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Brighton & Sussex Medical School

Tackling Neglected Tropical Diseases

BSMS > Research > Global health and Infection > Infection > Tackling neglected tropical diseases

Tackling neglected tropical diseases

It is estimated that over one billion people from the world’s most disadvantaged and poorest communities suffer from at least one neglected tropical disease (NTD), which can significantly impact upon their physical and emotional wellbeing.

The Brighton and Sussex Centre for Global Health Research acts as an international, multidisciplinary, research hub for three Neglected Tropical Diseases: podoconiosis, mycetoma and scabies.

Our research has a strong focus on capacity building, and we try to create enduring and equitable partnerships and that provide evidence to influence policy to meet our long-term goal of improving the health and wellbeing of those affected by NTDs. Researchers work on a range of subjects including epidemiology, immunology, environmental triggers, genetics, bioethics, health economics, clinical management and societal impact of these diseases.

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Podoconiosis

Podoconiosis, also known as ‘podo’, is a non-filarial form of lymphoedema which is endemic to the tropical, highland areas of Africa, central America and Asia and affects an estimated four million people in Africa alone. The disease is caused by a reaction to the volcanic soils unique to these regions and symptoms include disfigurement of the feet and lower legs and painful disabling acute attacks.

Podo is prevalent among subsistence farming communities who spend the majority of their time working barefoot in clay soils. Years of exposure can result in debilitating mobility issues, affecting people’s ability to earn a living. Local stigmatisation of the disease results in affected people and sometimes also their families being ostracised from their communities.

Professor Gail Davey came across cases of podoconiosis in Ethiopia’s southern districts in 2001, while working at the School of Public Health at Addis Ababa University. Podoconiosis had been largely forgotten as a tropical disease in western medicine and was not recognised locally by health authorities. She began building a research programme with the long-term aim of finding a way to eliminate podo globally.

Podoconiosis research areas at BSMS

To date, research has mapped the distribution and defined the burden of podoconiosis in Ethiopia in terms of disease prevalence, economic cost and the effects on mental health and society. Aetiological research has identified genetic variants conferring susceptibility and plausible mineral triggers of the disease. Mapping studies have been extended to Cameroon and Rwanda as the Podoconiosis Global Atlas project progresses.

Clinical staging, stigma and quality of life tools have been developed, and co-endemicity with other neglected tropical diseases documented. Behavioural work has identified common misconceptions about the condition and barriers to healthcare access. A simple treatment package has been tested, and strategies of delivering this package piloted.  

Future strategies

Research priorities over the next few years include finishing the global mapping of podoconiosis, further investigation into the immunology and pathogenesis of the disease, development of a point-of-care diagnostic test, and investigation of approaches to integrating care into state health systems, together with care of other foot-related diseases as well as building an understanding of the disease and its effects using a social science lens. 

Several of these projects are supported through the NIHR Unit on Neglected Tropical Diseases and the 5S Foundation based at BSMS.  

Researchers working on podoconiosis projects

Please click on each name to read more about their specific projects.

Prof Gail Davey >
Prof Melanie Newport >
Prof Abebaw Fekadu >
Dr Shahaduz Zaman >
Dr Kebede Deribe > 
Dr Natalia Ivashikina >
Dr Mei Trueba >
Dr Maya Semrau >
Dr Papreen Nahar >

PhD students and post-doctoral research fellows:

Dr Maya Semrau >
Dr Belete Legesse
Konstantinos Hatzikoulas
Dr Diana Alcantara >
Abdi Samuel
Dr Tabassum-Ur-Razaq Qureshi
Dereje Nigussie
Dr Oumer Ali  
Mikias Negash
Harriet Gislam
Kibur Engdawork
Dr Abraham Tesfaye 
Jean-Paul Bikorimana  
Dr Osama El Nour 
Dr Richard Kalisa 

MycetomaRC

Mycetoma

Mycetoma is a chronic, progressively destructive morbid inflammatory disease which usually affects the foot, but any part of the body can be affected. Infection is most probably acquired by traumatic inoculation of certain fungi or ‎bacteria into the subcutaneous tissue. Mycetoma was first described in the modern literature in 1694, but was first reported in the mid-19th century in the Indian town of Madura, and hence was initially called Madura foot. 

Mycetoma commonly affects young adults, particularly males aged between 20 and 40 years, mostly in developing countries. People of low socioeconomic status and manual workers such as agriculturalists, labourers and herdsmen are the worst affected.

Mycetoma has numerous adverse medical, health and socioeconomic impacts on patients, communities and health authorities.  As mycetoma is a badly neglected disease, accurate data on its incidence and prevalence are not available. However, early detection and treatment are important to reduce morbidity and improve treatment outcomes. 

Mycetoma research areas at BSMS

Epidemiological mapping of mycetoma in Sudan 

This project is part of the NIHR Unit on Neglected Tropical Diseases based at BSMS. The aim is to create an epidemiological map of mycetoma in Sudan. It will involve the development of a case definition algorithm in the first two years of the programme and nationwide fieldwork. Geospatial modelling will take place from the second year along with an economic analysis of the burden of disease. The work will aim to ascertain environmental risk factors for Mycetoma. This work is being undertaken in collaboration with the Mycetoma Research Centre at the University of Khartoum and the London School of Tropical Medicine and Hygiene.

Development of a community prevention programme

This project is part of the NIHR Unit on Neglected Tropical Diseases based at BSMS. The aim is to increase our understanding of mycetoma – the disease, its aetiology, and possible prevention. The work has included some in-depth anthropological observations, and a prevention package is now being developed. This project is being undertaken in collaboration with the Mycetoma Research Centre based at the University of Khartoum.

Mycetoma is one of the diseases which the 5S Foundation will focus on, looking to develop social science research capacity across our partner institutions, and ensure that there is an understanding of the disease from the perspective of the social sciences.

Researchers working on mycetoma projects

Please click on each name to read more about their specific projects.

Prof Melanie Newport >
Dr Natalia Ivashikina >
Dr Papreen Nahar >
Dr Shahaduz Zaman > 

PhD students and post-doctoral research fellows

Rayan Saifeldin Yousif Ali
Mohamed Nasr Mohamed Ahmed Elsheikh 
Rowa Fathelrahman Omer Hassan 
Dr Caroline Ackley >
Dr Gemma Aellah >

scabies mite

Scabies

Human scabies is a parasitic infestation caused by Sarcoptes scabiei var hominis. The mite, barely visible to the naked eye, burrows into the epidermis and lays eggs, triggering a host immune response that leads to intense itching in response to just a few mites.  

Globally, scabies affects more than 130 million people at any one time. Infestation is endemic in countries with hot, tropical climates, where infestation is endemic, especially in communities where overcrowding and poverty co-exist. In these settings, young children and the elderly are especially susceptible to scabies as well as to secondary complications of infestation such as bacterial infection which can lead to more serious consequences such as septicaemia, heart disease and chronic kidney disease.

Scabies research areas at BSMS

Impact Evaluation – Mass Drug Administration with ivermectin for scabies

This project is part of the NIHR Unit on Neglected Tropical Diseases based at BSMS. The aim is to refine the public response to scabies outbreaks in Ethiopia. In 2016 a sharp drop in the availability of water due to the worst drought the country had faced in decades led to a widespread outbreak of scabies. 

Scabies is one of the diseases which the 5S Foundation will focus on, looking to develop social science research capacity across our partner institutions, and ensure that there is an understanding of the disease from a broader human perspective. 

Researchers working on scabies projects

Please click on each name to read more about their specific projects.

Prof Gail Davey >
Prof Jackie Cassell >
Dr Natalia Ivashikina >
Prof Stephen Bremner > 
Dr Papreen Nahar >

PhD students and post-doctoral research fellows
Alexandra Rutherford
Robel Yirgu
Jo Middleton > 
Ursin Bayisenge 
Dereje Wonde 
Addisu Tsegaye
Dr Abraham Tesfaye