Over 1 billion people are infected with one or more NTDs. LSHTM researcher expertise extends over the vast majority of these often diverse diseases.
The LSHTM NTD Network is comprised of over 100 researchers with expertise in a wide range of diseases, research foci and specialties.
LSHTM is a founding member of the London Centre of NTD Research. An innovative research collaboration between LSHTM, Imperial College London, Natural History Museum and the Royal veterinary College.
Neglected tropical diseases (NTDs) are a diverse group of communicable diseases that impact on the lives of more than one billion people, causing mortality, morbidity, disability and stigma.
Communities living in poverty, without adequate sanitation and in close contact with infectious vectors and domestic animals and livestock are those worst affected.
The World Health Organization currently identify over 20 different diseases as NTDs. Research expertise at LSTHM covers 10 of these diseases. Click on the titles below to find out more about each disease and the researchers working on them.
- Buruli ulcer
Buruli ulcer is caused by a germ that produces a toxin – mycolactone – which destroys tissue. Mode of transmission is not known but infection leads to large painful ulcers usually on the legs or arms. Patients who do not receive early treatment suffer long-term disability. Early diagnosis and treatment are the only ways to minimize morbidity and prevent disability.
- Chagas (American trypanosomiasis)
Chagas disease, also known as American trypanosomiasis, is a potentially life-threatening illness caused by the protozoan parasite Trypanosoma cruzi (T. cruzi) transmitted by triatomine bugs. It infects about 6 million to 7 million people mostly in Latin America. Up to 30% of chronically infected people develop cardiac alterations and up to 10% develop digestive, neurological or mixed alterations which may require specific treatment. Vector control is the most useful method to prevent the disease.
Dengue is a mosquito-borne viral infection causing a severe flu-like illness and, sometimes causing a potentially lethal complication called severe dengue.Up to 50-100 million infections are now estimated to occur annually in over 100 endemic countries, putting almost half of the world’s population at risk. Severe dengue affects Asian and Latin American countries and has become a leading cause of hospitalization and death among children and adults in these regions.
- Human African trypanosomiasis (sleeping sickness)
Human African trypanosomiasis (HAT), also known as sleeping sickness, is a parasitic disease transmitted by the bite of the 'Glossina' insect, commonly known as the tsetse fly. The disease mostly affects poor populations living in remote rural areas of Africa. Untreated, it is usually fatal.
- Find LSHTM researchers working on Human African trypanosomiasis (sleeping sickness)
- LSHTM research on Human African trypanosomiasis (sleeping sickness)
The leishmaniases are a group of diseases caused by protozoan parasites from more than 20 Leishmania species.Parasites are are transmited by a femal phlebotomine sandfly. There are three main forms of leishmaniasis: cutaneous, visceral or kala-azar, and mucocutaneous. Leishmaniasis refers to the fact of becoming sick due to a Leishmania infection and not the mere fact of being infected with the parasite.
- Find LSHTM researchers working on Leishmaniasis
- LSHTM research on Leishmaniasis
- Research Online - Leishmaniasis
- KalaCORE - Control and elimination of Visceral Leishmaniasis
- SPEAK India - Setting the Post-Elimination Agenda for Kala-Azar in India
- A randomized trial of monotherapy and combination therapies for the treatment of VL in HIV positive patients in India
- Design and analysis of clinical trials for the treatment of VL
- Mathematical modelling of NTDs to support control and elimination
- Virtual laboratory for leishmaniasi
Leprosy is a chronic infectious disease caused by Mycobacterium leprae. The disease mainly affects the skin, the peripheral nerves, mucosal surfaces of the upper respiratory tract and the eyes. Leprosy is curable and early treatment averts most disabilities.The exact mechanism of transmission of leprosy is not known.
- Lymphatic filariasis
Lymphatic filariasis, commonly known as elephantiasis, is caused by three species of thread-like nematode worms, known as filariae. Filarial infection can cause a variety of clinical manifestations, including lymphoedema of the limbs, genital disease (hydrocele, chylocele, and swelling of the scrotum and penis) and recurrent acute attacks, which are extremely painful and are accompanied by fever.
- Find LSHTM researchers working on Lymphatic filariasis
- LSHTM research on Lymphatic filariasis
Onchocerciasis, also known as “river blindness”, is caused by the parasitic worm Onchocerca volvulus, transmitted through the bite of infected blackflies. Symptoms include severe itching, disfiguring skin conditions, and visual impairment, including permanent blindness. More than 99% of infected people live in 31 African countries. 99% of those infected live in 31 African countries. Community-directed treatment with ivermectin is the core strategy to eliminate onchocerciasis in Africa.
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. Scabies infestation is frequently complicated by bacterial infection, leading to the development of skin sores that, in turn, can cause more serious consequences such as septicaemia, heart disease and chronic kidney disease. Scabies is one of the commonest dermatological conditions, accounting for a substantial proportion of skin disease in developing countries. Globally, it affects more than 130 million people at any time.
Schistosomiasis infection occurs when people come into contact with fresh water infested with the larval forms (cercariae) of parasitic blood flukes, known as schistosomes. The microscopic adult worms live in the veins draining the urinary tract and intestines. Schistosomiasis affects almost 240 million people worldwide, and more than 700 million people live in endemic areas. Infection leads to chronic ill-health including increased rates of malnutrition, aneamia etc.
- Find LSHTM researchers working on Schistosomiasis
- LSHTM research on Schistosomiasis
- Research Online - schistosomiasis
- Validation of home-based self-sampling for the diagnosis of female genital schistosomiasis (FGS) in Zambian women with and without HIV seroconversion
- Global Atlas of Helminth Infection (GAHI)
- Studies towards infectious disease elimination on the Bijagos Archipelago of Guinea Bissau
- Development and application of a recombinase polymerase amplification (RPA) point-of-care test for the detection of Giardiasis in resource limited settings
- Lake Victoria Island Intervention Study on Worms and Allergy-related diseases (LaVIISWA)
- Soil-transmitted helminthiases
Soil-transmitted helminth infections are among the most common infections worldwide and affect the poorest and most deprived communities. They are transmitted by eggs present in human faeces which in turn contaminate soil in areas where sanitation is poor. Intestinal worms produce a wide range of symptoms including intestinal manifestations (diarrhoea, abdominal pain), general malaise and weakness. Hookworms cause chronic intestinal blood loss that result in anaemia
- Find LSHTM researchers working on Soil-transmitted helminths
- LSHTM research on Soil-transmitted helminthiases
Trachoma is the leading infectious cause of blindness in the world. Infection spreads from person to person, particularly from child to child and from child to mother to child. The disease thrives especially in crowded living conditions where there are shortages of water, inadequate sanitation and where numerous eye-seeking flies are present.
- Find LSHTM researchers working on Trachoma
- LSHTM research on Trachoma
- Research Online - Trachoma
- Environmental Health Group
- International center for Eye Health (ICEH)
- Studies towards infectious disease elimination on the Bijagos Archipelago of Guinea Bissau
- Extended mapping of trachoma in the Western Pacific Region
- Developing a chlamydia trachomatis vaccine for ocular infections: TRACVAC
- Eliminating trachoma in Malawi: towards a critical biosocial perspective
- The immunological determinants of protective immunity and immunopathology in trachoma
- Genetic susceptibility to scarring trachoma
- Training materials
- Eliminating Trachoma - An online course in which participants discover how communities and experts are joining together to end trachoma disease across 51 endemic coutnries by the year 2020.
- Yaws (Endemic treponematoses)
Yaws is a poverty-related chronic skin disease that affects mainly children below 15 years of age (with a peak between 6 and 10 years). The bacterial disease is transmitted by skin contact. Yaws mainly affects the skin, but can also involve the bone and cartilage. Early detection and treatment can avoid the gross disfigurement and disability which occur in about 10% of cases.
- Zoonotic diseases
WHO defines zoonoses as diseases and infections that are naturally transmitted between vertebrate animals and humans. A zoonotic agent may be a bacterium, a virus, a fungus or other communicable disease agent. At least 61% of all human pathogens are zoonotic, and have represented 75% of all emerging pathogens during the past decade.
- Find LSHTM researchers working on Zoonotic disease
- LSHTM research on neglected zoonoses
The multi-faceted challenge of controlling and eliminating NTDs as a public health concern requires a complex multidisciplinary response. With over 100 researchers working in the field of NTDs LSHTM provides a vital source of expertise and research findings to support governments and their development partners to develop the tools, policies and programmes they need to effectively target these diseases.
These research focuses can be grouped under three main categories:
Genomics, drugs and control tools
LSHTM research is at the forefront of efforts to develop and improve the tools and medicines needed to identify, target and treat NTDs.
A necessary step in understanding how to tackle NTDs is to understand the genomes of the parasites that cause the diseases. Genomic research by LSHTM is providing insights to facilitate the development of new strategies to prevent and treat these debilitating diseases.
LSHTM has longstanding expertise in the identification and development of new control tools and treatments. This expertise ranges from the development of new vaccines to research improving our understanding of anti-microbial resistance. LSHTM also serves as a centre of excellence for cutting edge research into disease control measures focusing on integrated vector management.
Selected research focusing on genomics, drugs and control tools:
Antimicrobial Resistance Centre - brings together a range of disciplines to promote and facilitate high quality research into anti-microbial resistance.
Arthropod Control Product Test Centre (arctec) - is an independent test centre for the evaluation and development of arthropod pest control technologies.
Vaccine Centre - is a collaborative partnership of over 100 scientists that aims to improve human and animal health through vaccination. Specifically they aim to develop new vaccines and evaluate their biological potential; test new vaccines for safety, immunogenicity and efficacy; and evaluate and optimise vaccine programmes and policies.
Pathogen Genome Cluster Computer - provides high performance computer clusters to provide the computation capacity necessary to conduct phylogenomic analysis of Trypanosoma cruzi the causative agent of South American trypanosomiasis. The outputs of the work provide insights into drug and vaccine candidates for Trypanosoma cruzi.Development and application of a recombinase polymerase amplification(RPA) point-of-care test for the detection of Giardiasis in resource limited settings - with advances in isothermal DNA amplification technology, this project intends to refine and adapt a novel field-appropriate, POC test based on recombinase polymerase amplification (RPA) useful in resource-poor settings and able to differentiate infection intensities.
- Characterisation of uptake and sub-cellular transit of human serum trypanolytic factors by Trypanosoma brucei – this project seeks to identify and characterise the parasite factors and pathways that support the lytic action of human serum and apolipoprotein-L1 against T. b. brucei.
Diagnostics, epidemiology and trials
The study and analysis of the patterns, causes and effects of NTDS on the communities they infect is at the core of efforts to control and eliminate NTDs.
LSHTM is a leading centre of NTD epidemiological research, encompassing spatial, statistical, environmental and genetic approaches alongside statistical and mathematical modelling. This expertise helps to map and predict the prevalence of NTDs and understand the underlying patterns which can be used to inform policy decisions and encourage evidence-based practices.
Decision making is also informed by effective and efficient tools to monitor and detect diseases. LSHTM researchers are working to improve diagnostics for NTDs which are vital for guiding control strategies at different thresholds of control, interruption of transmission, elimination and post-elimination surveillance.
Finally, to test treatment regimes or identify programmatic efficiencies LSTHM researchers are conducting a range of clinical and programmatic treatment trials. These range from testing different drug combinations to treat yaws infections on islands in the South Pacific to measuring the effectiveness of wide-scale deworming programmes in Malawi to eliminate STH.
Selected diagnostics, epidemiology and trials research:
London Applied and Spatial Epidemiology Research Group (LASER) - combines expertise in the fields of spatial statistics and GIS technology, quantitative epidemiology and operational research to build the evidence-base around diseases of poverty and the communities they affect.
Tropical Epidemiology Group - includes statistical epidemiologists specialising in studies on the epidemiology and control of major public health problems of developing countries, in particular Africa and Asia, with a special emphasis on intervention studies. The group conducts researches into trachoma, visceral leishmaniasis, helminth infections, and dengue.
Social and Mathematical Epidemiology (SaME) group - is a dynamic group of about 40 researchers working on a variety of areas in public health. A focus of this working is the mathematical modelling of the NTDs in particular leprosy and visceral leishmaniasis.
The Centre for the Mathematical Modelling of Infectious Diseases - is a multidisciplinary grouping of epidemiologists, mathematicians, economists, statisticians and clinicians from across all three faculties of LSHTM. CMMID interests in NTDs include work modelling dengue fever, lymphatic filariasis, schistosomiasis and trypanosomiasis.
Open Data Kit @ LSHTM - an electronic data collection service to help scientific researchers use ODK in their projects.
Erythema Nodosum Leprosum International STudy (ENLIST) Group - is a conducting two double blind randomised clinical trials to determine if methotrexate (an immunosuppressant) improves the outcomes for individuals with these severe episodes of inflammation as a result of treatment for leprosy.
Mapping and modelling
- Global Atlas of Helminth infections - GAHI shows the geographical distribution of neglected tropical diseases transmitted by worms: soil-transmitted helminthiasis, schistosomiasis, and lymphatic filariasis. All GAHI resources are available on an open access basis.
- Improving NTD mapping by integrating case-management and disease data – research project in partnership with AIM Initiative
- Studies towards infectious disease elimination on the Bijagos Archipelago of Guinea Bissau - mapping the epidemiology and social determinants of malaria and ntds including yaws, lymphatic filariasis, schistosomiasis and soil transmitted helminths in the islands.
- Mathematical modelling of NTD to support control and elimination - developing robust, validated analyses of transmission dynamic models of 9 of the 10 diseases in the London Declaration.
- Extended mapping of trachoma in the Western Pacific Region - using population based sero-epidemiological screening data together with direct tests for ocular infection and high resolution photography to understand the health threat that trachoma poses in the region.
- Projections on eliminating NTDs (integrating mapping with modelling) - combining geo-spatial mapping and transmission modelling to provide local estimates of the impact of intervention programs for onchocerciasis, lymphatic filariasis and the Gambian form of human African trypanosomiasis (gHAT) in priority countries in Africa.
- NTD Modelling Consortium: Reaching the 2020 Goals for human onchocerciasis - This project explores, using mathematical models of onchocerciasis transmission and control.
- Mathematical modelling of transmission and control, clinical trial simulation and epidemiological data analysis: The DeWorm3 Project - the DeWorm3 project is seeking to determine the feasibility of interrupting the transmission of three types of STHs in three trial sites.
- Validation of home-based self-sampling for the diagnosis of female genital schistosomiasis (FGS) in Zambian women with and without HIV seroconversion Methotrexate and Prednisolone studies in Erythema Nodosum Leprosum (MaPs in ENL)
- TUMIKIA Project - is a large clust RCT to determine whether combining school- and community-based deworming is more effective at controling and eliminating soil-transmitted helminths (STH or intestinal worms) in Kenya than school-based deworming alone.
- Lake Victoria Island Intervention Study on Worms and Allergy-related diseases (LaVIISWA) - a cluster RCT to evaluate whether effective anthelminthic treatment will result in a substantially increased prevalence and incidence of allergy in Lake Victoria island communities in which helminth prevalence is still high.
- Entebbe Mother and Baby Study - a trial to investigate possible benefits of treating worm infections during pregnancy and early childhood.
- Design and analysis of clinical trials for the treatment of Visceral Leishmaniasis (VL) - a series of Phase 2 and Phase 3 treatment trials for VL in East Africa conducted to identify safe, efficacious short-course treatments for VL patients in East Africa.
- Comparison of two different doses of azithromycin for treatment of yaws - single blinded, randomized, controlled open label non-inferiority phase III, trial with two parallel groups, conducted in Ghana and Papua New Guinea.
- Cluster Randomised Trial comparing one versus two doses of ivermectin for mass drug administration to control scabies - compares the impact of a single dose of ivermectin vs two doses of ivermectin as part of mass drug administration for the control of scabies in the Solomon Islands.
- A randomized trial of AmBisome® monotherapy and combination of AmBisome® and miltefosine for the treatment of VL in HIV positive patients in India - phase 3 randomised controlled trial based in Bihar, India to generate evidence for the best treatment for patients with visceral leishmaniasis who are co-infected with HIV.
Programmes, policy and health systems
Research has an important role to play in improving health systems and health care delivery. LSTHM researcher provides the NTD community with objective scientific evidence to identify what control approaches work, what does not, and why. This enables stakeholders to develop effective implementation strategies that are appropriate for the environment in which they are needed.
Selected LSHTM research on programmes, policy and health systems:
Communicable Diseases Policy Research Group - conducts research across the SE Asia region, and beyond. It provides a focus of expertise on the diverse public health problems associated with communicable disease control internationally and carries out research that is in support of and for policy reform.
Speak India: Setting the Post-Elimination Agenda for Kala-Azar in India - aims to develop a consensus on the additional knowledge required to ensure VL transmission is successfully interrupted and elimination is sustained.
KalaCORE - is a partnership to support the control and elimination of visceral leishmaniasis in six countries, three in Asia (India, Nepal and Bangladesh) and three in Africa (Ethiopia, Sudan and South Sudan).
Environmental Health Group - works with a range of other partners in the areas of hygiene, water, sanitation, behavior change, policy, capacity building and disease control including an expertise in helminths and trachoma. EHG combines engineering with epidemiology, biology, the social sciences and economics and encompasses:
- Hygiene central - develops and applies knowledge that will help improve hygiene, sanitation and household water treatment worldwide.
- Sanitation and Hygiene Applied Research for Equity SHARE - contributes to achieving universal access to effective, sustainable and equitable sanitation and hygiene by generating evidence to improve policy and practice worldwide.
- AfricanSnows – builds African capacity for interdisciplinary research in water supply, sanitation and environmental health, bringing together universities from across the continent, with research active universities in the North.
- Investigating Networks of Zoonosis Innovation (INZI) - is exploring how African trypanosomiasis (sleeping sickness) has been researched, understood and controlled from the Second World War to the present day.
- Eliminating trachoma in Malawi - critical biosocial analysis to show how biomedical categories of diagnosis, assumptions of transmission, and technologies of elimination, shape trachoma at a local level.
LSHTM is a founding member of the London Centre of NTD Research, a innovative collaboration between NTD researchers from LSHTM, Imperial College London, Natural History Museum and the Royal Veterinary College.
The London School of Hygiene and Tropical Medicine is a founding member of the London Centre for Neglected Tropical Disease Research (LCNTDR). Ann innovative research collaboration, bringing together leading experts to tackle diseases which affect the lives of over 1.7 billion of the poorest people across the globe.
The LCNTDR undertakes cutting-edge research to build the evidence base around the design, implementation and evaluation of neglected tropical disease control and elimination programmes.
The LCNTDR was launched in 2013 with the aim of providing focused operational and research support for NTD control. The LCNTDR member institutions house leading NTD experts with a wide range of specialties, making the Centre a valuable resource for cross-sectoral research and collaboration.
It is a joint initiative of:
- Royal Veterinary College
- Imperial College London
- London School of Hygiene & Tropical Medicine
- Natural History Museum
The LCNTDR will facilitate coordination of NTD research activities between its members, with its priority being to enhance efforts to control some of the most common NTDs worldwide.
- Provide evidence based technical and training support to countries investing in national NTD programmes;
- Support harmonization of multi-sectoral partnerships and collaborations;
- Act as an NTD knowledge base for disseminating innovative and evidence based information for policy and programme formulation;
- Provide a neutral coordinating platform for partner collaboration on NTD control and prevention efforts;
- Carry out research on new approaches to the study of the geography, transmission dynamics and control of NTDs, with a particular focus on integrated diagnosis and mapping and integrated control of more than one NTD.