Neglected Tropical Diseases among the Association of Southeast Asian Nations (ASEAN): Overview and Update

The ten member states of the Association of Southeast Asian Nations (ASEAN) constitute an economic powerhouse, yet these countries also harbor a mostly hidden burden of poverty and neglected tropical diseases (NTDs). Almost 200 million people live in extreme poverty in ASEAN countries, mostly in the low or lower middle-income countries of Indonesia, the Philippines, Myanmar, Viet Nam, and Cambodia, and many of them are affected by at least one NTD. However, NTDs are prevalent even among upper middle-income ASEAN countries such as Malaysia and Thailand, especially among the indigenous populations. The three major intestinal helminth infections are the most common NTDs; each helminthiasis is associated with approximately 100 million infections in the region. In addition, more than 10 million people suffer from either liver or intestinal fluke infections, as well as schistosomiasis and lymphatic filariasis (LF). Intestinal protozoan infections are widespread, while leishmaniasis has emerged in Thailand, and zoonotic malaria (Plasmodium knowlesi infection) causes severe morbidity in Malaysia. Melioidosis has emerged as an important bacterial NTD, as have selected rickettsial infections, and leptospirosis. Leprosy, yaws, and trachoma are still endemic in focal areas. Almost 70 million cases of dengue fever occur annually in ASEAN countries, such that this arboviral infection is now one of the most common and economically important NTDs in the region. A number of other arboviral and zoonotic viral infections have also emerged, including Japanese encephalitis; tick-borne viral infections; Nipah virus, a zoonosis present in fruit bats; and enterovirus 71 infection. There are urgent needs to expand surveillance activities in ASEAN countries, as well as to ensure mass drug administration is provided to populations at risk for intestinal helminth and fluke infections, LF, trachoma, and yaws. An ASEAN Network for Drugs, Diagnostics, Vaccines, and Traditional Medicines Innovation provides a policy framework for the development of new control and elimination tools. Together with prominent research institutions and universities, the World Health Organization (WHO), and its regional offices, these organizations could implement important public health improvements through NTD control and elimination in the coming decade.     

Distribution and variability of deformed wing virus of honeybees (Apis mellifera) in the Middle East and North Africa

Three hundred and eleven honeybee samples from 12 countries in the Middle East and North Africa (MENA) (Jordan, Lebanon, Syria, Iraq, Egypt, Libya, Tunisia, Algeria, Morocco, Yemen, Palestine, and Sudan) were analyzed for the presence of deformed wing virus (DWV). The prevalence of DWV throughout the MENA region was pervasive, but variable. The highest prevalence was found in Lebanon and Syria, with prevalence dropping in Palestine, Jordan, and Egypt before increasing slightly moving westwards to Algeria and Morocco Phylogenetic analysis of a 194 nucleotide section of the DWV Lp gene did not identify any significant phylogenetic resolution among the samples, although the sequences did show consistent regional clustering, including an interesting geographic gradient from Morocco through North Africa to Jordan and Syria. The sequences revealed several clear variability hotspots in the deduced amino acid sequence, which furthermore showed some patterns of regional identity. Furthermore, the sequence variants from the Middle East and North Africa appear more numerous and diverse than those from Europe.     

Middle East and North Africa consensus on osteoporosis

With the increasing life expectancy, osteoporosis is becoming a major worldwide health problem. The magnitude of the disease may become larger in developing countries, more particularly in the Middle East region where the prevalence of low bone mass is higher than in western countries. Although several local organizations and countries have developed guidelines for osteoporosis, no previous regional guidelines have been developed encompassing all Middle-Eastern and North African countries. The present document reviews all the regional published data on bone mineral density, risk factors, fracture prevalence and vitamin D status. It also gives simple recommendations applicable to all these countries. This document was endorsed by leading members of all the different regional countries including, Iran, Egypt, Tunisia, Jordan, Palestine, Syria, Iraq, Libya, Oman, Kuwait, Saudi Arabia and Bahrain.     

Sea cucumbers of the Arabian Peninsula and Iran – A review of historical and current research trends

Sea cucumbers are benthic marine invertebrates with immense ecological and commercial value. Processed sea cucumbers known as “Beche-de-mer” are a delicacy in southeast Asian countries with an ever-increasing demand depleting wild stocks on a global scale. Aquaculture techniques are well developed for commercially important species (e.g. Holothuria scabra) to aid in conservation and trade. In the Arabian Peninsula and Iran, where the major land mass is surrounded by marginal seas (Arabian Gulf, Gulf of Oman, Arabian Sea, Gulf of Aden, and Red Sea), studies on sea cucumbers are rather limited and its economic value is underestimated. Historical and current research trends indicate impoverished diversity (82 species) due to environmental extremes. Artisanal fisheries exist for the sea cucumbers of Iran, Oman, and Saudi Arabia, with Yemen and United Arab Emirates (UAE) playing a key role in collection and export to Asian countries. Stock assessment and data on export indicates depletion of natural stocks in Saudi Arabia and Oman. Aquaculture trials of high value species (H. scabra) were successful in Saudi Arabia, Oman and Iran with prospects for further expansion. Research on ecotoxicological properties and bioactive substances conducted in Iran demonstrates an immense research potential. Molecular phylogeny, biology, use in bioremediation, and characterisation of bioactive compounds were identified as potential gaps in research. Expanding aquaculture operations could revive exports and recuperate damaged stocks through sea ranching. Furthermore, regional cooperation, networking, training, and capacity building could help fill the gaps in sea cucumber research, which will aid in its effective conservation and management.     

The neglected tropical diseases of Latin America and the Caribbean: a review of disease burden and distribution and a roadmap for control and elimination

The neglected tropical diseases (NTDs) represent some of the most common infections of the poorest people living in the Latin American and Caribbean region (LAC). Because they primarily afflict the disenfranchised poor as well as selected indigenous populations and people of African descent, the NTDs in LAC are largely forgotten diseases even though their collective disease burden may exceed better known conditions such as of HIV/AIDS, tuberculosis, or malaria. Based on their prevalence and healthy life years lost from disability, hookworm infection, other soil-transmitted helminth infections, and Chagas disease are the most important NTDs in LAC, followed by dengue, schistosomiasis, leishmaniasis, trachoma, leprosy, and lymphatic filariasis. On the other hand, for some important NTDs, such as leptospirosis and cysticercosis, complete disease burden estimates are not available. The NTDs in LAC geographically concentrate in 11 different sub-regions, each with a distinctive human and environmental ecology. In the coming years, schistosomiasis could be eliminated in the Caribbean and transmission of lymphatic filariasis and onchocerciasis could be eliminated in Latin America. However, the highest disease burden NTDs, such as Chagas disease, soil-transmitted helminth infections, and hookworm and schistosomiasis co-infections, may first require scale-up of existing resources or the development of new control tools in order to achieve control or elimination. Ultimately, the roadmap for the control and elimination of the more widespread NTDs will require an inter-sectoral approach that bridges public health, social services, and environmental interventions.     

Sea cucumbers of the Arabian Peninsula and Iran – A review of historical and current research trends

Sea cucumbers are benthic marine invertebrates with immense ecological and commercial value. Processed sea cucumbers known as “Beche-de-mer” are a delicacy in southeast Asian countries with an ever-increasing demand depleting wild stocks on a global scale. Aquaculture techniques are well developed for commercially important species (e.g. Holothuria scabra) to aid in conservation and trade. In the Arabian Peninsula and Iran, where the major land mass is surrounded by marginal seas (Arabian Gulf, Gulf of Oman, Arabian Sea, Gulf of Aden, and Red Sea), studies on sea cucumbers are rather limited and its economic value is underestimated. Historical and current research trends indicate impoverished diversity (82 species) due to environmental extremes. Artisanal fisheries exist for the sea cucumbers of Iran, Oman, and Saudi Arabia, with Yemen and United Arab Emirates (UAE) playing a key role in collection and export to Asian countries. Stock assessment and data on export indicates depletion of natural stocks in Saudi Arabia and Oman. Aquaculture trials of high value species (H. scabra) were successful in Saudi Arabia, Oman and Iran with prospects for further expansion. Research on ecotoxicological properties and bioactive substances conducted in Iran demonstrates an immense research potential. Molecular phylogeny, biology, use in bioremediation, and characterisation of bioactive compounds were identified as potential gaps in research. Expanding aquaculture operations could revive exports and recuperate damaged stocks through sea ranching. Furthermore, regional cooperation, networking, training, and capacity building could help fill the gaps in sea cucumber research, which will aid in its effective conservation and management.     

Helicobacter pylori: the Middle East scenario.

A review of Helicobacter pylori in the Middle East is presented. Prevalence studies have been performed in asymptomatic population groups from Algeria, Israel, Saudi Arabia and Turkey. These showed that the prevalence of H. pylori is similar to that of the developing countries of the world with a high level of infection in childhood (40 to 70 percent), which increases with age to 85 to 90 percent. Israel, however, has a low prevalence in children (10 percent), but there is a rapid rise in the second decade of life to 39 percent, reaching 79 percent in those over 60 years old. The prevalence rates were higher in those living in communal settlements (72 percent) than in urban dwellers (65 percent). The infection rates were higher in persons of Mediterranean and Asian origin (89 percent) compared to those of Western European/North American origin (57 percent). The prevalence rate of H. pylori infection in patients undergoing endoscopy for upper gastrointestinal symptoms has now been reported from many Middle Eastern countries, including Egypt, Iran, Israel, Oman, Saudi Arabia, the United Arab Emirates and Yemen. These studies showed that patients with gastritis and peptic ulcer disease had similar rates of infection as reported from Europe, United States and Africa (71 to 92 percent). However, patients with non-ulcer dyspepsia had higher rates of infection (61 to 89 percent). The H. pylori scenario from the prevalence rates, treatment protocols and responses to treatment does not differ very much from other developing areas of the world.     

Distribution of carpenter-moths (Lepidoptera, Cossidae) in the Palaearctic deserts

Specific features of the carpenter-moths (Cossidae) distribution in the Palaearctic deserts are considered. The Palaearctic frontier was delimited to the Arabian Peninsula (the eastern and northern parts of Arabia are attributed to the Palaearctic Region; Yemen, southwestern Saudi Arabia, and southernmost Iran belong to the Afrotropical Region). Cossidae are highly endemic to arid areas. Some Palaearctic carpenter-moth genera penetrate to Africa southward of the Sahara Desert (an important characteristic distinguishing them from most of the other Lepidoptera). The local faunas of the Palaearctic deserts are united into 4 groups: the Sahara-Arabian-Southern-Iranian, Central-Asian-Kazakhstanian, Western-Gobian, and Eastern-Gobian. In the Eastern Gobi Desert, the fauna is the most specific; it should be considered as a separate zoogeographical subregion.     

The genus Iphiona (Compositae-Inuleae)

The genus Iphiona Cass. emend. A. Anderb. (Compositae-Inuleae-Inulinae) is revised and considerably amended. The former genera Grantia Boiss. (= Perralde-riopsis Rauschert) and Hirschia Baker are included as well as the major part of Iphiona Cass. s.str. and the species Inula grantioides Boiss., and Pulicaria phillipsiae S. Moore. Five new combinations are made: I. anthemidifolia (Baker) A. Anderb., I. arachnoidea (Boiss.) A. Anderb., I. grantioides (Boiss.) A. Anderb., I. phillipsiae (S. Moore) A. Anderb., and I. senecionoides (Baker) A. Anderb. The new species I. teretifolia A. Anderb. is described. A discussion of the phylogeny of the group and a cladogram, involving reticulation, of the Iphiona species are presented. The 11 species are distributed in Egypt, Israel, Jordan, Sudan, Ethiopia, Somalia, Saudi Arabia, Peoples Democratic Republic Yemen, Oman, Iran and Pakistan.     

Genetic diversity among different species of the genus Leiurus (Scorpiones: Buthidae) in Saudi Arabia and the Middle East

The molecular phylogenetic relationship among two species of genus Leiurus, from Saudi Arabia with additional comparative sequence data available from Egypt, Oman and Turkey is presented. The molecular phylogeny was performed using maximum parsimony, neighbor joining and bayesian inference. Our results indicate a clear deep splitting between the Western clade, which represented by L. quinuestriatus sequences from Egypt and those from the Eastern clade which encompassing different Leiurus species from Saudi Arabia, Oman and Turkey was shown. Also, the phylogenetic relationship represents additional support for the taxonomic status of Arabian Leiurus species.     

Genetic diversity of populations of Old World screwworm fly, Chrysomya bezziana, causing traumatic myiasis of livestock in the Gulf region and implications for control by sterile insect technique

Abstract.  Fly larvae were collected from 181 cases of traumatic myiasis in livestock in 10 regions of four countries in the Middle East Gulf region: Iran, Iraq, Saudi Arabia and Oman. The predominant fly species responsible for cases was the Old World screwworm (OWS) fly, Chrysomya bezziana Villeneuve (Diptera: Calliphoridae). In cases from Iran and Oman, which included non-OWS fly species, OWS fly was found solely responsible for 67.6% of cases and jointly with other fly species for a further 12.7% of cases. The major hosts were sheep and goats, together comprising 84.6% of the total, which reflects their predominance among the livestock of these Gulf countries. The major site of wounding on sheep and goats was the tail (40.3%), followed by female genitalia (14.0%). The 3' terminal 715 nucleotides of the mitochondrial cytochrome b gene were sequenced for 178 larvae of OWS. Five haplotypes were identified: three had been recorded previously in the region (two were common throughout and one was unique to Oman), and two were newly identified, one from southern Iraq and the other from Saudi Arabia, both in regions sampled for the first time. The haplotypes varied from one another only at one or two nucleotide sites, equivalent to an intraspecific difference of 0.14–0.28% across the entire 715-bp fragment. There was a single statistically significant association between host species and haplotype in Saudi Arabia, a first such record for OWS fly. The small degree of genetic diversity between geographical populations of OWS fly within the Gulf region suggests that a single Gulf colony could be used to implement the sterile insect technique within an integrated control programme.     

The zoogeographical composition and distribution of the Arabian termite fauna

Thirty-three termite species have been recorded from the Arabian peninsula (from Saudi Arabia, North and South Yemen, Oman, Bahrain, Abu Dhabi, Qatar and Kuwait). The fauna is predominantly Afro-tropical (Ethiopian) but with a major Palaearctic (Eremic) element. The greatest diversity occurs in the south-west where mountainous regions provide greater habitat diversity than elsewhere. The Afro-tropical influence decreases towards the north and east, the Palaearctic influence increasing correspondingly; the Oriental influence is negligible and the level of endemism is high.     

Review of subtribe Pterellina Rohdendorf, 1967 (Diptera: Sarcophagidae) of Middle East with descriptions of twelve new species

Summary

Based on a revision of large recent collections housed at the Natural History Museum (London), Tel Aviv University and in the private collection of Yu. Verves and L. Khrokalo (Kyiv, Ukraine), new distributional data and an updated list with comments of 28 species of Middle Eastern Sarcophagidae of the subtribe Pterellina are presented. Seventeen of them are recorded for Israel, 11 for Egypt, four for Iran, two each for the Palestinian Authority, Saudi Arabia and Turkey, and one each for Jordan and the UAE. No data are known for the territories of Bahrain, Cyprus, Iraq, Kuwait, Lebanon, Oman, Qatar, Syria and Yemen. Twelve species new to science are described, including nine from Israel (Chaetapodacra montana n. sp., Eremasiomyia bicolor n. sp., E. deserta n. sp., E. fuscata n. sp., Protomiltogramma bidentata n. sp., P. serrata n. sp., Pterella hermonica n. sp., P. indigens n. sp., P. zefatica n. sp.), two from Egypt (Chaetapodacra griseola n. sp., Eremasiomyia alba n. sp.) and one from Saudi Arabia (Protomiltogramma arabica n. sp.). The male of Eremasiomyia nigra Rohdendorf, 1935 is described for the first time. One new combination of specific name is proposed ? Protomiltogramma immunita (Villeneuve, 1923), n. comb. Original keys for the identification of genera and species are proposed. An annotated list of all world genera and species and compiled data on larval habits of Pterellina are included.     

The field-testing of a novel integrated mapping protocol for neglected tropical diseases

Background

Vertical control and elimination programs focused on specific neglected tropical diseases (NTDs) can achieve notable success by reducing the prevalence and intensity of infection. However, many NTD-endemic countries have not been able to launch or scale-up programs because they lack the necessary baseline data for planning and advocacy. Each NTD program has its own mapping guidelines to collect missing data. Where geographic overlap among NTDs exists, an integrated mapping approach could result in significant resource savings. We developed and field-tested an innovative integrated NTD mapping protocol (Integrated Threshold Mapping (ITM) Methodology) for lymphatic filariasis (LF), trachoma, schistosomiasis and soil-transmitted helminths (STH).

Methodology/Principal Findings

The protocol is designed to be resource-efficient, and its specific purpose is to determine whether a threshold to trigger public health interventions in an implementation unit has been attained. The protocol relies on World Health Organization (WHO) recommended indicators in the disease-specific age groups. For each disease, the sampling frame was the district, but for schistosomiasis, the sub-district rather than the ecological zone was used. We tested the protocol by comparing it to current WHO mapping methodologies for each of the targeted diseases in one district each in Mali and Senegal. Results were compared in terms of public health intervention, and feasibility, including cost. In this study, the ITM methodology reached the same conclusions as the WHO methodologies regarding the initiation of public health interventions for trachoma, LF and STH, but resulted in more targeted intervention recommendations for schistosomiasis. ITM was practical, feasible and demonstrated an overall cost saving compared with the standard, non-integrated, WHO methodologies.

Conclusions/Significance

This integrated mapping tool could facilitate the implementation of much-needed programs in endemic countries.     

Indigofera rubromarginata sp. nov. (Leguminosae) from southern Arabia, with a note on I. eremophila

Thulin, M. 1995. Indigofera rubromarginata sp. nov. (Leguminosae) from southern Arabia, with a note on I. eremophila. — Nord. J. Bot. 15: 519–521. Copenhagen. ISSN 0107–055X.
The new species Indigofera rubromarginata , widespread along the coast of southern Arabia in Yemen and Oman, is described and illustrated. The closely related I. eremophila , previously known only from eastern Ethiopia and Somalia, is reported also from Yemen.     

Cluster structure of barley (Hordeum vulgare L.) populations at hordein-coding loci in countries of Southwest Asia, North and Northeast Africa, the Middle East, and South Arabia

The cluster population structure of barley landraces with known sampling localities in nine countries of Southwest Asia, the Middle East, North and Northeast Africa, and South Arabia was examined using the allele-frequency data for three hordein-coding loci. A total of 92 populations from Turkey, 56 populations from Syria, 34 from Jordan, 23 populations from Iraq, 6 from Morocco, 16 from Algeria, 34 populations from Egypt, 100 from Ethiopia, and 71 populations from Yemen with known sampling localities were included in the analysis. It was demonstrated that the cluster population structure in different countries was different and varied from a single cluster in Morocco to five clusters in Ethiopia. Furthermore, populations with sampling sites located at a considerable distance from one another were grouped into one cluster. It is suggested that the existence of several population clusters within a single country can be evidence of repeated population introduction, while the grouping of the populations with sampling sites considerably distant from one another into one cluster can indicate the distribution of once introduced populations of cultivated barley within countries through local farmer migration.     

Strengthening data collection for neglected tropical diseases: What data are needed for models to better inform tailored intervention programmes?

Locally tailored interventions for neglected tropical diseases (NTDs) are becoming increasingly important for ensuring that the World Health Organization (WHO) goals for control and elimination are reached. Mathematical models, such as those developed by the NTD Modelling Consortium, are able to offer recommendations on interventions but remain constrained by the data currently available. Data collection for NTDs needs to be strengthened as better data are required to indirectly inform transmission in an area. Addressing specific data needs will improve our modelling recommendations, enabling more accurate tailoring of interventions and assessment of their progress. In this collection, we discuss the data needs for several NTDs, specifically gambiense human African trypanosomiasis, lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths (STH), trachoma, and visceral leishmaniasis. Similarities in the data needs for these NTDs highlight the potential for integration across these diseases and where possible, a wider spectrum of diseases.     

Five new species of Triotemnus (Coleoptera, Curculionidae, Scolytinae) from Morocco and Yemen

Fivenew species of the genus Triotemnus from Morocco and Yemen are described. Triotemnus is a new genus of Scolytinae for the Yemen region. External morphology of the new species and all morphologically related species of the genus were studied. While the new species from Morocco are morphologically similar to the known species from the corresponding region, all three newly described species from Yemen, mainly two of them living in Socotra, are morphologically very different from all other known species of the genus. Geographical distribution and the probability of endemicity are discussed.     

Modelling potential habitat suitability for critically endangered Arabian leopards (Panthera pardus nimr) across their historical range in Saudi Arabia

Camera trapping can detect and monitor rare species in landscapes spanning thousands of square kilometres but placement of cameras in areas where the animals most likely occur will increase detection success. This vital information is lacking for the critically endangered Arabian leopard (Panthera pardus nimr) that has undergone a 90% decline across its range in Saudi Arabia. We aimed to identify suitable Arabian leopard habitat and potential population capacity in Saudi Arabia using data from leopards living in ecologically analogous habitat in South Africa and Oman. We developed a resource selection function (RSF) from 14 leopards’ GPS data in the Cederberg, South Africa, and validated the model using three leopards in the Little Karoo, and two Arabian leopards in Oman. We then projected the model to the historical range of Arabian leopards in Saudi Arabia to estimate likely leopard locations and potential population sizes based on home range metrics. The RSF successfully discriminated between used and available locations (specificity = 96.7%) and had high predictive ability (Rho > 0.9). Leopards selectively used areas away from human settlements and roads, with high enhanced vegetation index, and intermediate slopes and elevations. Saudi Arabia could theoretically host 4 distinct populations totalling 162–362 Arabian leopard females, depending on home range size. Camera traps deployed in the south-western mountains of Saudi Arabia may be most likely to detect remnant populations of Arabian leopards. Further research is needed into the local abundance of prey species and human activity to ensure the persistence of suitable leopard ranges and inform conservation actions.