Diseases of poverty

Diseases of poverty

Diseases of poverty is a term sometimes used to collectively describe diseases and health conditions that are more prevalent among the poor than among wealthier people. In many cases poverty is considered the leading risk factor or determinant for such diseases, and in some cases the diseases themselves are identified as barriers to economic development that would end poverty. These diseases are in contrast to so-called "diseases of affluence", which are diseases thought to be a result of increasing wealth in a society.

Contents

Examples

At the global level, the three primary diseases of poverty are AIDS, malaria, and tuberculosis.[1] Developing countries account for 95% of the global AIDS prevalence[2] and 98% of active tuberculosis infections.[3] Furthermore, 90% of malaria deaths occur in sub-Saharan Africa.[4] Together, these three diseases account for 10% of global mortality.[1]

Three other diseases, measles, pneumonia, and diarrheal diseases are also closely associated with poverty, and are often included with AIDS, malaria, and tuberculosis in broader definitions and discussions of diseases of poverty.[5]

In addition, infant mortality and maternal mortality are far more prevalent among the poor. For example, 98% of the 11,600 daily maternal and neonatal deaths occur in developing countries.[6]

Together, diseases of poverty kill approximately 14 million people annually.[3] However, partial results released in October 2009 study on diarrheal diseases show they alone kill some 2.6 million people annually, much more than previously thought.[7][8]

AIDS

AIDS is a disease of the human immune system caused by the human immunodeficiency virus (HIV).[9] Primary modes of HIV transmission in sub-Saharan Africa are sexual intercourse, mother-to-child transmission (vertical transmission), and through HIV-infected blood.[10][11][12] Since rate of HIV transmission via heterosexual intercourse is so low, it is insufficient to cause AIDS disparities between countries.[10] Critics of AIDS policies promoting safe sexual behaviors believe that these policies miss the biological mechanisms and social risk factors that contribute to the high HIV rates in poorer countries. [10] In these developing countries, especially those in sub-Saharan Africa, certain health factors predispose the population to HIV infections.[13][14][15][16][17]

Mechanisms and Causes

For many environmental and social reasons, including crowded living and working conditions, inadequate sanitation, and disproportionate occupation as sex workers, the poor are more likely to be exposed to infectious diseases. Malnutrition, stress, overwork, and inadequate, inaccessible, or non-existent health care can hinder recovery and exacerbate the disease.[18] Malnutrition is associated with 54% of childhood deaths from diseases of poverty, and lack of skilled attendants during childbirth is primarily responsible for the high maternal and infant death rates among the poor.[6][19]

Lack of Nutrition

Malnutrition disproportionately affect those in sub-Saharan Africa. Over 35 percent of children under the age of 5 in sub-Saharan Africa show physical signs of malnutrition.[20] Malnutrition, the immune system, and infectious diseases operate in a cyclical manner: infectious diseases have deleterious effects on nutritional status, and nutritional deficiencies can lower the strength of the immune system which affects the body’s ability to resist infections.[20] Similarly, malnutrition of both macronutrients (such as protein and energy) and micronutrients (such as iron, zinc, and vitamins) increase susceptibility to HIV infections by interfering with the immune system and through other biological mechanisms. Depletion of macronutrients and micronutrients promotes viral replication that contributes to greater risks of HIV transmission from mother-to-child as well as those through sexual transmission.[21] Increased mother-to-child transmission is related to specific deficiencies in micronutrients such as vitamin A.[17][22] Further, anemia, a decrease in red the number of red blood cells, increases viral shedding in the birth canal, which also increases risk of mother-to-child transmission.[23] Without these vital nutrients, the body lacks the defense mechanisms to resist infections.[20] At the same time, HIV lowers the body’s ability to intake essential nutrients. HIV infection can affect the production of hormones that interfere with the metabolism of carbohydrates, proteins, and fats.[20]

Inadequate sanitation

Contaminated water and inadequate sanitation are related to diseases of poverty such as malaria, parasitic diseases, and schistosomiasis.[24] These infections act as cofactors that increase the risk of HIV transmission.[10]

Africa also accounts for a majority of malaria infections and deaths worldwide. Over 90 percent of the 300 to 500 million malaria infections occurring annually worldwide are in Africa. Each year, about one million malaria deaths happen in children under the age of five.[25] Malaria is directly related to the spread of HIV in sub-Saharan Africa.[26] It increases viral load seven to ten times, which increases the chances of transmission of HIV through sexual intercourse from a patient with malaria to an uninfected partner.[27] After the first pregnancy, HIV can also decrease the immunity to malaria. This contributes to the increase of the vulnerability to HIV and higher mortality from HIV, especially for women and infants.[28] HIV and malaria interact in a cyclical manner—being infected with malaria increases susceptibility to HIV infection, and HIV infections increase malarial episodes. The co-existence of HIV and malaria infections helps spread both diseases, particularly in Sub-Saharan Africa.[29]

Intestinal parasites are extremely prevalent in tropical areas.[10] These include hookworms, roundworms, and other amoebas. They can aggravate malnutrition by depleting essential nutrients through intestinal blood loss and chronic diarrhea. Chronic worm infections can further burden the immune system.[30][31] At the same time, chronic worm infections can cause immune activation that increases susceptibility of HIV infection and vulnerability to HIV replication once infected.

Schistosomiasis (bilharzia) is a parasitic disease caused by the parasitic flatworm trematodes. Moreover, more than 80 percent of the 200 million people worldwide who have schiostosomiasis live in sub-Saharan Africa.[32] Infections often occur in contaminated water where freshwater snails release larval forms of the parasite. After penetrating the skin and eventually traveling to the intestines or the urinary tract, the parasite lays eggs and infects those organs.[10][32] It damages the intestines, bladder, and other organs and can lead to anemia and protein-energy deficiency.[13][33] Along with malaria, schiostosomiasis is one of the most important parasitic cofactors aiding in HIV transmission. Epidemiological data shows schistosome-endemic areas coincide with areas of high HIV prevalence, suggesting that parasitic infections such as schiostosomiasis increase risk of HIV transmission.[34]

Consequences

Diseases of poverty reflect the dynamic relationship between poverty and poor health; while such diseases result directly from poverty, they also perpetuate and deepen impoverishment by sapping personal and national health and financial resources. For example, malaria decreases GDP growth by up to 1.3% in some developing nations, and by killing tens of millions in sub-Saharan Africa, AIDS alone threatens “the economies, social structures, and political stability of entire societies”.[35][36]

For Women

Women and children are often put at a high risk of being infected by schiostosomiasis, which in turn puts them at a higher risk of acquiring HIV.[10] Since the mode of schiostosomiasis transmission is usually through contaminated water in streams and lakes, women and children who do their household chores by the water are more likely to acquire the disease. Activities that women and children often do around waterfront include washing clothes, collecting water, bathing, and swimming.[10][32] Women who have schiostosomiasis lesions are three times more likely to be infected with HIV.[37]

Women also have a higher risk of HIV transmission through the use of medical equipment such as needles.[10] Because more women than men use health services, especially during pregnancy, they are more likely to come across unsterilized needles for injections.[11][37] Although statistics estimate that unsterilized needles only account for 5 to 10 percent of primary HIV infections, studies show this mode of HIV transmission may be higher than reported.[10][38] This increased risk of contracting HIV through non-sexual means has social consequences for women as well. Over half of the husbands of HIV-positive women in Africa tested HIV-negative.[39] When HIV-positive women reveal their HIV status to their HIV-negative husbands, they are often accused of infidelity and face violence and abandonment from their family and community.[10][39]

Relating to Human Capabilities

Malnutrition associated with HIV impacts people’s ability to provide for themselves and their dependents, thus limiting the human capabilities of both themselves and their dependents.[20] HIV can negatively affect work output, which impacts the ability to generate income.[40] This is crucial in parts of Africa where farming is the primary occupation and obtaining food is dependent on the agricultural outcome. Without adequate food production, malnutrition becomes more prevalent. Children are often collateral damage in the AIDS crisis. As dependents, they can be burdened by the illness and eventual death of one or both parents due to HIV/AIDS. Studies have shown that orphaned children are more likely to display physical symptoms of malnutrition than children whose parents are both alive.[20]

Proposed Policy Solutions

Changes to HIV/AIDS Policy

  • Nutrition Supplements: Focusing on reversing the pattern of malnutrition in sub-Saharan African and other poor countries is a one possible way of decreasing susceptibility to HIV infections. Micronutrients such as iron and vitamin A can be delivered and provided at a very low cost. For example, vitamin A supplements cost $0.02 per capsule if provided twice a year. Iron supplements per child cost $0.02 if provided weekly or $0.02 if provided daily.[10]
  • Eliminating Cofactors: Tackling the very diseases that increase risk of HIV infections can help slow down the rates of HIV transmission. Cofactors such as malaria and parasitic infections can be combated in an effective and cost-efficient manner. For example, mosquito nets can be easily used to prevent malaria.[10] Parasites can be eliminated with medication that is cost-effective and easy to administer. Twice-yearly treatments range from $0.02 to $0.25 depending on the type of worm.[41][42]

See also

External links

Further reading

References

  1. ^ a b WHO/WPRO-Poverty Issues Dominate RCM
  2. ^ "HIV/AIDS and Poverty". UNFPA State of World Population 2002. United Nations Population Fund. http://www.unfpa.org/swp/2002/english/ch6/index.htm. 
  3. ^ a b RESULTS: World Health/Diseases of Poverty.
  4. ^ Roll Back Malaria Partnership: What is malaria?
  5. ^ http://www.results.org/website/article.asp?id=238
  6. ^ a b WHO | Ensuring skilled care for every birth.
  7. ^ "Diarrhoea kills 3 times more". Straits Times. http://www.straitstimes.com/Breaking%2BNews/Tech%2Band%2BScience/Story/STIStory_448440.html. 
  8. ^ Manila Bulletin Publishing:Diarrhea causes 1.5 million infant deaths a year — UN.
  9. ^ Sepkowitz KA (June 2001). "AIDS—the first 20 years". N. Engl. J. Med. 344 (23): 1764–72. doi:10.1056/NEJM200106073442306. PMID 11396444. 
  10. ^ a b c d e f g h i j k l m Stillwaggon, Eileen (2008). "Race, Sex, and the Neglected Risks for Women and Girls in Sub-Saharan Africa". Feminist Economics 14 (4): 67–86. doi:10.1080/13545700802262923. 
  11. ^ a b Gisselquist D, Potterat JJ, Brody S, Vachon F (March 2003). "Let it be sexual: how health care transmission of AIDS in Africa was ignored". Int J STD AIDS 14 (3): 148–61. doi:10.1258/095646203762869151. PMID 12665437. http://ijsa.rsmjournals.com/cgi/pmidlookup?view=long&pmid=12665437. 
  12. ^ World Health Organization (WHO). 2003. ‘‘Unsafe Injection Practices: A Plague of Many Health Care Systems.’’ http://www.who.int/injection_safety/about/resources/ BackInfoUnsafe/en/ (accessed January 2004).
  13. ^ a b Scrimshaw NS, SanGiovanni JP (August 1997). "Synergism of nutrition, infection, and immunity: an overview". Am. J. Clin. Nutr. 66 (2): 464S–477S. PMID 9250134. http://www.ajcn.org/cgi/pmidlookup?view=long&pmid=9250134. 
  14. ^ Beisel WR (October 1996). "Nutrition in pediatric HIV infection: setting the research agenda. Nutrition and immune function: overview". J. Nutr. 126 (10 Suppl): 2611S–5S. PMID 8861922. http://jn.nutrition.org/cgi/pmidlookup?view=long&pmid=8861922. 
  15. ^ Woodward B (January 1998). "Protein, calories, and immune defenses". Nutr. Rev. 56 (1 Pt 2): S84–92. PMID 9481128. 
  16. ^ Cunningham-Rundles S (January 1998). "Analytical methods for evaluation of immune response in nutrient intervention". Nutr. Rev. 56 (1 Pt 2): S27–37. PMID 9481122. 
  17. ^ a b Semba RD, Miotti PG, Chiphangwi JD et al. (June 1994). "Maternal vitamin A deficiency and mother-to-child transmission of HIV-1". Lancet 343 (8913): 1593–7. doi:10.1016/S0140-6736(94)93056-2. PMID 7911919. 
  18. ^ "Health and Poverty". UNFPA State of World Population 2002. United Nations Population Fund. http://www.unfpa.org/swp/2002/english/ch5/index.htm. 
  19. ^ WHO | Goal 4: reduce child mortality
  20. ^ a b c d e f Piwoz, Ellen G.; Preble, Elizabeth A. (December 2000). "HIV/AIDS and Nutrition: A Review of the Literature and Recommendations for Nutritional Care and Support in Sub-Saharan Africa" (PDF). Washington DC: Academy for Educational Development. PN-ACK-673. http://www.dec.org/pdf_docs/PNACK673.pdf. 
  21. ^ Friis H, Michaelsen KF (March 1998). "Micronutrients and HIV infection: a review". Eur J Clin Nutr 52 (3): 157–63. doi:10.1038/sj.ejcn.1600546. PMID 9537299. 
  22. ^ Nimmagadda A, O'Brien WA, Goetz MB (March 1998). "The significance of vitamin A and carotenoid status in persons infected by the human immunodeficiency virus". Clin. Infect. Dis. 26 (3): 711–8. doi:10.1086/514565. PMID 9524850. http://www.cid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=9524850. 
  23. ^ John GC, Nduati RW, Mbori-Ngacha D et al. (January 1997). "Genital shedding of human immunodeficiency virus type 1 DNA during pregnancy: association with immunosuppression, abnormal cervical or vaginal discharge, and severe vitamin A deficiency". J. Infect. Dis. 175 (1): 57–62. doi:10.1093/infdis/175.1.57. PMID 8985196. http://www.jid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=8985196. 
  24. ^ "Common water and sanitation-related diseases". UNICEF. 2005. http://www.unicef.org/wash/index_wes_related.html. 
  25. ^ World Health Organization (WHO). 2004. http://www.who.int/tdt/diseases/malaria/diseaseinfo.htm (accessed March 2011).
  26. ^ Whitworth J, Morgan D, Quigley M et al. (September 2000). "Effect of HIV-1 and increasing immunosuppression on malaria parasitaemia and clinical episodes in adults in rural Uganda: a cohort study". Lancet 356 (9235): 1051–6. doi:10.1016/S0140-6736(00)02727-6. PMID 11009139. http://linkinghub.elsevier.com/retrieve/pii/S0140-6736(00)02727-6. 
  27. ^ Hoffman IF, Jere CS, Taylor TE et al. (March 1999). "The effect of Plasmodium falciparum malaria on HIV-1 RNA blood plasma concentration". AIDS 13 (4): 487–94. doi:10.1097/00002030-199903110-00007. PMID 10197377. http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0269-9370&volume=13&issue=4&spage=487. 
  28. ^ Rowland-Jones SL, Lohman B (October 2002). "Interactions between malaria and HIV infection-an emerging public health problem?". Microbes Infect. 4 (12): 1265–70. doi:10.1016/S1286-4579(02)01655-6. PMID 12467769. http://linkinghub.elsevier.com/retrieve/pii/S1286457902016556. 
  29. ^ Abu-Raddad LJ, Patnaik P, Kublin JG (December 2006). "Dual infection with HIV and malaria fuels the spread of both diseases in sub-Saharan Africa". Science 314 (5805): 1603–6. doi:10.1126/science.1132338. PMID 17158329. http://www.sciencemag.org/cgi/pmidlookup?view=short&pmid=17158329. 
  30. ^ Bentwich Z, Kalinkovich A, Weisman Z (April 1995). "Immune activation is a dominant factor in the pathogenesis of African AIDS". Immunol. Today 16 (4): 187–91. doi:10.1016/0167-5699(95)80119-7. PMID 7734046. http://linkinghub.elsevier.com/retrieve/pii/0167569995801197. 
  31. ^ Borkow G, Bentwich Z (May 2002). "Host background immunity and human immunodeficiency virus protective vaccines, a major consideration for vaccine efficacy in Africa and in developing countries". Clin. Diagn. Lab. Immunol. 9 (3): 505–7. doi:10.1128/CDLI.9.3.505-507.2002. PMC 119996. PMID 11986252. http://cvi.asm.org/cgi/pmidlookup?view=long&pmid=11986252. 
  32. ^ a b c World Health Organization (WHO). 2004. http://www.who.int/tdt/diseases/schisto/diseaseinfo.htm (accessed March 2011).
  33. ^ Stephenson L (1993). "The impact of schistosomiasis on human nutrition". Parasitology 107 (Suppl): S107–23. doi:10.1017/S0031182000075545. PMID 8115176. 
  34. ^ Harms G, Feldmeier H (June 2002). "HIV infection and tropical parasitic diseases — deleterious interactions in both directions?". Trop. Med. Int. Health 7 (6): 479–88. doi:10.1046/j.1365-3156.2002.00893.x. PMID 12031069. http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1360-2276&date=2002&volume=7&issue=6&spage=479. 
  35. ^ http://www.rbm.who.int/cmc_upload/0/000/015/363/RBMInfosheet_10.htm
  36. ^ http://www.unfpa.org/swp/2002/english/ch6/page2.htm
  37. ^ a b Kjetland EF, Ndhlovu PD, Gomo E et al. (February 2006). "Association between genital schistosomiasis and HIV in rural Zimbabwean women". AIDS 20 (4): 593–600. doi:10.1097/01.aids.0000210614.45212.0a. PMID 16470124. http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?doi=10.1097/01.aids.0000210614.45212.0a. 
  38. ^ Drucker E, Alcabes PG, Marx PA (December 2001). "The injection century: massive unsterile injections and the emergence of human pathogens". Lancet 358 (9297): 1989–92. doi:10.1016/S0140-6736(01)06967-7. PMID 11747942. http://linkinghub.elsevier.com/retrieve/pii/S0140-6736(01)06967-7. 
  39. ^ a b Gisselquist, David; Potterat, John J.; Salerno, Lilian (2007). "Injured and Insulted: Women in Africa Suffer from Incomplete Messages about HIV Risks". Horn of Africa Journal of AIDS 4 (1): 15–8. 
  40. ^ Hsu, Jean W-C., Paul B. Pencharz, Dereck Macallan, and Andrew Tomkins. 2005 "Macronutrients and HIV/AIDS: A Review of Current Evidence." Presented April 2005 for the Consultation on Nutrition and HIV/AIDS in Africa: Evidence, lessons and recommendations for action.
  41. ^ World Bank. 2003. “School Deworming At a Glance.” http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTHEALTHNUTRITIONANDPOPULATION/EXTPHAAG/0,,contentMDK:20785786~menuPK:1314819~pagePK:64229817~piPK:64229743~theSitePK:672263,00.html#PDFl (accessed March 2011).
  42. ^ Montresor A, Ramsan M, Chwaya HM et al. (July 2001). "Extending anthelminthic coverage to non-enrolled school-age children using a simple and low-cost method". Trop. Med. Int. Health 6 (7): 535–7. doi:10.1046/j.1365-3156.2001.00750.x. PMID 11469947. http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1360-2276&date=2001&volume=6&issue=7&spage=535. 
v · d · eDiseases of poverty
Diseases of poverty
Neglected diseases
Miscellaneous

Wikimedia Foundation. 2010.

Игры ⚽ Нужен реферат?

Look at other dictionaries:

  • Diseases of affluence — is a term sometimes given to selected diseases and other health conditions which are commonly thought to be a result of increasing wealth in a society.[1] Also referred to as the Western disease” paradigm, these diseases are in contrast to so… …   Wikipedia

  • Poverty in China — refers to people whose income is less than a poverty line of $1 per day (PPP) set by the World Bank benchmark (see Measuring poverty). Poverty has affected all aspects of the nation’s life, including the environment, health, education, housing,… …   Wikipedia

  • Poverty — Street children sleeping in Mulberry Street – Jacob Riis photo New York, United States (1890) Poverty is the state of one who lacks a certain amount of material possessions or money.[1] Absolute poverty or destitution is inability to afford …   Wikipedia

  • Poverty in Pakistan — is a growing concern. Although the middle class has grown in Pakistan, nearly one quarter of the population is classified poor as of October 2006.cite web url=http://southasia.oneworld.net/article/view/135153/1/1893 title=World bank, UNDP… …   Wikipedia

  • Poverty in Africa — African nations typically fall toward the bottom of any list measuring small size economic activity, such as income per capita or GDP per capita, despite a wealth of natural resources. The bottom 25 spots of the United Nations (UN) quality of… …   Wikipedia

  • Neglected diseases — A young boy from Panama suffering from Chagas disease. It has manifested as an acute infection with swelling of one eye (chagoma). The neglected diseases are a group of tropical infections which are especially endemic in low income populations in …   Wikipedia

  • Child poverty — A boy from an East Cipinang trash dump slum in Jakarta, Indonesia shows his find. Child poverty refers to the phenomenon of children living in poverty. This applies to children that come from poor families or orphans being raised with limited, or …   Wikipedia

  • Cycle of poverty — In economics, the cycle of poverty is the set of factors or events by which poverty, once started, is likely to continue unless there is outside intervention. [1] The cycle of poverty has been defined as a phenomenon where poor families become… …   Wikipedia

  • Young China Scholars Poverty Research Network — The Young China Scholars Poverty Research Network co sponsored by the Canadian organisations the International Development Research Centre (IDRC) and the Centre for International Governance Innovation (CIGI) was created to identify and support a… …   Wikipedia

  • Chronic diseases in China — Chronic diseases, non communicable diseases now account for an estimated 80% of total deaths and 70% of disability adjusted life years (DALYs) lost in China. Cardiovascular diseases, chronic respiratory disease and cancer are the leading causes… …   Wikipedia

Share the article and excerpts

Direct link
… Do a right-click on the link above
and select “Copy Link”