Lessons learned from chemoprophylaxis programmes for neglected diseases and diseases of poverty in Latin America: a systematic review

Abstract

It is estimated that over a billion people globally are affected by neglected tropical diseases, mainly in developing countries. This systematic review examines the scope, effectiveness, and challenges of chemoprophylaxis programs targeting lymphatic filariasis, leprosy, onchocerciasis, schistosomiasis, soil-transmitted helminths, and tuberculosis in Latin America. The aim is to evaluate the implementation and outcomes of these programs by analyzing studies published from January 2000 to March 2023. A comprehensive search was conducted across six electronic databases, resulting in 66 relevant studies from an initial pool of 2481 records. These studies, originating from thirteen countries, were assessed using the PRISMA guidelines. The results indicate that chemoprophylaxis programs, particularly those led by local healthcare professionals, have significantly reduced infectious disease prevalence and transmission rates in endemic regions. The effectiveness of these programs is influenced by several factors, including the length of regimen, patient adherence, and community engagement. In order to increase participation and ensure program success, educational strategies and adopting more localized approaches are essential. However, challenges remain, particularly in remote areas and regions with high migration rates, such as the Amazon. While the review highlights the potential of chemoprophylaxis in improving public health outcomes, it also underscores the need for more extensive cost-effectiveness studies to assess the financial viability of these interventions. The evidence supports the continued optimization of chemoprophylaxis programs, emphasizing the importance of sustained, community-centered approaches. Ongoing research and improvement are critical to overcoming current obstacles and enhancing global efforts to control and eradicate these diseases.