CIATEN: Leishmaniasis, Chagas Disease, Tuberculosis and Leprosy gain visibility in Piauí

CIATEN experiences can be reproduced and adapted to other tropical regions inside and outside Brazil

The recent signing of a cooperation agreement will allow a pioneering service in the state of Piauí. It is the Intelligence Center for Emerging and Neglected Tropical Diseases and Injuries (CIATEN), whose purpose is to develop public policies based on scientific evidence; generate and disseminate scientific knowledge and innovative technologies; teach and train public administration professionals and other interested parties; besides producing drugs and biotechnological devices. To the Scientific Coordinator, Dr. Bruno Guedes (UFPI), this is an opportunity of unique importance for Piauí. Our state has a distinct intellectual potential, but still little used. Our faculty brings together excellent professionals with national and international prominence. With adequate investment, I am sure that great health care improvements can be done on this tropical side, he emphasizes. The signing of the term was possible thanks to the union of efforts and resources of the Piaui Secretary of State for Health (SESAPI) and the Federal University of Piauí (UFPI).

CIATEN is a Research Center of the Federal University of Piauí and a proposal of the Institute of Diseases of the Sertão for the State Secretariat of Health of Piauí and has the support of the World Bank. Its task is to elect and suggest health priorities in the context of these emerging and neglected diseases, to systematically review issues to assess the degree of evidence supporting the policies already in place, and to propose the development of policies based on available evidence. When the evidence does not exist or are fragile, CIATEN should initiate research on the subject. To complement its support for the qualification of public policies in the area, CIATEN will be a training center for health workers, particularly at the interface between emerging and neglected diseases and primary health care.

Thus CIATENs public policy suggestions are based on scientific evidence and provide for the development of research in four thematic groups: a nucleus of emerging communicable diseases, dedicated to arbovirus epidemics, especially those transmitted by Aedes aegypti and West Nile encephalitis; a nucleus of non-communicable emergent diseases, dedicated to injuries caused by unintentional violence, focused on accidents with motorcycles; a nucleus of neglected vector-borne diseases, which will prioritize leishmaniasis, particularly kala-azar, and Chagas disease; and the Nucleus of Neglected Diseases of Direct Transmission, which will prioritize tuberculosis and leprosy. Coccidioidomycosis can also compose the list of diseases to be prioritized.

The lack of synthesis in the literature, analytic epidemiology, biostatistics, risk analysis, among others, lead to vulnerabilities while elaborating effective policies for the control of tropical diseases. We intend to train and qualify researchers and health professionals to improve the understanding of the causes and dynamics of neglected diseases, for the elaboration of adequate public policies, ranging from the structure of morbidity and mortality to the organization of the services related to basic health care and the States strategic health components. The Center combines scientific intelligence with public health to provide responses to the state and society that can be reproduced and adapted to other tropical regions – inside and outside Brazil, says Dr. Guedes.

The diseases and injuries

In Portuguese, the single word injuries stands beyond the disease and refers to any circumstance that leads to peoples health prejudice and can be classified as: Tropical injuries, those with greater incidence in countries located between the tropics of Capricorn and Cancer, conditioned by tropical climate and economic poverty. The emerging injuries affect a large part of the population and on which there is still little or no control. The neglected injuries are diseases that have a higher incidence on less privileged groups, and for this reason result in lower profitability for pharmaceutical industries.

The coordinator of the project and professor at UFPI Medical School, Carlos Henrique Costa, explains that emerging non-communicable issues were prioritized because they are part of our reality. Today, we are experiencing an epidemic of diseases and injuries, motorcycle accidents, in various parts of the world, especially in the poorer (tropical) countries. If we take into account the ten causes of death in the world, we will see that motorcycle accidents are among them, and Piauí is proportionately one of the Brazilian states with more deaths. According to the professor, motorcycle accidents are characterized by a tragedy, with innumerable sequels, which become diseases, and lead to preventable deaths, affecting young people and the economically active population, as well as resulting in a high economic and social cost to the population. We should also not forget the emergence of intentional violence, linked to drug trafficking, particularly crack cocaine, which plagues Latin America as a whole, he recalls.

Dr. Carlos Henrique points out that neglected diseases are those that have no investment in knowledge, drugs or vaccines, because it affects very poor populations or are rare diseases, and therefore, there is no interest in them. In this group of parasitic diseases are the two leishmaniasis (visceral and cutaneous) and Chagas disease. In addition to these, there are two other old diseases that still have very bad indicators here in Brazil, particularly in the state of Piauí, which are tuberculosis and leprosy, he laments.

The interaction between health and informatics is also expected to be contemplated by CIATEN, since the use of technologies as Internet of Things (IoT) and Artificial Intelligence (AI) associated with health are important tools which may assist in the control of emerging and neglected, transmissible or non-communicable injuries or diseases. We must make this interaction. The world is entering a new phase, innovations arise every day. Faster diagnostics, more accurate predictions, health information processing and treatment. Through a platform in computing and AI, we will actively participate in this process, says Dr. Guedes.

CIATEN

The Center of Intelligence in Tropical, Emerging and Neglected Injuries and Diseases has been devised for several years. It is already established in activities and its researchers already have cooperation with international institutions, such as the University of York, in the United Kingdom and Tehran University, in Iran. Partnerships with international research centers, for example, Center de Recherche en Infectiologie (CRI) of the Center Hospitalier Universitaire de Québec (CHUQ) are underway. In addition to these projects, CIATEN intends to count on the support of national institutions such as Serrapilheira and international organizations such as the Bill & Melinda Gates Foundation and the World Bank. The Federal University of Piauí (UFPI), the State Health Secretariat (SESAPI) and the Foundation for Research Support of the State of Piauí (FAPEPI) are important partners of the Center.

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