Schistosomiasis
Schistosomiasis
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DOI：
10.1038/s41572-018-0013-8
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发表时间：
2018-08-09
影响因子：
81.5
通讯作者：
Zhou, Xiao-Nong
中科院分区：
文献类型：
--
作者：
McManus, Donald P.;Dunne, David W.;Zhou, Xiao-Nong
血吸虫病（血吸虫病）是由血吸虫属的寄生扁虫（血吸虫）引起的一种被忽视的热带疾病，在中东、南美洲、东南亚部分地区，特别是在撒哈拉以南非洲，发病率相当高。感染性幼虫在穿透最终人类宿主的皮肤之前在中间宿主（淡水蜗牛）中生长。成熟蠕虫寄生在肠系膜静脉（曼氏血吸虫和日本血吸虫）或盆腔静脉（埃及血吸虫）中，雌蠕虫产卵，并分泌到粪便或尿液中。卵被困在周围组织和器官中，如肝脏和膀胱，引起炎症免疫反应（包括肉芽肿），导致肠道，肝脾或泌尿生殖系统疾病。诊断需要检测排泄物中的虫卵或血清中的蠕虫抗原，并需要对生活在流行地区的人群进行敏感、快速的即时检测。吡喹酮对六种血吸虫蠕虫均安全有效。感染人类;然而，它不能防止再感染，抗药性的出现是一个令人关切的问题。消除血吸虫病需要采取多方面的办法，包括：治疗;控制蜗牛;信息、教育和通信;改善水、环境卫生和个人卫生;准确的诊断;以及随时根据社会生态环境调整的监测反应系统。
Schistosomiasis (bilharzia) is a neglected tropical disease caused by parasitic flatworms (blood flukes) of the genus Schistosoma, with considerable morbidity in parts of the Middle East, South America, Southeast Asia and, particularly, in sub-Saharan Africa. Infective larvae grow in an intermediate host (fresh-water snails) before penetrating the skin of the definitive human host. Mature adult worms reside in the mesenteric (Schistosoma mansoni and Schistosoma japonicum) or pelvic (Schistosoma haematobium) veins, where female worms lay eggs, which are secreted in stool or urine. Eggs trapped in the surrounding tissues and organs, such as the liver and bladder, cause inflammatory immune responses (including granulomas) that result in intestinal, hepato-splenic or urogenital disease. Diagnosis requires the detection of eggs in excreta or worm antigens in the serum, and sensitive, rapid, point-of-care tests for populations living in endemic areas are needed. The anti-schistosonnal drug praziquantel is safe and efficacious against adult worms of all the six Schistosoma spp. infecting humans; however, it does not prevent reinfection and the emergence of drug resistance is a concern. Schistosomiasis elimination will require a multifaceted approach, including: treatment; snail control; information, education and communication; improved water, sanitation and hygiene; accurate diagnostics; and surveillance-response systems that are readily tailored to social-ecological settings.