Covid-19 may have turned the tide of serious parasitic disease

The Covid-19 pandemic has turned the clock back years in the fight against other diseases. It interrupted research, trials and other efforts to alleviate the public health burden.

For example, a regimen for Parkinson’s disease would start clinically trials this year. But it was postponed due to the pandemic.

Researchers have warned that if COVID-19 stops the spread of long-lasting insecticidal nets, cases of malaria could increase by 206 million and deaths from malaria by 379,000 in sub-Saharan Africa. Scientists predict that deaths related to HIV could increase by 10%, tuberculosis by up to 20% and malaria by 36% over the next five years.

Some of the health conditions that may have faced a setback are leishmaniasis, a parasitic disease associated with poverty problems such as malnutrition and poor housing. It is spread by a sandfly that race in unhygienic conditions such as open sewage and uncontrolled waste, which was possible neglected in the pandemic.

Leishmaniasis is high below neglected tropical diseases. Over one-seventh of the world’s population is in danger of getting it. The disease is important public health problem in different parts of the world, including Africa. It can cause devastating changes in lifestyle, disability, social stigma, poor labor productivity and death.

We believe that COVID-19 could possibly reverse the fight against leishmaniasis by at least a decade.

Treatment and control interruptions

COVID-19 has put great pressure on the capacity and infrastructure of healthcare systems. The pandemic has created a huge demand for hospital admissions, intensive care and medical staff. Even hospitals and pharmacies are limited to the services they can provide under certain restrictions on closure.

Treatment for patients with leishmaniasis requires that trained medical personnel inject drugs. People with leishmaniasis need access to health facilities for daily drug treatment. If it is not available, patients should be hospitalized for a long period of time to facilitate treatment.

During the pandemic, this would not be possible if all hospital beds were pre-set for COVID-19 patients.

The prevention and control of leishmaniasis involves monitoring diseases, controlling vectors with insecticide spray and providing nets treated with insecticides to households in endemic areas. These activities are hampered by limited allocation of funds or restriction of movement to prevent the spread of COVID-19.

The transportation of researchers and clinicians to the areas most affected, many of which are remote, is also under surveillance. With physical distance measures, researchers and clinicians cannot do this questionnaire type of data collection. As a result, they are unable to determine rates of infection or identify possible disease hotspots.

Redirected resources

Scientists have rushed to develop medicines, diagnostic kits, vaccines and protective kits for COVID-19. To facilitate this, most governments have diverted funds intended for the management of other infectious diseases in the direction of anti-COVID-19 efforts. Neglected tropical diseases such as leishmaniasis already receive about 0.6% in the WHO’s research on health development budget. Reducing more funds can mean missing goals for leishmaniasis.

The suspension of several research projects around the world may have led to several deadlines not being met, leading to a likely loss of research funding. For example research budget cuts which was made necessary by the impact of COVID-19 has already been seen in South Africa.

Co-infection

There is another concern: South America is one of the centers of coronavirus disease and all countries on the continent have cases of leishmaniasis, except Chile in Uruguay. To prevent any infection, a person needs a strong immune system system. But the Leishmania parasite and SARS CoV2 target the cells needed to fight invasive pathogens. It is therefore likely that some people will be infected with both diseases, and that co-infection may complicate and aggravate both conditions.

Collectively, COVID-19 cannot stand in isolation. Many parts of the world are plagued by various devastating diseases. These diseases should not be overlooked in the quest to control the new pandemic.

Raphael Taiwo Aruleba, PhD candidate, University of Cape Town; Bernard Ong’ondo Osero, Arturo Falaschi ICGEB PhD Fellow, University of Cape Town, en Dr Ramona Hurdayal, Lecturer and Team Leader: Leishmaniasis Research Group, University of Cape Town

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