Following the most deadly conflict since World War II, and nearly two decades of population displacement, the Democratic Republic of Congo (DR Congo) now may represent one of the world's highest burdens of neglected tropical diseases (NTDs). A lack of surveillance activities and epidemiologic data is a key factor in delaying progress in disease control and elimination programs, scientists report in an editorial publishing Thursday, August 1 in PLOS Neglected Tropical Diseases.

Based on the limited information available, the researchers found that DR Congo may have some of the highest levels of intestinal helminth infections, lymphatic filariasis and schistosomiasis on the African continent. DR Congo also bears the greatest number of cases of leprosy in Africa and human African trypanosomiasis (HAT) globally. A number of important human viral infections including HIV/AIDS, Chikungunya, Ebola and monkeypox may have also first emerged from DR Congo.

Despite the likelihood of widespread NTDs, there are only minimal reported surveillance activities in DR Congo, a nation that is nearly the size of Western Europe. To strengthen DR Congo's health infrastructure and ultimately its economic output, the authors propose a comprehensive NTD mapping, control and research program.

"Identifying the reach and severity of NTDs is an essential first step to providing targeted treatments to millions of people in DR Congo," said co-author Dr. Anne Rimoin, associate professor in the Department of Epidemiology at the UCLA School of Public Health. "Increasing surveillance activity of NTDs and studying the emergence of key viral infections should be one of the top health priorities for the country."

As the authors recognize, the Ministry of Public Health of DR Congo has demonstrated willingness to expand NTD disease surveillance and control activities in the years ahead. With the support of the United States Agency for International Development (USAID), DR Congo is planning an ambitious program of NTD mapping and integrated diseases control focused on mass drug administration, while the World Health Organization, its Regional Office for Africa (AFRO) and the Belgium Development Agency have offered additional support.

"We have a responsibility to better understand the true burden of NTDs in DR Congo," said Dr. Peter Hotez, founding dean of the National School of Tropical Medicine at Baylor College of Medicine and President of the Sabin Vaccine Institute. "Future findings from enhanced disease surveillance and research will help shape and achieve important global development milestones in a country that has missed out on much of the economic and social progress spreading throughout many other parts of Africa."