Neglected tropical diseases in Uganda: the prospect and challenge of integrated control

Abstract

So-called 'neglected tropical diseases' (NTDs) are becoming less neglected, with increasing political and financial commitments to their control. These recent developments were preceded by substantial advocacy for integrated control of different NTDs, on the premise that integration is both feasible and cost-effective. Although the approach is intuitively attractive, there are few countrywide experiences to confirm or refute this assertion. Using the example of Uganda, this article reviews the geographical and epidemiological bases for integration and assesses the potential opportunities for, and operational challenges of, integrating existing control activities for several of these diseases under an umbrella vertical programme.

Figure 1

Areas of Uganda endemic or coendemic for NTDs that are controlled using MDA of preventative chemotherapy. Areas shown in red are endemic for schistosomiasis, light green areas are endemic for onchocerciasis, yellow areas are endemic for VL and light blue areas are endemic for LF. Dark blue areas indicate counties (administrative areas below district level) coendemic for schistosomiasis and onchocerciasis, orange areas are districts in which schistosomiasis and LF are coendemic and dark green areas are districts in which schistosomiasis, LF and onchocerciasis are present. STHs are endemic throughout Uganda.