A new report publishing June 27, 2013 in PLOS Neglected Tropical Diseases highlights a little known and largely unrecognized group of neglected tropical diseases (NTDs) affecting the poorest people in the state of Texas. An estimated five million Texans live below the poverty line and are vulnerable to NTDs, with large numbers of people in the state affected.

Among the most prominent NTDs in Texas are Chagas disease, a parasitic infection transmitted by kissing bugs and linked with severe heart disease; dengue and West Nile virus infection, each an arbovirus transmitted by mosquitoes; cysticercosis and toxocariasis, parasitic worm infections of the brain, and high rates of tuberculosis in people with diabetes. Other NTDs in the state include cutaneous leishmaniasis, trichomoniasis, and murine typhus.

Together these diseases disproportionately affect people living in extreme poverty, especially in South Texas and some of the major urban areas, including Houston, as well as people of color. While the NTDs do not attract the sensationalism of attention of conditions such as avian influenza or the Middle Eastern coronavirus, which have shown only potential for mass harm, the report emphasizes that these NTDs may be some of the most common afflictions of disease of poverty in Texas. Many of these NTDs are transmitted within the borders of Texas and may have existed in the state for decades or longer.

The report was led by scientists and public health efforts from the National School of Tropical Medicine at Baylor College of Medicine, together with experts from institutions throughout the state, including the University of Texas campuses in Galveston and Brownsville, and several key federal and international agencies including the Pan American Health Organization - the regional center for the World Health Organization in the Americas.

The results were presented at a one day forum in Houston jointly sponsored by NSTM, the American Society of Tropical Medicine, and Research!America, a nonprofit advocacy alliance.

"The findings are an example of what we can learn from global health research and development and apply to strategies to combat NTDs, particularly among Americans living at or below the poverty level," said Mary Woolley, president and CEO of Research!America.

Key steps identified include:
  • Identify public health gaps and health needs for those with NTDs in Texas and nearby regions
  • Conduct research to establish the prevalence of NTDs in the U.S., the modes of disease transmission and the factors causing urban transmission
  • Heightened measures for active transmission and better map the prevalence of these diseases
  • Understand the role of poverty in NTD transmission
  • Identify prevention strategies
  • Train workforce in identifying and treating these diseases - this includes physicians, nurse practitioners and other healthcare provides
  • Develop better control tools for NTDs including new drugs, vaccines, diagnostics, insecticides and mathematical and computational models
Hotez and other researchers at the forum are calling for a coordinated play for advocacy and education related to NTDs.

"The report is a wake-up call for greater awareness of the NTD problem in Texas and for stepped up measures to combat NTDs in the southern part of the U.S." said Dr. Peter Hotez, founding Dean of the NSTM at BCM.

"The report is an opportunity to view the infectious disease problem in Texas, much as we would elsewhere in the Western Hemisphere" according to Dr. Jon Andrus, Deputy Director of the Pan American Health Organization.