Surveillance and Control of Neglected Intestinal Parasitic Infections of Poverty in the United States

Download or read book Surveillance and Control of Neglected Intestinal Parasitic Infections of Poverty in the United States written by Rachael Michelle Singer and published by . This book was released on 2020 with total page 244 pages. Available in PDF, EPUB and Kindle. Book excerpt: My dissertation aims to inform strategies for the estimation of prevalence and burden of disease caused by neglected intestinal parasitic infections in the United States, with a view toward their control. The current burden of soil-transmitted helminth (STH) and intestinal protozoa (IP) infections in the US is unknown; consequentially, little existing surveillance and disease control framework exists to protect US residents. This group of infections is considered neglected due to lack of adequate surveillance. For example, despite documented historical and contemporary autochthonous transmission, the STH are not required by state law to be reported nor are they nationally notifiable, with the exception of mandated reporting for three species in Texas, as of September 2015. Without a tangible sense of the disease burden, little attention is paid to the prevention, diagnosis, and/or treatment of STH and IP in the US. I investigate the hypothesis that a significant burden of neglected intestinal parasitic infections persists in vulnerable communities throughout the US, and seek to identify and characterize the prevalence of intestinal parasites in a study at the local level. Our results from an epidemiological study in central Texas, as well as a species distribution modeling study of the STH Strongyloides stercoralis, suggest that STH represent a sufficient threat to US public health and therefore merit an organized public health response. Given that the US has a rudimentary or non-existent framework for addressing STH, I conduct a systematic review of global examples of intestinal parasite prevalence estimation, surveillance, and control programs to model solutions that can be adapted for the US context. My dissertation contributes to the characterization of a neglected public health problem, quantifying the burden of intestinal parasites locally and offering evidence-based solutions at the local, state, national, and health systems levels. The epidemiological insights we have gained about intestinal parasitic infections in the US suggest several public health, clinical, and policy strategies that may help to address the burden of disease, and, combined with additional historic and contemporary evidence call for a shift in the way we think about health equity and the provision of human rights in the US