Tropical Medicine – the global issue

 

By Dr Philippa C. Matthews 

 

Image credit: Street by aamiraimer. CC0 Public Domain via Pixabay.


Everyone is vulnerable to threats which wreak their worst effects in the tropics – organisms like Streptococcus pneumoniae (a cause of pneumonia) and E. coli (a cause of diarrhoea and urinary tract infections) are common the world over. In Africa, malaria still kills over 290,000 children every year – that is a child every two minutes. None of us should absolve ourselves of responsibility for continued investment in tackling this humanitarian tragedy.

 

The Ebola virus (read this freely available chapter), arising out of a tropical situation, was in no way confined by the bounds of Cancer and Capricorn; it had the potential to take hold in situations of poverty and limited infrastructure and then to spread fast, facilitated by its huge infectivity, and fuelled by human behaviour and environments including crowding, migration, and international travel. Other organisms, like cholera, measles, meningitis, and polio rear their heads in disaster situations; in a world so uncertain, none of us knows when this is around the next corner.

 

Changes in climate and the environment allow creatures that are the reservoirs and vectors of infection to spread to new locations; the concern for the Zika epidemic in South America has been its rapid dissemination by a mosquito that has the potential to become ubiquitous. The spread of organisms that are resistant to multiple drugs is another major threat to global health. One example is Mycobacterium tuberculosis, the organism that causes TB, where multi-drug resistant (MDR) and extensively-drug resistant (XDR) strains are now well-established. Associated with a high burden of disease, high death rates, and difficult, expensive treatment, these organisms are by no means confined to the tropics.

 

Financial security too has an impact on ‘tropical disease’. Infections that flourish in the tropics continue to cause a catastrophic burden at the level of individual patients, their families, and wider society at national and international level. They impose an enormous economic cost upon healthcare systems and society, related both to providing care and to the lost output of young adults who are unable to contribute to society through work or raising their families. Labelling them as ‘tropical’ identifies a strong association with some of the world’s most vulnerable settings – but perhaps we need to move on from the term ‘tropical medicine’ to considering ‘global health’. The strides we make against ‘tropical diseases’ represent steps forward for us all.

 

A longer version of this post was first published on the OUPblog.


Philippa C Matthews is a Wellcome Trust Clinical Research Fellow at the Nuffield Department of Medicine, University of Oxford, and is Honorary Consultant in Infectious Diseases and Microbiology at Oxford University Hospitals NHS Foundation Trust.

 

Dr Matthews is the author of Tropical Medicine Notebook, is now available in print and online.

 

Follow Dr Matthews on Twitter @pippa_matt.

 
For previous articles, visit our Article Archive.

 

 

 

New and recently updated: 

 

       

 

    

  

    

 

 

 

 

  

 

 

           

   

   

    

 

 Helpful Resources:  

 For Librarians: 

 

News

October 16, 2017

Lyme Disease Fact Sheet

With an increased risk of Lyme Disease, the bacterial infection spread through tick bites, learn more from some of the best resources on Oxford Medicine Online collated into a Lyme Disease fact sheet.

October 12, 2017

Free chapters from Medical Ethics reading list

This year marks 70 years since the conclusion of the Doctors' Trial at Nuremburg, an important milestone in the development of bioethics, which considers ethical practices for dealing with experiments and research involving human subjects. Read free chapters on the ethics of human research through our specially-curated reading list.
 

October 9, 2017

‘Universal’ Flu Jab

Researchers may have finally cracked the code for a “universal” flu jab. Read more about the deadly pandemic that galvanised the global medical community to work towards this goal, and other lessons from the last 20 years in healthcare.