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972 WHO Technical Report Series 972 Research Research Research Priorities for Helminth Infections Infections Helminth for Priorities Over a billion people in sub-Saharan Africa, Asia and the Americas are infected with one or more helminth species, causing morbidity that helps maintain the vicious cycle of poverty, decreased productivity, and inadequate socioeconomic development. This report presents an evaluation of current research and challenges in controlling the helminthiases of public health importance, including onchocerciasis, lymphatic filariasis, soil-transmitted helminthiases, schistosomiasis, food-borne trematodiases and taeniasis/cysticercosis. The evaluation Research Priorities covers five major themes – intervention, epidemiology and surveillance, environmental and social ecology, data and modelling, and fundamental biology. for Helminth Infections Despite the recent demonstrated successes and expansion of tools for the helminthiases outlined here, and the development of some research capacity, the evaluation found major WHO deficiencies in our current control tools, in diagnostics, and Technical Report of the TDR Disease Reference Group on in our fundamental knowledge of helminth biology and Report Series Technical transmission dynamics, as well as in capacity and policy for Helminth Infections health research. Thus the current research issues are summarized here, and opportunities for improving disease control and reducing poverty are identified. Recommendations are presented to inform public health policy, guide implementation programmes, and focus the research community on the needs of disease control and the opportunities for bettering human welfare. This is one of ten disease and thematic reference group reports that have come out of the TDR Think Tank, all of which have contributed to the development of the Global Report for Research on Infectious Diseases of Poverty, available at: www.who.int/tdr/capacity/global_report. The World Health Organization was established in 1948 as a specialized agency of the SELECTED WHO PUBLICATIONS OF RELATED INTEREST United Nations serving as the directing and coordinating authority for international health matters and public health. One of WHO’s constitutional functions is to provide objective and reliable information and advice in the field of human health, a responsibility that it fulfils in part through its extensive programme of publications. The Organization seeks through its publications to support national health strategies Global Report for Research on Infectious Diseases of Poverty and address the most pressing public health concerns of populations around the Available online at: www.who.int/tdr/capacity/global_report world. To respond to the needs of Member States at all levels of development, WHO Research Priorities for Zoonoses and Marginalized Infections publishes practical manuals, handbooks and training material for specific categories WHO Technical Report Series, No. 971 (120 pages) of health workers; internationally applicable guidelines and standards; reviews and Available online at: www.who.int/tdr/publications/zoonoses analyses of health policies, programmes and research; and state-of-the-art consensus reports that offer technical advice and recommendations for decision-makers. Research Priorities for Chagas Disease, Human African Trypanosomiasis and These books are closely tied to the Organization’s priority activities, encompassing Leishmaniasis disease prevention and control, the development of equitable health systems based WHO Technical Report Series, No. 975 (116 pages) on primary health care, and health promotion for individuals and communities. Available online at: www.who.int/tdr/publications/research_priorities Progress towards better health for all also demands the global dissemination and exchange of information that draws on the knowledge and experience of all WHO’s Research Priorities for the Environment, Agriculture and Infectious Diseases of Member Countries and the collaboration of world leaders in public health and the Poverty biomedical sciences. To ensure the widest possible availability of authoritative WHO Technical Report Series, No. 976 (140 pages) Available online at: www.who.int/tdr/publications/environment information and guidance on health matters, WHO secures the broad international distribution of its publications and encourages their translation and adaptation. By helping to promote and protect health and prevent and control disease throughout the world, WHO’s books contribute to achieving the Organization’s principal objective – the attainment by all people of the highest possible level of health. The WHO Technical Report Series makes available the findings of various international groups of experts that provide WHO with the latest scientific and technical advice on a broad range of medical and public health subjects. Members of such expert groups serve without remuneration in their personal capacities rather than as representatives of governments or other bodies; their views do not necessarily reflect the decisions or the stated policy of WHO. An annual subscription to this series, comprising four to six such reports, costs CHF 150.00/US$ 180.00 (CHF 105.00/US$ 126.00 in developing countries). For further information, please Further information on these and other WHO publications can be obtained from contact: WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, WHO Press, World Health Organization, 1211 Geneva 27, Switzerland Switzerland (tel. +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]; (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]; order on line: http://www.who.int/bookorders). order on line: http://www.who.int/bookorders) WHO Technical Report Series Research Priorities for Helminth Infections Technical Report of the TDR Disease Reference Group on Helminth Infections This report contains the collective views of an international group of experts and does not necessarily represent the decisions or the stated policy of the World Health Organization WHO Library Cataloguing-in-Publication Data Research priorities for helminth infections: technical report of the TDR disease reference group on helminth infections. (Technical report series ; no. 972) 1. Helminthiasis - prevention and control. 2. Research. 3. Neglected diseases. 4. Poverty. I.World Health Organization. II.Series. ISBN 978 92 4 120972 4 (NLM classification: WC 800) ISSN 0512-3054 © World Health Organization 2012 All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press through the WHO web site (http://www.who.int/about/licensing/copyright_form/en/index.html). 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 the World Health Organization 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 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 the World Health Organization 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 the World Health Organization 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 the World Health Organization be liable for damages arising from its use. This publication contains the collective views of an international group of experts and does not necessarily represent the decisions or the policies of the World Health Organization. Printed in Italy Contents The TDR Disease Reference Group on Helminth Infections vii Acronyms and abbreviations ix List of species xiii Executive summary xv 1. Introduction 1 1.1 The problem of helminthiases 1 1.2 Human helminthiases, populations at risk and resulting diseases 6 1.3 Group membership 12 1.4 Host country 14 1.5 Think Tank members 14 2. Methodology and prioritization 15 2.1 Identification of the helminth infections to be considered 15 2.2 Identification of the research gaps to be considered 16 2.3 The first DRG4 meeting 17 2.4 Prioritization of themes 19 2.4.1 Underlying values 19 2.4.2 Criteria for ranking 19 2.5 The second DRG4 meeting 20 2.6 Ranking of priority research areas by experts in DRG4 20 2.7 Stakeholders consultation meetings and other external contributions 21 2.7.1 First stakeholders’ consultation 21 2.7.2 Second stakeholders’ consultation 21 2.8 Publication of the DRG4 report 22 3. Overview of trends and driving forces of persistent, emerging and re-emerging helminth infections and the consequent research and control challenges 23 3.1 Parasite population biology
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