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106 THIRD WHO REPORT ON NEGLECTED TROPICAL DISEASES *** Burden and distribution Although cases of foodborne trematodiases have been reported from more than 70 countries worldwide, countries in Asia and Latin America are those worst affected. The burden of disease associated with these infections is still unclear. For example, paragonimiasis is known to be transmitted in the central and western parts of Africa, yet information on its epidemiological status is limited. Estimates referring to a selected group of 17 countries indicate that in 2005 more than 56 million individuals were infected with foodborne trematodes: 7.9 million had severe sequelae and more than 7000 died (1) (Fig. 4.7.1–4.7.4). Morbidity due to foodborne trematode infections is both acute and chronic, and both systemic and organ-specific; it becomes more severe as the number of worms increases through subsequent rounds of infection. Chronic infections with C. sinensis and O. viverrini are strongly associated with cholangiocarcinoma, a fatal form of bile duct cancer. Both parasites are classified by the International Agency for Research on Cancer as carcinogenic to humans (2). Fig. 4.7.1 Distribution of clonorchiasis, worldwide, latest year available Countries with reported cases of Clonorchis sinensis infection No data available Not applicable
*** THE DISEASES − CHAPTER 4 107 Fig. 4.7.2 Distribution of opisthorchiasis, worldwide, latest year available Countries with reported cases of Opisthorchis viverrini infection Countries with reported cases of Opisthorchis felineus infection Countries with reported cases of Opisthorchis viverrini and Opisthorchis felineus infections No data available Not applicable Fig. 4.7.3 Distribution of fascioliasis, worldwide, latest year available Countries with reported cases of Fasciola spp. infection No data available Not applicable
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INVESTING TO OVERCOME THE GLOBAL IM
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ii THIRD WHO REPORT ON NEGLECTED TR
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iv THIRD WHO REPORT ON NEGLECTED TR
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vi THIRD WHO REPORT ON NEGLECTED TR
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*** FOREWORD ix FOREWORD BY THE DIR
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*** EXECUTIVE SUMMARY xi EXECUTIVE
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*** EXECUTIVE SUMMARY xiii for the
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*** EXECUTIVE SUMMARY xv Neglected
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*** THE RESOLUTION AND THE ROADMAP
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*** INVESTING TOWARDS UNIVERSAL COV
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*** KEY INTERVENTIONS: SITUATION RE
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*** THE DISEASES − CHAPTER 4 157
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*** ANNEXES 179 ANNEXES
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*** ANNEXES 181 Annex 1a (cont’d)
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*** ANNEXES 183 WHA66.12 Recognizin
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*** ANNEXES 185 WHA66.12 3. REQUEST
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*** ANNEXES 187 Annex 3. Classifica
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*** ANNEXES 189 Annex 5. Medicines
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*** ANNEXES 191 WHO REGIONAL OFFICE
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