perpetuating the vicious cycle of neglected diseases as both a consequence and a cause of poverty. Patients with chronic conditions require proper health care in order to prevent further damage and improve their living and social conditions. This should be provided at the primary health care level, as patients suffering from NID are often unable to travel to or afford to pay for specialized care services. Care for patients suffering from chronic morbidity caused by NID should be integrated into care for other chronic conditions caused by non-communicable diseases. For example, services that provide health care for patients with diabetic neuropathy could also offer care for patients with peripheral neuropathy caused by leprosy. Relatively simple measures, including self-care, can help prevent and improve the quality of life of patients living with chronic sequelae of NID. Comprehensive disease management, care, and rehabilitation services should be integrated within the general health system. Providing morbidity management and disability prevention (MMDP) services for NID will contribute to the achievement of target 3.3 of the Sustainable iv Development Goals (SDG), “By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases,” and also to the achievement of universal health coverage (UHC), making sure that no one is being left behind. The manual presented here provides a framework for MMDP of patients affected by NID and gives specific guidance for the proper care of patients suffering from chronic conditions caused by lymphatic filariasis, leprosy, trachoma, and Chagas disease. This manual is intended to be used mainly by health care workers at the primary health care level, but health workers at more complex and specialized levels may also find it useful. PAHO’s Neglected Infectious Diseases Program commissioned this manual to Ms. Linda Lehman, who has a great breadth of knowledge and experience working on MMDP and NID, particularly on leprosy in Brazil. She was able to convene an outstanding group of renowned experts as authors and reviewers for each of the chapters of the manual. PAHO wishes to thank Linda, the authors, and reviewers for their excellent work and hopes that health care workers working in often remote locations where NID are prevalent will find this manual useful for the benefit of the patients and the communities they serve. Santiago Nicholls Regional Advisor, Neglected Infectious Diseases Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization v Acknowledgments The Neglected Infectious Diseases Program, Neglected, Tropical and Vector Borne Diseases Unit, Pan American Health Organization sincerely expresses its gratefulness and appreciation to Linda F. Lehman (OTR/L MPH C.Ped), Senior Advisor for Morbidity Management and Disability Prevention, American Leprosy Missions, who served as the technical editor and principal author for the publication. In addition, we would also like to thank the authors and reviewers of each chapter of this manual, listed below. This publication would not have been possible without their valuable expertise.
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