Neglected infectious diseases in the geriatrics

Abrar Abdulfattah Al Yamani, Yahya Mohammad Falqi, Yussif Mohammed Alnawar, Lama Mohammed Almahrous, Haitham Ahmed Alwael, Ali Ibrahim Al Muhaif, Hebah Adel Mansour, Ghadeer Adil Banjar, Tameem Abdullah Sabrah, Hanady Mohammed Idreis, Yousef Shamlan Al Harban


Infectious diseases in the elderly population pose a significant threat to their lives. Neglected tropical diseases significantly impact the health of the affected patients and populations at risk. Reports show that many of these disorders are among the highest ten most typical causes of disability-adjusted life years. In the present literature review, we have discussed the most common neglected tropical infections in geriatrics based on data from the current studies in the literature. Different infections can affect the geriatric population. However, evidence shows that this population is susceptible to developing severe disease-related conditions. This has been reported with dengue infection, onchocerciasis, and cholera. It has been demonstrated that ocular lesions and other clinical manifestations are highest among the elderly population with onchocerciasis. Severe dengue and dengue hemorrhagic fever are also reported at a high rate in this age group. Concurrent infections and disorders were documented with many of these infections, probably due to reduced immunity. Socioeconomic factors, co-morbidities, access to healthcare settings, environmental factors, sanitation, clustering, and overcrowding contribute to the frequency of neglected tropical diseases in the elderly. Further studies are still needed because the current report is scarce, which might underestimate the current evidence.


Geriatrics, Infection, Neglected clinical characteristics

Full Text:



Feasey N, Jones M, Mabey DC, Solomon AW. Neglected tropical diseases. Br Med Bull. 2010;93:179-200.

Collier P. The bottom billion: Why the poorest countries are failing and what can be done about it. USA: Oxford University Press; 2008.

Hotez PJ, Fenwick A, Savioli L, Molyneux DH. Rescuing the bottom billion through control of neglected tropical diseases. Lancet. 2009;373(9674):1570-5.

Molyneux DH, Malecela MN. Neglected tropical diseases and the millennium development goals: why the "other diseases" matter: reality versus rhetoric. Parasit Vectors. 2011;4:234.

Gruchy S. Introducing the United Nations Millennium Declaration. J Theol Southern Africa. 2001;110:57.

WHO. Neglected tropical diseases, hidden successes, emerging opportunities, 2021. Available at: Accessed on 15 October 2021.

Silva NR, Brooker S, Hotez PJ, Montresor A, Engels D, Savioli L. Soil-transmitted helminth infections: updating the global picture. Trends Parasitol. 2003;19(12):547-51.

Hotez PJ, Molyneux DH, Fenwick A, Kumaresan J, Sachs SE, Sachs JD, et al. Control of neglected tropical diseases. N Engl J Med. 2007;357(10):1018-27.

Brooker S, Rowlands M, Haller L, Savioli L, Bundy DA. Towards an atlas of human helminth infection in sub-Saharan Africa: the use of geographical information systems (GIS). Parasitol Today. 2000;16(7):303-7.

King CH, Dickman K, Tisch DJ. Reassessment of the cost of chronic helmintic infection: a meta-analysis of disability-related outcomes in endemic schistosomiasis. Lancet. 2005;365(9470):1561-9.

Engels D, Savioli L. Reconsidering the underestimated burden caused by neglected tropical diseases. Trends Parasitol. 2006;22(8):363-6.

Smith JL, Haddad D, Polack S, Esch EM, Hooper PJ, Mabey DC, et al. Mapping the global distribution of trachoma: why an updated atlas is needed. PLoS Negl Trop Dis. 2011;5(6):973.

Frick KD, Hanson CL, Jacobson GA. Global burden of trachoma and economics of the disease. Am J Trop Med Hyg. 2003;69(5):1-10.

Rowe EK, Leo YS, Wong JG, Thein TL, Gan VC, Lee LK, et al. Challenges in dengue fever in the elderly: atypical presentation and risk of severe dengue and hospital-acquired infection. PLoS Negl Trop Dis. 2014;8(4):2777.

Rivera EJ, Pérez JG. Dengue severity in the elderly in Puerto Rico. Rev Panam Salud Publica. 2003;13(6):362-8.

Rivera EJ, Pérez JG. Dengue severity in the elderly in Puerto Rico. Rev Panam Salud Publica. 2003;13(6):362-8.

Liu CC, Huang KJ, Huang MC. High case-fatality rate of adults with dengue hemorrhagic fever during an outbreak in non-endemic Taiwan: risk factors for dengue-infected elders. American J Infect Dis. 2008;4(1):10-7.

Lin CH, Schiøler KL, Jepsen MR, Ho CK, Li SH, Konradsen F. Dengue outbreaks in high-income area, Kaohsiung City, Taiwan, 2003-2009. Emerging infectious diseases. 2012;18(10):1603-11.

Thein TL, Gan VC, Lye DC, Yung CF, Leo YS. Utilities and limitations of the World Health Organization 2009 warning signs for adult dengue severity. PLoS neglected tropical diseases. 2013;7(1):2023.

Rothman AL, Ennis FA. Immunopathogenesis of Dengue hemorrhagic fever. Virology. 1999;257(1):1-6.

Yew YW, Ye T, Ang LW. Seroepidemiology of dengue virus infection among adults in Singapore. Annals of the Academy of Medicine, Singapore. 2009;38(8):667-75.

Pang J, Salim A, Lee VJ. Diabetes with hypertension as risk factors for adult dengue hemorrhagic fever in a predominantly dengue serotype 2 epidemic: a case control study. PLoS neglected tropical diseases. 2012;6(5):1641.

Opal SM, Girard TD, Ely EW. The immunopathogenesis of sepsis in elderly patients. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. 2005;41(7):504-12.

Geerlings SE, Hoepelman AI. Immune dysfunction in patients with diabetes mellitus (DM). FEMS Immunol Med Microbiol. 1999;26(3-4):259-65.

Magalhães BM, Alexandre MA, Siqueira AM. Clinical profile of concurrent dengue fever and Plasmodium vivax malaria in the Brazilian Amazon: case series of 11 hospitalized patients. American J Tropical Med Hygiene. 2012;87(6):1119-24.

Sharp TM, Bracero J, Rivera A. Fatal human co-infection with Leptospira spp. and dengue virus, Puerto Rico, 2010. Emerg Infect Dis. 2012;18(5):878-80.

Chai LY, Lim PL, Lee CC. Cluster of Staphylococcus aureus and dengue co-infection in Singapore. Annals Academy Med. 2007;36(10):847-50.

Mathew A, Kurane I, Green S, Vaughn DW, Kalayanarooj S, Suntayakorn S, et al. Impaired T cell proliferation in acute dengue infection. J Immunol. 1999;162(9):5609-15.

Leo YS, Thein TL, Fisher DA, Low JG, Oh HM, Narayanan RL, et al. Confirmed adult dengue deaths in Singapore: 5-year multi-center retrospective study. BMC Infect Dis. 2011;11:123.

Lee IK, Liu JW, Yang KD. Clinical characteristics and risk factors for concurrent bacteremia in adults with dengue hemorrhagic fever. American J Trop Med Hyg. 2005;72(2):221-6.

Gaudio AR, Rinaldi S, Chelazzi C, Borracci T. Pathophysiology of sepsis in the elderly: clinical impact and therapeutic considerations. Curr Drug Targets. 2009;10(1):60-70.

Comin F, Speziali E, Oliveira R, Faria AM. Aging and immune response in chronic human schistosomiasis. Acta Trop. 2008;108(2-3):124-30.

Nwosu SN. Low vision in persons aged 50 and above in the onchocercal endemic communities of Anambra State, Nigeria. West Afr J Med. 2000;19(3):216-9.

Schwartz EC, Huss R, Hopkins A, Dadjim B, Madjitoloum P, Hénault C, et al. Blindness and visual impairment in a region endemic for onchocerciasis in the Central African Republic. Br J Ophthalmol. 1997;81(6):443-7.

Akogun OB. Eye lesions, blindness and visual impairment in the Taraba river valley, Nigeria and their relation to onchocercal microfilariae in skin. Acta Tropica. 1992;51(2):143-9.

Schwartz EC, Huss R, Hopkins A, Dadjim B, Madjitoloum P, Hénault C, et al. Blindness and visual impairment in a region endemic for onchocerciasis in the Central African Republic. Br J Ophthalmol. 1997;81(6):443-7.

Okoro N, Nwali U, Oli A, Innocent O, Somadina O, Shedrack E. The Prevalence and Distribution of Human Onchocerciasis in Two Senatorial Districts in Ebonyi State, Nigeria. American J Infect Dis Microbiol. 2014;2:39-44.

Dozie I, Onwuliri C, Nwoke B. Onchocerciasis in Imo state, Nigeria (2): the prevalence, intensity and distribution in the upper Imo river basin. Int J Environ Health Res. 2004;14(5):359-69.

Shintouo CM, Shey RA, Mets T, Vanhamme L, Souopgui J, Ghogomu SM, et al. Onchocerciasis Fingerprints in the Geriatric Population: Does Host Immunity Play a Role? Trop Med Infect Dis. 2021;6(3):153.

Gopinath R, Ostrowski M, Justement SJ, Fauci AS, Nutman TB. Filarial infections increase susceptibility to human immunodeficiency virus infection in peripheral blood mononuclear cells in vitro. J Infect Dis. 2000;182(6):1804-8.

Colebunders R, Siewe FN, Hotterbeekx A. Onchocerciasis-associated epilepsy, an additional reason for strengthening onchocerciasis elimination programs. Trends Parasitol. 2018;34(3):208-16.

Fodjo JN, Mandro M, Mukendi D, Tepage F, Menon S, Nakato S, Nyisi F, et al. Onchocerciasis-associated epilepsy in the Democratic Republic of Congo: Clinical description and relationship with microfilarial density. PLoS Negl Trop Dis. 2019;13(7):7300.

Egbert PR, Jacobson DW, Fiadoyor S, Dadzie P, Ellingson KD. Onchocerciasis: a potential risk factor for glaucoma. British J Ophthalmol. 2005;89(7):796-8.

Ryan ET, Dhar U, Khan WA, Salam MA, Faruque AS, Fuchs GJ, et al. Mortality, morbidity, and microbiology of endemic cholera among hospitalized patients in Dhaka, Bangladesh. Am J Trop Med Hyg. 2000;63(1-2):12-20.

Phelps M, Perner ML, Pitzer VE, Andreasen V, Jensen PKM, Simonsen L. Cholera Epidemics of the Past Offer New Insights Into an Old Enemy. J Infect Dis. 2017;217(4):641-9.

Bellizzi S, Pichierri G, Cegolon L, Napodano CMP, Maher OA. Coordination during Cholera Outbreak Response: Critical Insights from Yemen. Am J Trop Med Hyg. 2021;105(5):1155-6.

Qaserah AM, Al AMA, Serouri AA, Khader YS. Risk Factors of Cholera Transmission in Al Hudaydah, Yemen: Case-Control Study. JMIR Public Health Surv. 2021;7(7).

Son PT, Reda A, Viet DC. Exchange transfusion in the management of critical pertussis in young infants: a case series. Vox sanguinis. 2021;116(9):976-82.

Thieu H, Bach Dat B, Nam NH. Antibiotic resistance of Helicobacter pylori infection in a children's hospital in Vietnam: prevalence and associated factors. Minerva Medica. 2020;111(5):498-501.

Hansen J, Chaignat C. Neglected tropical diseases: Equity and social etermin. 2010:135-57.