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Fri, 4 Dec 23:03:16 GMT17

 
Health and diseases

Last reviewed: 17-09-2009

BIGGEST KILLER DISEASES AND CONDITIONS


Women react as a paramedic gives tetanus vaccinations in the Indonesian city of Yogyakarta. REUTERS/Beawiharta
Women react as a paramedic gives tetanus vaccinations in the Indonesian city of Yogyakarta. REUTERS/Beawiharta
Below is information on some of the most lethal conditions people face in developing countries, in order of death rates.

Cancer and heart disease are not included.

  • Lower respiratory infections
  • HIV/AIDS
  • Perinatal conditions and maternal mortality
  • Diarrhoea diseases
  • Tuberculosis
  • Malaria
  • Measles
  • Sleeping sickness
  • Dengue
  • Ebola
  • Polio
  • Bird flu
  • Swine flu

    LOWER RESPIRATORY INFECTIONS


    Nearly 4 million people die of lower respiratory infections each year - most of them children under five years old.

    These includes diseases of the lungs, windpipe or bronchial tubes, the most lethal being pneumonia. Other respiratory diseases are bronchitis and Legionnaire's disease - a rare form of pneumonia.

    Tuberculosis and whooping cough are also lower respiratory infections, but death tolls are tallied separately by the U.N. World Health Organisation (WHO).

    They are spread by coughing, sneezing, laughing or exhaling.

    PNEUMONIA

    Infection: Half of pneumonia cases are caused by bacteria, but they can also be caused by viruses. The alveoli - microscopic air-filled sacs of the lung responsible for absorbing oxygen from the atmosphere - become inflamed and flooded with fluid.

    Symptoms: Sudden onset of shivering fits, fever, chest pains and coughing. The cough starts out dry, but patients soon begin to cough up phlegm, which can be yellow or bloodstained. Breathing can become fast and shallow and painful, and patients sometimes find themselves gasping for air. They may even start to go blue around the lips and nails due to a lack of oxygen.

    Treatment: Pneumonia can be treated with antibiotics, and there is a vaccine available against the most common form of pneumonia, caused by the bacterium Streptococcus pneumoniae.

    CHRONIC OBSTRUCTIVE PULMONARY DISEASE

    This is a non-communicable respiratory disease that kills more than 3 million people a year. It is mostly caused by smoking and is not curable.

    HIV/AIDS


    Boys carry out an AIDS awareness presentation in Ghana. REUTERS/Siphiwe Sibeko
    Boys carry out an AIDS awareness presentation in Ghana. REUTERS/Siphiwe Sibeko
    Twenty-five years after HIV/AIDS was first identified, nearly 40 million people are living with the virus. It is the leading cause of death in sub-Saharan Africa, but the virus is spreading fast in Asia and Eastern Europe.

    Spread: The HIV virus is transmitted through unprotected sex, through blood (particularly through transfusions or intravenous drug use) and from mother to baby via pregnancy, labour or breast milk. Most people living with HIV do not know they are infected.

    Treatment and prevention: There is no cure for HIV/AIDS, but its effects can be contained with drugs. However, about three quarters of people living with HIV/AIDS do not have access to the necessary daily cocktail of drugs.

    Condom use is the most effective form of prevention.

    For more detailed information, see our AIDS pandemic crisis briefing or click on one of our regional HIV/AIDS briefings:

  • AIDS in Africa
  • AIDS in Americas
  • AIDS in Asia
  • AIDS in Eastern Europe/Central Asia
  • AIDS in Middle East

    PERINATAL CONDITIONS AND MATERNAL MORTALITY


    PERINATAL CONDITIONS

    These are the third-highest killers and affect children during the period just before and soon after birth.

    Low birth weight is the most common cause of death, followed by birth asphyxia and birth trauma. In all they kill 2.5 million babies a year, according to WHO.

    The conditions develop because the mother is malnourished or in poor health, and because of a lack of proper medical care at birth.

    MATERNAL MORTALITY

    Malnutrition and poor medical care also mean 530,000 women a year die from complications related to pregnancy or childbirth. And about 20 times that number suffer serious injury or disability - between 8 million and 20 million a year.

    DIARRHOEA DISEASES


    A baby rests in a cradle in in Dhaka. REUTERS/Rafiqur Rahman
    A baby rests in a cradle in in Dhaka. REUTERS/Rafiqur Rahman
    Diarrhoea is a symptom of gastrointestinal infection that kills around 2.2 million people a year, mostly children.

    The best known infections are cholera and dysentery, which cause severe, sometimes life-threatening forms of diarrhoea.

    Even when it is not lethal it contributes to worsening malnutrition and weakness. Four billion people a year develop diarrhoea.

    It is caused by a host of bacterial, viral and parasitic organisms.

    Infection is spread through contaminated food or drinking-water, or from person to person as a result of poor hygiene. The most common cause is contamination of water or food with human faeces.

    Diarrhoea can be treated with oral re-hydration salts. Zinc is also now advocated as an accompanying treatment.

    CHOLERA

    Infection: Cholera infects an estimated 110,000 to 380,000 people globally every year. Few die of the disease. It is an acute intestinal infection caused by the bacterium Vibrio cholerae and spread through contaminated food and water.

    Sudden, large outbreaks are usually caused by a contaminated water supply. If a community is unprepared for an outbreak, as many as 50 percent of people with cholera may die because of lack of treatment.

    Source: The World Health Organisation says hygienic disposal of human faeces, an adequate supply of safe drinking water and good food hygiene are essential.

    Symptoms: Develop within one to five days and include diarrhoea and vomiting that can quickly lead to severe dehydration and death if not treated promptly. But most infected people do not become ill, although the bacterium is present in their faeces for seven to 14 days.

    Treatment: Cholera is easy to treat through oral rehydration salts to replace lost fluids. In severe cases, intravenous drips may be needed to save the patient's life.

    There are limited supplies of two oral vaccines that provide high-level protection for several months against cholera caused by V. cholerae O1. Both are suitable for use by travellers but they have not yet been used on a large scale for public health purposes.

    DYSENTERY

    Dysentery is a term covering diseases that trigger inflammation of the lining of the large intestines, causing stomach pains, diarrhoea, vomiting and fever.

    Infection: Dysentery is highly contagious, and caused by bacteria from contaminated food or water, or by physical contact with a person who has already been infected.

    Epidemic dysentery is a particularly severe form that is caused by the bacterium Shigella dysenteriae type 1 (Sd1).

    Amoebic dysentery is caused by the amoeba parasite that burrows through the intestinal wall into the bloodstream and spreads to other organs, including the liver, lungs and brain.

    Symptoms: Bloody diarrhoea, abdominal cramps, fever and rectal pain.

    Treatment: Adults usually only need rehydration salts to recover from dysentery caused by bacteria. Children may need antibiotics.

    Amoebic dysentery however needs to be treated with a combination of drugs to kill the parasite, treat any bacterial infection, and fight infection of the liver and other tissues.

    TUBERCULOSIS


    An orphan living with HIV/AIDS and tuberculosis walks home from a clinic in Kenya. REUTERS/Damien Guerchois
    An orphan living with HIV/AIDS and tuberculosis walks home from a clinic in Kenya. REUTERS/Damien Guerchois
    Tuberculosis (TB) is on the rise, particularly affecting Southeast Asia and Africa. A third of the world's population is infected with TB.

    It kills 2 million people a year, and is a leading killer of people living with HIV/AIDS - a third of those with HIV will develop TB.

    Each year, more than 8 million people become sick with TB. The average TB patient loses three to four months of work time as a result of TB.

    Unlike most of the diseases listed above, TB affects adults more than children.

    Symptoms: These depend on where the TB bacteria grow. TB in the lungs may cause a persistent bad cough, pain in the chest or blood or sputum to be coughed up.

    Other symptoms are weakness, weight loss, chills, fever and night-time sweating.

    Spread: TB of the lungs or throat can be spread through the air when an infected person coughs or sneezes. But TB is usually not infectious if it has settled in other parts of the body such as the kidneys or spine.

    Treatment: This takes at least six months and requires as many as four different drugs, which are often unavailable in developing countries. When available, they are effective in up to 95 percent of cases, according to the Global Fund to Fight AIDS, Tuberculosis and Malaria.

    However, there are growing concerns about the rise of multi-drug resistant TB caused by inconsistent or partial treatment, which threatens TB control efforts and HIV/AIDS treatment.

    MALARIA


    A woman holds her child as she stands before a hanging mosquito net in the village of Lybe in Gabon. REUTERS/Daniel Flynn
    A woman holds her child as she stands before a hanging mosquito net in the village of Lybe in Gabon. REUTERS/Daniel Flynn
    More than 40 percent of world's population is at risk from malaria, which is spread by the female anopheles mosquito.

    It affects people in most developing countries, but the vast majority of deaths occur in sub-Saharan Africa, home to the most deadly form of the virus.

    An estimated 247 million people contract malaria each year, and 880,000 die of the disease.

    Symptoms: Include fever and flu-like illness with headaches, muscle aches, shivering and lethargy. Nausea, vomiting, diarrhoea, anaemia and jaundice can also occur.

    If not properly treated, infection with the type of malaria known as Plasmodium falciparum may cause kidney failure, seizures, coma and death within hours.

    Prevention and treatment: In recent years drug-resistant strains of malaria have spread, rendering once effective - and cheap - anti-malarial drugs such as chloroquine almost useless in many areas. Drug-resistant strains of Plasmodium falciparum now occur in 90 percent of cases in Africa.

    A treatment called artemisinin combination therapy, or ACT, has been introduced and is slowly replacing obsolete anti-malarial drugs. This more expensive treatment is derived from a Chinese herb but there are concerns about the appearance of fake Chinese-made malaria drugs appearing on the market.

    In some countries, the disease may account for as much as 40 percent of public health expenditure and 30-50 percent of inpatient admissions.

    Insecticide spraying and bednets help prevent the spread of malaria.

    For more, read AlertNet's malaria briefing.

    MEASLES


    There has been a vaccine for this childhood disease for 40 years, yet it is a leading cause of death for young children in developing countries. In 2006, an estimated 242,000 children died of the virus.

    The virus grows in cells lining the back of the throat and lungs.

    Spread: Measles is one of the most contagious diseases known, spread by coughing and sneezing, or close personal contact.

    Symptoms: High fever begins about 11 days after infection, and lasts for up to a week. A runny nose, cough, red and watery eyes and small white spots inside the cheeks are early symptoms.

    Later a rash develops on the face and upper neck, and can spread to the hands and feet. Children do not usually die of measles directly but of complications, including encephalitis, severe diarrhoea, ear infections and pneumonia. Blindness can also result from measles.

    SLEEPING SICKNESS


    African trypanosomiasis, or sleeping sickness, is caused by a parasite that is spread by the tsetse fly. In 2002, it killed 48,000 people.

    There are two forms:

    More than 90 percent of cases are Trypanosoma brucei gambiense, found in western and central Africa. Symptoms usually do not emerge for months or years after the person became infected, by which time the central nervous system is affected.

    A few cases are Trypanosoma brucei rhodesiense, found in eastern and southern Africa. Symptoms emerge a few weeks or months after infection.

    Symptoms: In the first stage symptoms include fever, headaches, joint pains and itching.

    The second stage begins when the parasite invades the central nervous system, called the neurological stage, and this is when symptoms usually begin to appear. These include confusion, sensory disturbances, poor coordination, and disturbance of the sleep cycle.

    Treatment: Without treatment, sleeping sickness is fatal. Diagnosis must be before the neurological stage in order to avoid difficult and risky treatment procedures.

    Early treatment includes drugs which are generally effective and less toxic. Drugs used in the second stage have to reach the parasite, which means crossing the blood-brain barrier. These are both toxic and difficult to administer - in some cases the side effects can be fatal.

    DENGUE FEVER


    A man sprays insecticide near a market to fight an onset of dengue fever in Phnom Penh. REUTERS/Chor Sokunthea
    A man sprays insecticide near a market to fight an onset of dengue fever in Phnom Penh. REUTERS/Chor Sokunthea
    Dengue fever has spread dramatically in the past few decades, and now some 2.5 billion people are at risk from dengue.

    It is a mosquito-borne tropical virus that infects 50 million people each year, most of them in Southeast Asia and the western Pacific, and can be fatal.

    Unlike the mosquitoes that cause malaria, dengue mosquitoes are daytime feeders.

    Symptoms usually appear a week after infection, and include a sudden high fever, headaches and severe joint and muscle pain. The illness lasts up to ten days but complete recovery can take a month.

    Treatment involves rest and drinking plenty of fluids. Two of the four types of dengue fever can progress to dengue haemorrhagic fever, which causes bleeding from the nose, gums and inside the body. Five percent of haemorrhagic cases are fatal.

    No vaccine is currently available.

    EBOLA


    Ebola haemorrhagic fever (EHF) is a severe, often fatal disease that has appeared sporadically since it was identified in 1976. The disease is caused by infection with Ebola virus, named after a river in the Democratic Republic of Congo where it was first recognised.

    Symptoms: Include a sudden onset of fever, intense weakness, muscle pain, headache and sore throat.

    This is often followed by vomiting, diarrhoea, rash, impaired kidney and liver function and, in some cases, both internal and external bleeding. The fever has an incubation period of two to 21 days.

    Spread: The Ebola virus is transmitted by direct contact with the blood, secretions, organs or other bodily fluids of infected people.

    Burial ceremonies where mourners have direct contact with the body of the deceased person can play a significant role in the transmission of Ebola. Health care workers have frequently been infected while treating Ebola patients.

    Treatment: There is no specific treatment or vaccine.

    Major outbreaks:

    Approximately 1,850 cases with more than 1,200 deaths have been documented since the Ebola virus was discovered.

  • Between June and November 1976, EHF infected 284 people in Sudan, causing 151 deaths. In the Democratic Republic of Congo, there were 318 cases and 280 deaths in late 1976.

  • Between September 2000 and January 2001, the Sudan subtype of the Ebola virus infected 425 people, including 224 deaths, making it the largest epidemic so far of Ebola.

  • From October 2001 to December 2003, several EHF outbreaks of the Zaire subtype, were reported in Gabon and the Republic of Congo, with a total of 302 cases and 254 deaths.

    POLIO


    Poliomyelitis (polio) is a highly infectious disease caused by a virus that invades the nervous system, and can cause total paralysis within hours.

    Spread: The virus is spread through contaminated food and water, multiplies in the intestine and spreads to the nervous system.

    Symptoms: Many people have no symptoms, but excrete the virus in their faeces and transmit it to others.

    Visible symptoms are fever, fatigue, headache, vomiting, stiffness in the neck and pain in the limbs. A few cases lead to irreversible paralysis (usually in the legs), and can be fatal.

    It mainly affects children under the age of five.

    Treatment and prevention: There are several vaccines that protect a child for life. However, there is no cure.

    The number of cases has dropped by 99 percent since a global effort to eradicate the disease was launched in 1988 when an estimated 350,000 people developed polio. In 2006 there were just 128 cases.

    See this UNICEF resource to see how the fight against polio has progressed since 1988.

    BIRD FLU


    Ducks in a Thai rice field. REUTERS/Sukree Sukplang
    Ducks in a Thai rice field. REUTERS/Sukree Sukplang
    The current outbreak of avian flu, which originated in Southeast Asia in 2003, has spread to the Middle East, Europe, South Asia and Africa.

    So far it has mainly affected bird populations, with millions of birds being culled across the world.

    A few people have died from the H5N1 strain, but almost all had caught it from birds. Scientists, however, believe there have been a few cases of human to human transmission.

    Health experts are worried that if the virus acquires the ability to jump easily between humans, it could unleash a pandemic, killing millions of people within months.

    No cure exists, but many countries are stockpiling antiviral drugs that may improve survival prospects if taken within 48 hours of symptoms appearing. But no one really knows how effective they would be against a bird flu pandemic.

    To find out more, read our bird flu crisis briefing.

    SWINE FLU


    Governments worldwide have been on high alert since a new human flu virus emerged in April 2009 in Mexico and the United States. The World Health Organisation (WHO) declared a global pandemic in June and warned the new virus could infect hundreds of millions of people.

    To find out more, read our swine flu crisis briefing.


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