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Dear colleagues,
Herewith another article of Special Edition of TDR Newsletter
we wish to share by email. Please help disseminate it widely.
Jocelyne Bruyere
TDR Communications
Inclusion of dengue in TDR's disease portfolio
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http://www.who.int/tdr/publications/tdrnews/special/dengue.htm
In preparation for discussions during JCB-22, where the proposed
inclusion of dengue and tuberculosis in TDR's disease portfolio was to
be reviewed, an informal consultation took place in WHO at the beginning
of June. During this meeting, WHO in-house experts and outside
scientists (from the American, European, Asian and Pacific regions)
sought to identify research gaps, pinpoint research needed, and propose
a potential agenda for TDR activities regarding dengue and dengue
haemorrhagic fever (DHF).
WHO staff presented an analysis of the global situation for dengue, and
an outline of WHO's ongoing activities in dengue control and vaccine
development. Three discussion groups proposed a list of priority
subjects where TDR could initiate activities:
In social, economic and behavioural research -- cost-benefit and
cost-effectiveness of vector control strategies; social and
economic impact; social, environmental and economic determinants of
risk; appropriate behaviour to promote in endemic communities for
reducing risk; and community-based surveillance systems.
In vector research -- vector biology and behaviour, and
transmission dynamics; community-based strategies for vector
control; new/improved tools for vector control; improvement of
current tools for vector surveillance e.g. GISs; and alternative
pesticides for use in emergency situations.
In diagnosis -- antigen detection; serological testing including
evaluation of available recombinant antigens; antigen and genomic
characterization of dengue strains; and simple PCR techniques for
routine use.
In pathophysiology -- virulence; early markers of infection; plasma
leakage and coagulopathy; genetic susceptibility; and the molecular
basis of intereference among dengue viruses.
In vaccine discovery and development -- definition of a vaccine
product profile; continued support to ongoing work on live
tetravalent vaccines; development of new technologies e.g. use of
live clones to construct chimeric viruses, and subunit vaccines;
and animal models.
The global pandemic of dengue, which began after World War II, has
intensified over the last 15 years as the geographic distribution of
dengue viruses and their mosquito vectors has expanded and epidemics
have increased dramatically. The reasons for the global emergence are
complex and related to social and environmental factors associated with
uncontrolled urbanization, inadequate supply of piped water, increased
movement of human populations, and substandard housing and waste
management.
At present, the only methods for controlling or preventing dengue and
DHF rely on controlling the mosquito vector. Developing appropriate and
efficient vector control methods, improving laboratory diagnosis and
case management of patients, and developing an effective vaccine are
therefore the primary objectives of research and capability
strengthening.
Additional information can be obtained from Drs M Nathan at
<[log in to unmask]>, R Arthur at <[log in to unmask]> and F Zicker at
<[log in to unmask]>.
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