Clinical Research on Neglected Tropical Diseases: Challenges and Solutions

Research pertaining to the neglected tropical diseases (NTDs) poses specific challenges that are linked to the diseases investigated, infrastructure (or lack thereof), culture, social-ecological systems, conflicting health policies, and ethics requirements, among others [1–3]. In 2010, the European research network on better diagnosis for neglected infectious diseases (NIDIAG consortium; see: http://www.nidiag.org) was launched to carry out collaborative research with an emphasis on NTDs. NIDIAG’s overarching goal was to generate evidence about the spectrum of causal pathogens of selected syndromes in different epidemiologic settings in order to improve the diagnosis and management. The NIDIAG consortium is composed of research groups from African and Asian countries endemic for human African trypanosomiasis, schistosomiasis, soil-transmitted helminthiasis, visceral leishmaniasis (VL), and other NTDs, together with European biomedical and clinical researchers working on the same topics. The research is facilitated by a grant from the European Union (EU) within the Seventh Framework Programme (FP7). The consortium launched its work on November 1, 2010, for an initial five-year period and an additional six-month nocost extension until April 30, 2016. In the current issue of PLoS Neglected Tropical Diseases, a collection of articles [4–8, 39]— mainly prepared in the style of symposia—is published, in which we would like to share experiences and lessons from the NIDIAG consortium that range from designing, setting up, implementing, and evaluating multiple clinical studies in partner countries in the global South. In this editorial, we provide an umbrella, discuss perceived challenges in the field of NTD research, and propose solutions on how these issues were overcome during the conduct of the NIDIAG studies. We hope that this article collectionwill stimulate others working on clinicaldiagnostic issues of NTDs to further improve patient management and population-based control and elimination.