NIDIAG

Syndromic approach to Neglected Infectious Diseases (NID) at primary health care level: an international collaboration on integrated diagnostic-treatment platforms

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 Obiettivo del progetto (Objective)

'Neglected Infectious Diseases (NID) such as trypanosomiasis, leishmaniasis, schistosomiasis and soil-transmitted helminthiasis receive less than 5% of the global investment for tropical diseases research. Clinical praxis in disease-endemic countries (DEC) is rarely evidence based and does not make use of the latest innovations in diagnostic technology. NID–related research on diagnostics is particularly underfunded, and diagnostic tools are lacking for a number of NID. The aim of this proposal is to bridge the gap between existing technological innovation in diagnostics and clinical care practice for NID in resource-poor settings. The specific objectives are to develop simple, cost-effective diagnosis-treatment algorithms for three NID-related clinical syndromes: the persistent fever, the neurological and the digestive syndromes. Evidence-based algorithms for the primary care level will be designed with a patient-centred approach, following guidance from DEC stakeholders and making the best possible use of existing assays and treatments. Relevant diagnostic technology and diagnostic platforms will be introduced according to the specific epidemiological contexts in Africa and South-Asia. The research consortium brings together a network of clinical epidemiologists, a diagnostics development group, several partners from academia and SMEs. The consortium further includes workpackages on reference laboratory, economic evaluation, quality assurance and translation to policy. By developing accurate and affordable diagnostic platforms and by optimizing diagnostic-treatment algorithms, this project will rationalise treatment use, circumvent progression to severe presentations and thereby reduce NID morbidity/mortality and hinder the emergence of resistances. The project will result in two main deliverables: policy recommendation for health authorities in DEC, and a series of innovative diagnostic platforms.'

Introduzione (Teaser)

A global front on the diagnosis and management of neglected infectious diseases (NID) should significantly improve their therapeutic decision-making.

Descrizione progetto (Article)

Tropical diseases such as trypanosomiasis, leishmaniasis and schistosomiasis receive minimal funding for research and thus fall under the category of neglected infectious diseases (NID). Clinical management and treatment of these diseases in endemic countries is not evidence-based and hardly utilises the latest technology.

The EU-funded NIDIAG (Syndromic approach to neglected infectious diseases (NID) at primary health care level: an international collaboration on integrated diagnostic-treatment platforms) project aims to introduce technological innovations in diagnostics for NID-related clinical care. The primary goal is to develop evidence-based algorithms for the treatment and diagnosis of the NID-related persistent fever, neurological and digestive syndromes. By bringing in experts in clinical epidemiology and diagnostics, the consortium will focus on Africa and South Asia.

As a first step, partners will perform an epidemiological assessment of relevant NIDs and the existing diagnostic capacity in the participating NID-endemic countries. Next, the plan is to perform clinical studies on the three NID-related syndromes as well as develop novel diagnostic tests.

Considerable work has been devoted towards a rapid diagnostic test for human African trypanosomiasis (HAT), which has already passed phase II evaluation. Phase III evaluation is scheduled in the near future.

Cost-effectiveness analyses are underway in different countries to find the most financially viable solution for regional NID management. The aim is to overcome vertical approaches in NID management and improve the quality of offered healthcare. For this purpose, local personnel are undergoing extensive training on diagnosis and disease management.

Collectively, the activities of the NIDIAG study will provide clinicians important tools towards NID management and treatment. Long-term the aim is to rationalise drug use, and avoid disease progression, thereby reducing NID-associated morbidity and mortality.