Neglected and (re-)emergent infections of the CNS i n low-/middle-income countries

Graciela Cárdenas; Perla Salgado; Enrique Laura-Foronda; Ignacio Popoca-Rodriguez; Rosa Delia Delgado-Hernández; Rafael Rojas; Enrique Palacios

doi:10.53854/liim-2904-3

Neglected and (re-)emergent infections of the CNS i n low-/middle-income countries

Infez Med. 2021 Dec 10;29(4):513-525. doi: 10.53854/liim-2904-3. eCollection 2021.

Authors

Graciela Cárdenas¹, Perla Salgado², Enrique Laura-Foronda¹, Ignacio Popoca-Rodriguez¹, Rosa Delia Delgado-Hernández², Rafael Rojas³, Enrique Palacios⁴

Affiliations

¹ Neuro-infectious Diseases Department, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, Mexico.
² Neuroimaging Department, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, Mexico.
³ Neuroimaging Department, The Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusett, USA.
⁴ Neuroimaging Department, Tulane University, New Orleans, USA.

Abstract

Low- and middle-income countries (LMIC) have suffered from long-term health system deficiencies, worsened by poor living conditions, lack of sanitation, a restricted access to health facilities and running water, overcrowding, and overpopulation. These factors favor human displacement and deepen marginalization; consequently, their population endures a high burden of infectious diseases. In this context, the current epidemiological landscape and its impact on health and economic development are not promissory, despite the commitment by the international community to eradicate neglected tropical infections - especially tuberculosis and malaria, by 2030. Neglected and (re)-emerging infectious diseases affecting the central nervous system (CNS) are a major public health concern in these countries, as they cause a great morbidity and mortality; furthermore, survivors often suffer from severe neurological disabilities. Herein, we present a retrospective review focused on some neglected and (re)-emerging infectious diseases, including neurocysticercosis, malaria, rabies, West Nile virus encephalitis, tuberculosis, neuroborreliosis, and SARS-CoV-2 in LMIC. A retrospective review of studies on selected neglected and (re)-emerging infectious diseases in LMIC was performed, including reports by the World Health Organization (WHO) published within the last five years. Data on infection by SARS-CoV-2 were provided by the John Hopkins University Coronavirus Resource Center. CNS neglected and (re)-emerging infectious diseases remain as important causes of disease in LMIC. An alarming increase in the prevalence of malaria, tuberculosis, and cysticercosis is observed in the region, compounded by the recent COVID-19 pandemic. The WHO is currently supporting programs/efforts to cope with these diseases. Herein, we highlight the epidemiological burden of some CNS infections in LMIC, and their clinical and neuroimaging features, to facilitate an accurate diagnosis, considering that most of these diseases will not be eradicated in the short term; instead, their incidence will likely increase along with poverty, inequality, and related socioeconomic problems.

Keywords: Neglected; central nervous system; emergent; infections; low/middle income countries.

Publication types

Review