Diagnosis of Neglected Tropical Diseases Among Patients With Persistent Digestive Disorders
Diagnosis of Neglected Tropical Diseases Among Patients With Persistent Digestive Disorders
NIDIAG is an international collaboration on integrated diagnosis-treatment platforms, funded
 by the European Commission (EC). NIDIAG aims to develop an improved, patient-centred system
 for delivering primary health care in resource-constrained settings. NIDIAG will investigate
 three clinical syndromes, namely (i) persistent digestive disorders, (ii) persistent fever
 and (iii) neurological disorders, due to neglected tropical diseases (NTDs). The current
 study focuses on persistent digestive disorders, which are defined as diarrhoea or abdominal
 pain that last for at least 2 weeks.

 While acute diarrhoea has been studied globally, few research activities have focused on the
 epidemiology, diagnosis and treatment of long-lasting diarrhoeal episodes (2 weeks and
 longer) in the tropics. The spectrum of possibly involved pathogens includes more than 30
 bacterial, parasitic and viral infectious agents. This lack of data may be explained by the
 fact that people suffering from NTDs might only seek care at a late stage of the disease.
 Furthermore, health systems in affected regions are often weak and their primary health-care
 centres are often under-staffed and lack essential diagnostic equipment.

 The hypothesis of this study is that development of an evidence-based syndromic approach can
 lead to better diagnosis and management of NTDs in patients with persistent digestive
 disorders. The study will be carried out in two West African countries (Côte d'Ivoire and
 Mali) and in two Asian countries (Indonesia and Nepal). The study will follow a
 "case-control" design and patients and controls will be prospectively enrolled. In order to
 address the knowledge gaps, three specific objectives will be pursued. First, the
 contribution of NTDs to the 'persistent digestive disorders syndrome' will be assessed.
 Second, the value of clinical features and rapid diagnostic tests (RDTs) for the diagnosis of
 target NTDs that give rise to persistent digestive disorders will be determined. Third, the
 clinical response to standard empiric and targeted treatment of several NTDs in patients with
 persistent digestive disorders will be evaluated. These objectives will provide a long-term
 benefit for the communities by improving the clinical decision-making process for the target
 NTDs and thus, better diagnostic work-up and patient management can be achieved in the study
 countries and other similar resource-constrained countries
Inclusion Criteria:

 1. Individuals aged ≥1 year presenting with persistent diarrhoea (≥3 loose stools per
 days for ≥2 weeks; symptomatic group) and/or children (aged 1-18 years) with
 persistent abdominal pain (localized or diffuse abdominal pain lasting for ≥2 weeks,
 with possible intermittence/recurrence).

 2. Individuals with written informed consent provided.

 Exclusion Criteria:

 1. Individuals in need of immediate intensive or surgical care.

 2. Individuals who are unable or unwilling to give written informed consent.

 3. Individuals who do not meet the inclusion criteria for being a case or control (e.g.
 people with acute diarrhoea).

 4. Individuals with clinical jaundice (assessed by direct observation of the
 conjunctivae).

 5. Individuals who are unable, in the study physician's opinion, to comply with the study
 requirements.

 6. Individuals who are already participating in other ongoing diagnostic studies and/or
 clinical trials.