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Professor Kishor Wasan

What is an Underdiagnosed Infectious Disease?

Whether you're interested in researching a neglected infectious disease or simply attempting to comprehend the aetiology of specific diseases, you must grasp a few things. These include what it is, how it occurs, and potential treatment choices.


Buruli ulcer, first described in Uganda in 1897 by British surgeon Sir Albert Cook, is a skin illness caused by Mycobacterium ulcerans. It belongs to the family of leprosy-causing bacteria. Mycolactone, a unique toxin generated by Mycobacterium ulcerans, destroys the tissue and inhibits normal cell activity.


The illness is prevalent in subtropical and tropical environments. It affects the skin, skeletal structure, and soft tissues. It can also impact animals. According to the World Health Organization, it is a neglected tropical illness. The tuberculosis-related bacteria Mycobacterium ulcerans cause it. The biting of an aquatic bug often transmits it. The unknown is the actual mechanism of transmission.


Chagas disease, often known as "American trypanosomiasis," is a parasite illness that can damage the heart and digestive tract. Numerous deaths have been caused by the illness throughout Latin America, particularly in rural regions. An estimated 6-7 million individuals are afflicted with the parasite. This number represents a considerable economic and social burden. A triatomine insect spreads Chagas, also called a "kissing bug." The parasite is found in the insect's excrement. The illness is most prevalent in Central and South America, although it is also found in several Western Pacific nations.


Typically, Chagas disease is identified after the first obvious symptoms, which might include lymph node enlargement and skin lesions. However, many individuals with the condition exhibit no symptoms. This makes illness identification challenging. Leishmaniasis is one of the most prevalent neglected tropical illnesses. Leishmania-genus parasitic protozoa cause this sickness. The vector of this disease is sand flies, which transmit the virus by biting an affected individual.


Leishmaniasis is an extremely complicated illness for which few preventative measures exist. Despite this, the illness has a significant morbidity rate, and many infected individuals suffer long-term impairment. To avoid the sickness, it is essential to understand the causes of infection and how to cure it. Two kinds of leishmaniasis exist. One form of the disease, cutaneous leishmaniasis, affects the skin. This kind of leishmaniasis typically develops weeks or months following the first bite. In most situations, skin lesions heal without therapy, but if left untreated, they might become infections.


Mycetoma, formerly Madura foot, is a persistent granulomatous infection affecting the skin, bones, and muscles. Bacteria, fungi, and filamentous organisms cause it. Males are more likely to have this condition, which frequently affects the hands, feet, and ankles. Mycetoma is a subcutaneous chronic granulomatous infection that is predominantly endemic to tropical and subtropical regions. It is caused by various bacteria and fungi and is characterized by the presence of grains, fistulas, and a fluid discharge.


Mycetoma is diagnosed based on the patient's clinical presentation and the identification of the causative organisms. Noting that the majority of instances are not detected until the illness has advanced is crucial. Therefore, early identification is crucial to optimize treatment results and decrease morbidity.


Previously referred to as subcutaneous mycosis, chromoblastomycosis is a persistent skin fungal illness. It is particularly widespread in tropical locations and is caused by the implantation of dematiaceous fungus into the dermis. Multiple fungi are responsible for chromoblastomycosis. Slow-growing lesions that may evolve into verrucous or cauliflower-like lesions define the condition. These lesions may undergo malignant development into squamous cell carcinoma in advanced situations. Additionally, lesions may penetrate bone. The condition can cause physical impairment, and some people may develop lymphedema.


Several distinct dematiaceous fungus cause chromoblastomycosis. At the injection site, the infection begins in the skin and develops into a plaque-like lesion. The pathogenic species are isolated from decaying plant matter and are prevalent in tropical and subtropical climates. World Health Organization did not classify chromoblastomycosis as a neglected tropical disease (NTD) until recently (WHO). In 2017, the organization designated chromoblastomycosis as an NTD and released a detailed plan to combat the disease. The road map also includes several other subcutaneous or implantation mycoses and chromoblastomycosis.


This road plan is renowned for emphasizing domestic finance, strengthening the health system, and rural population access to care. The route map also contains several other NTDs not included on the first list. Included in this category are sporotrichosis, paracoccidioidomycosis, and histoplasmosis. The Road Map is also remarkable for its emphasis on measuring effect. The new grading system enables clinicians to assess the severity of mycetoma more.

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