Via PLOS Neglected Tropical Diseases: NTD and NCD Co-morbidities: The Example of Dengue Fever. Excerpt:
Recent findings of paradoxically high endemicity of neglected tropical diseases (NTDs) among populations living in the Group of 20 (G20) countries could portend high rates of these diseases among patients with underlying non-communicable diseases (NCDs), with resultant co-morbidities.
Today, the G20 countries, together with Nigeria, account for a surprising burden of the world’s NTDs, including approximately one-half of the major helminth infections and almost two-thirds or more of dengue, leprosy, Chagas disease, and leishmaniasis as well as tuberculosis. This finding has led to evidence of widespread neglected diseases among the poor who live in proximity to wealth, a concept that has been termed “blue marble health”.
Additional evidence that 70% of NCDs are also found in the G20 countries and Nigeria suggests the possibility that we should find significant geographic overlap between NTDs and NCDs, especially in the largest middle-income countries such as Brazil, India, Indonesia, Mexico, and China. Ultimately, we can expect to see NTDs occurring among patients with underlying NCDs, and it will be of interest to determine whether unique co-morbidities arise as a result of such a clinical scenario.
Dengue and NCDs
Dengue fever represents a potentially important example of an NTD now rapidly emerging or re-emerging among the G20 countries.
According to the Global Burden of Diseases, Injuries, and Risk Factors 2013 study (GBD 2013), the incidence of dengue has increased an astounding 610.87% between 1990 and 2013 with up to 390 million cases now occurring annually.
The largest number of cases of dengue is found in South Asia, especially India and Bangladesh, as well as in Southeast Asia—Indonesia, China, Philippines, Vietnam, Thailand—and in Brazil and Mexico in the Americas. These same countries also account for some of the highest deaths resulting from NCDs, including diabetes, cardiovascular disease, cancer, and chronic obstructive pulmonary disease.
The literature on dengue co-morbidities with NCDs in Asia and the Americas is still in a relatively nascent stage, but it is growing. There is evidence that dengue exacerbates the effects of NCDs and vice versa.