Cholera: A new homeland in Africa?
Cholera: A new homeland in Africa?
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DOI：
10.4269/ajtmh.2007.77.705
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发表时间：
2007-10-01
影响因子：
3.3
通讯作者：
Mintz, Eric D.
中科院分区：
文献类型：
--
作者：
Gaffga, Nicholas H.;Tauxe, Robert V.;Mintz, Eric D.
一个多世纪前，工业化国家通过水和污水处理基本上消除了霍乱。如今，它仍然是发展中国家发病和死亡的一个重要原因，也是发展中国家饮用水和卫生基础设施不足的一个标志。霍乱死亡可以通过简单的口服治疗来预防，或者在严重的情况下，通过静脉补液来预防。因此，霍乱病死率反映了获得基本医疗保健的情况。我们回顾了世界卫生组织 (WHO) 1960 年至 2005 年间报告的霍乱病例和死亡数据。在 20 世纪 60 年代，也就是第七次霍乱大流行开始时，霍乱仅以亚洲为重点。 1.970年，疫情蔓延至撒哈拉以南非洲，并一直在那里根深蒂固。 1991年，第七次大流行蔓延至拉丁美洲，导致该地区在3年内报告了近100万例病例。与非洲持续存在的情况相反，拉丁美洲的霍乱在十年之内基本被消灭。 2005年，向世卫组织报告本土霍乱病例的40个国家中有31个（78%）位于撒哈拉以南非洲。 2005年撒哈拉以南非洲报告的本土霍乱发病率（166例/百万人口）比亚洲报告的发病率（1.74例/百万人口）高95倍，比拉丁美洲报告的发病率（0.01例/百万人口）高16,600倍。同年，撒哈拉以南非洲地区的霍乱病死率（1.8%）是亚洲（0.6%）的3倍；拉丁美洲没有霍乱死亡报告。非洲霍乱的持续或控制将成为全球实现千年发展目标的努力以及八国集团国家领导人最近承诺增加对该地区发展援助的一个关键指标。
Cholera was largely eliminated from industrialized countries by water and sewage treatment over a century ago. Today it remains a significant cause of morbidity and mortality in developing countries, where it is a marker for inadequate drinking water and sanitation infrastructure. Death from cholera can be prevented through simple treatment-oral, or in severe cases, intravenous rehydration. The cholera case-fatality rate therefore reflects access to basic health care. We reviewed World Health Organization (WHO) data on cholera cases and deaths reported between 1960 and 2005. In the 1960s, at the beginning of the seventh and current cholera pandemic, cholera had an exclusively Asian focus. In 1.970, the pandemic reached sub-Saharan Africa, where it has remained entrenched. In 1991, the seventh pandemic reached Latin America, resulting in nearly I million reported cases from the region within 3 years. In contrast to the persisting situation in Africa, cholera was largely eliminated from Latin America within a decade. In 2005, 31 (78%) of the 40 countries that reported indigenous cases of cholera to WHO were in sub-Saharan Africa. The reported incidence of indigenous cholera in sub-Saharan Africa in 2005 (166 cases/million population) was 95 times higher than the reported incidence in Asia (1.74 cases/million population) and 16,600 times higher than the reported incidence in Latin America (0.01. cases/million population). In that same year, the cholera case fatality rate in sub-Saharan Africa (1.8%) was 3 times higher than that in Asia (0.6%); no cholera deaths were reported in Latin America. The persistence or control of cholera in Africa will be a key indicator of global efforts to reach the Millennium Development Goals and of recent commitments by leaders of the G-8 countries to increase development aid to the region.