Severe communicable diseases include tuberculosis, HIV / AIDS, malaria, viral hepatitis, and meningitis. Each of these diseases is fatal if untreated. Today, the world has recorded critical levels of incidences and mortality from these pathologies. Controlling these diseases is recognized as one of WHO's public health top priorities, but each of these pathologies still results in thousands of deaths annually, mostly due to the severe cases.
While most guidelines focus predominantly on conventional, common occurrence of these diseases, severely ill patients often lack necessary attention and care. The search for new, more effective ways to control severe cases of communicable diseases is the top priority of INCURE. Our aim is to improve outcomes in such categories of patients.
Tuberculosis (TB) is the infectious (contagious) disease caused by M. tuberculosis, usually called “Koch's bacillus” after the scientist who discovered this agent in 1882. This disease is transmitted mainly by airborne droplets from an infected person to a healthy person. Tuberculosis, in most cases, primarily affects the lungs, but the disease can occur in any organ of the body, such as the kidneys, spine, brain, lymph nodes, intestines, skin, genitals, etc.
People become infected through inhalation of air containing the causative agent – m. tuberculosis.
Today, tuberculosis is curable in most cases. However, the mortality rate from this disease is critically high, especially in countries with a high burden of TB, where the mortality rate can reach 60-70%. Typically, this is due to late diagnosis, lack of access to adequate treatment, the severity of disease, and the Koch's bacillus resistance to antituberculosis drugs.
Severe forms of tuberculosis, which in most cases lead to disability or death of patients, include:
extended tuberculosis
caseous pneumonia
extrapulmonary forms of tuberculosis
tuberculous meningitis.
Moreover, tuberculosis is often combined with severe general condition of the patient, or the presence of severe comorbidities which worsen through the course of tuberculosis and/or limit the ability to take anti-tuberculosis drugs (for example, if the patient is unconscious, unable to swallow, has hepatic disease, malabsorption syndrome, when anti-tuberculosis drugs are not absorbed in the gastro-intestinal tract and the patient, in fact, does not receive the necessary treatment, even if he/she takes all the necessary drugs). Today, treatment of such patients is associated with a variety of difficulties, the solution of which will save tens of thousands of lives each year.
The HIV is a RNA virus belonging to the group of Lentiviridae within the family of Retroviridae, which causes an HIV disease that typically leads to AIDS in the late stage.
Acquired immunodeficiency syndrome (AIDS) is a term which applies to the most advanced stages of HIV infection. It is defined by the occurrence of any of more than 20 opportunistic infections or HIV-related cancers.
HIV is transmitted by three main routes: sexual contact, significant exposure to infected body fluids or tissues, and from mother to child during pregnancy, delivery, or breastfeeding (known as vertical transmission). There is no risk of acquiring HIV if exposed to feces, nasal secretions, saliva, sputum, sweat, tears, urine, or vomit unless these are contaminated with blood.
According to estimates by WHO and UNAIDS, 36.7 million people were living with HIV globally at the end of 2016. That same year, some 1.8 million people became newly infected, and 1 million died of HIV-related causes.
By mid-2017, 20.9 million people were receiving HIV antiretroviral therapy (ART) globally. While this number illustrates a formidable success in HIV treatment scale up, nearly half of all people in need are still waiting for treatment.
After the diagnosis of AIDS, if treatment is not available, survival ranges between 6 and 19 months. Highly active antiretroviral therapy (HAART) and appropriate prevention of opportunistic infections reduces the death rate by 80%, and raises the life expectancy for a newly diagnosed young adult to 20–50 years.
Malaria is a life-threatening disease caused by parasitic protosoans belonging to the Plasmodium type that are transmitted to people through the bites of infected female Anopheles mosquitoes. It is preventable and curable.
The disease is widespread in the tropical and subtropical regions that exist in a broad band around the equator. This includes much of Sub-Saharan Africa, Asia, and Latin America. In 2016, there were 216 million cases of malaria worldwide resulting in an estimated 731,000 deaths.
WHO recommends protection for all people at risk of malaria with effective malaria vector control. Two forms of vector control – insecticide-treated mosquito nets and indoor residual spraying – are effective in a wide range of circumstances. Other methods used to prevent
malaria include medications, mosquito elimination and the prevention of bites.
When properly treated, people with malaria can usually expect a complete recovery. However, severe malaria can progress extremely rapidly and cause death within hours or days. In the most severe cases of the disease, fatality rates can reach 20%, even with intensive care and treatment.
Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. Hepatitis viruses are the most common cause of hepatitis in the world.
There are 5 main hepatitis viruses, referred to as types A, B, C, D and E. Hepatitis A is always an acute, short-term disease, while hepatitis B, C, and D are most likely to become ongoing and chronic. Hepatitis E is usually acute but can be particularly dangerous in pregnant women. Treatment options are determined by which type of hepatitis and whether the infection is acute or chronic.
Viral hepatitis is a leading cause of death globally, accounting for 1.34 million deaths per year – comparable to HIV/AIDS, tuberculosis or malaria. Together, hepatitis B virus and hepatitis C cause 80% of most liver cancer cases in the world.
With the availability of effective vaccines and treatments for hepatitis B and a cure for hepatitis C, the elimination of viral hepatitis is achievable, but greater awareness of the disease and the risks is a must, as is access to cheaper diagnostics and treatment.
Meningitis is an acute inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. Several different bacteria can cause meningitis. Neisseria meningitidis is the one with the potential to cause large epidemics. There are 12 serogroups of N. meningitidis that have been identified, 6 of which (A, B, C, W, X and Y) can cause epidemics.
For some causes of meningitis, protection can be provided in the long term through vaccination, or in the short term with antibiotics. Some behavioral measures may also be effective. Untreated bacterial meningitis is almost always fatal. With treatment the risk of death is
reduced.
In new-borns the risk of death with treatment is 20 to 30%, in older children it is around 2% with treatment. The death risk is higher for adults even with treatment at 19 to 37%.
