Misconceptions and paradoxes in soiltransmitted helminthiases control as a public health problem

KROLEWIECKI AJ

PLOS NEGLECTED TROPICAL DISEASES

PUBLIC LIBRARY SCIENCE

Lugar: San Francisco; Año: 2018

1935-2735

Soil-transmitted helminthiases (STHs) constitute a public health problem that requiresimmediate action to resolve the morbidity of those harboring the parasites in their guts, toprevent infection in all those at risk, and to interrupt the vicious circle of poverty and diseasein the affected communities, structural poverty being the main determinant of this group ofinfectious diseases. Since the times of the Rockefeller initiatives over a hundred years ago,the strategy has been viewed as one requiring community-wide efforts rather than pure individualcase management. The World Health Organization (WHO) and its regional offices, asthe governing institutions endorsed by the countries and their governments, have been theleaders in stating the actual executive measures to reach the goals and endpoints for themanagement of the problem. With the task of setting a group of activities that could belaunched, monitored, and measured, these actions were established with the availableresources since this public health problem had to be launched immediately, resourceswere those available at the moment and not those appearing on a wish list. Considerableprogress has been made in the establishment of policies for the achievement of the MillenniumDevelopment Goals (MDGs), later followed by the Sustainable Development Goals(SDGs) through WHO-lead actions for the control of neglected tropical diseases (NTDs).With an initial goal of morbidity control, there are already discussions and proposals forelimination of STH if support is sustained and empiric facts confirm data emerging frommodeling and small-scale studies. The aim of these comments is to describe and questioninstances of currently accepted concepts, theories, and practices that conform to the dogmaticstatus quo that serves as the foundation on top of which the new elimination aspirationsare supposed to be built on, which might not be serving the desired purpose if takenunrevised.