A glance at Neglected Tropical Diseases: SDG 3.3

India bears the highest burden of Neglected tropical diseases and deaths. Neglected Tropical Diseases( NTDs) by World Health Organization are a diverse set of 20 conditions caused mainly by various pathogens, including viruses, bacteria, parasites, fungi, and toxins. The disease groups with a similar impact on the poor socio-economic groups where water safety, sanitation, and healthcare access are substandard. Together they affect more than 1 billion people globally with devastating health, social and economic consequences. NTDs are responsible for 1.3% of total DALYs and 0.66% of total deaths in India.

Japanese encephalitis, dengue, Rabies, Leishmaniasis and cystic echinococcosis are India's most dangerous neglected causes of death. More than half of the deaths were caused by JE. These diseases primarily happen because of the bite of infected sandflies and mosquitoes.

Kala-azar became an Endemic in eastern states of India, namely Bihar, Jharkhand, West Bengal and Uttar Pradesh. It is estimated that around 165.4 million population are at risk in 4 states. Bihar is the most prone area for Kala-azar cases and deaths. Visceral leishmaniasis (Kala-azar) had reduced from 8500 in 2015 to 2033 cases in 2020. However, another condition, i.e. Post-Kala-azar Dermal Leishmaniasis (PKDL), emerge in Indian Kala-azar patients usually 1-2 years or more following recovery of Kala-azar is terrible in these states.

Chikungunya and Dengue have significantly increased year by year, causing emerging health risks. Currently, more than 30 states have been affected by chikungunya and Dengue. Chikungunya has been reported from Andhra Pradesh, Karnataka, Maharashtra, Tamil Nadu, Madhya Pradesh, Gujarat, Kerala, A&N Island, GNCT of Delhi, Rajasthan, and Pondicherry. Dengue cases have been reported from Uttar Pradesh, Maharashtra, Madhya Pradesh, Punjab, Rajasthan, Andhra Pradesh, Haryana, Gujarat, Karnataka, Delhi, Tamil Nadu, Odisha, Kerala, Goa and J& K.

Filariasis has been a significant public health problem in India, next only to malaria. Cases have been reported from about 21 States/Union Territories. Cases of filariasis have been recorded from Andhra Pradesh, Assam, Bihar, Chhattisgarh, Goa, Jharkhand, Karnataka, Gujarat, Kerala, Madhya Pradesh, Maharashtra, Orissa, Tamil Nadu, Uttar Pradesh, West Bengal, Pondicherry, Andaman & Nicobar Islands, Daman & Diu, Dadra & Nagar Haveli and Lakshadweep.

JE is widespread in India, outbreaks have been reported across different states in India. Cases have been reported from about 23 States/Union Territories. Major said cases from Uttar Pradesh, West Bengal, Assam, Bihar, Jharkhand, Manipur, Meghalaya, Odisha, Tamil Nadu, Karnataka and Tripura.

According to HEALTH AND FAMILY WELFARE STATISTICS, 2019-2020, the case fatality ratio of Leprosy is 2.39%, highest in Meghalaya and Tripura, followed by Manipur, Assam, Arunachal Pradesh,  Delhi, and Puducherry.

The Case Fatality Ratio for Dengue is 0.03%. The number of cases of Chikungunya, Kalaazar/V Leishmaniasis, and Lymphatic Filariasis is 16208, 3128 and 20872 in 2019- 2020, respectively.

Table 1: Burden of major Neglected Tropical Diseases in India

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Source: Institute for Health Metrics and Evaluation, 2019 ; National Center for Vector-Borne Diseases Control (NCVBDC), 2020

The burden of NTDs arises due to various risk factors, such as WASH, air pollution, and other environmental issues of ozone and radon. Sustainable Development Goals Target 3.3 says to end the neglected tropical diseases by 2030. Public health approaches such as preventive chemotherapy, individual case management, vector control, veterinary public health and water, sanitation and hygiene (WASH) need to be scaled up to eliminate these diseases.

The most common neglected tropical diseases in India are Kala-azar- V leishmaniasis, Dengue, Chikungunya, filariasis, rabies and leprosy. However, Disease burden estimates, cases and deaths data are not available for several other important Neglected Tropical Diseases, including Leprosy, rabies, etc., by National Center for Vector-Borne Diseases Control.

Note:  Diseases come under NTDs--- Buruli ulcer, Chagas disease, dengue and chikungunya, dracunculiasis (Guinea-worm disease), echinococcosis, foodborne trematodiases, human African trypanosomiasis (sleeping sickness), leishmaniasis, leprosy (Hansen’s disease), lymphatic filariasis, mycetoma, chromoblastomycosis and other deep mycoses, onchocerciasis (river blindness), rabies, scabies and other ectoparasitoses, schistosomiasis, soil-transmitted helminthiases, snakebite envenoming, taeniasis/cysticercosis, and cystic echinococcosis, trachoma, and yaws and other endemic treponematoses.