Effect of water resource development and management on lymphatic filariasis, and estimates of populations at risk
Effect of water resource development and management on lymphatic filariasis, and estimates of populations at risk
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DOI：
10.4269/ajtmh.2005.73.523
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发表时间：
2005-09-01
影响因子：
3.3
通讯作者：
Utzinger, J
中科院分区：
文献类型：
--
作者：
Erlanger, TE;Keiser, J;Utzinger, J
淋巴丝虫病(LF)是一种由班克罗夫氏舞蹈菌(Wuchereria Bancrofti)引起的令人衰弱的疾病，该疾病由各种蚊子传播。在这里，我们提供了一个系统的文献综述，目的如下：(I)建立全球和区域估计的有LF风险的人口，特别是考虑水资源开发项目，以及(Ii)评估水资源开发和管理对该病的频率和传播动态的影响。我们估计，在全球范围内，有20亿人面临LF的风险。其中，有3.945亿城市居民无法获得改善的卫生条件，2.13亿农村居民生活在靠近灌溉的地方。水资源开发和管理引起的环境变化一直导致病媒物种构成的转变，总体上导致病媒种群的强劲增长。例如，在世界卫生组织(世卫组织)分区域1和2，冈比亚按蚊复合体和按蚊在灌溉地区的蚊子密度比无灌溉地区高25倍。虽然在水利工程实施后，LF的感染率经常增加，但与临床症状没有明显的联系。结论是，有必要评估和量化低频传播参数和临床表现在整个水资源开发过程中的变化。在资源允许的情况下，综合病媒管理应该补充大规模的药物管理，对疾病的广泛监测和监测应该成为大规模废物管理和卫生项目的组成部分，其基本原理在于对城市、地区和区域各级的卫生服务和疾病预防采取系统的方法。
Lymphatic filariasis (LF) is a debilitating disease overwhelmingly caused by Wuchereria bancrofti, which is transmitted by various mosquito species. Here, we present a systematic literature review with the following objectives: (i) to establish global and regional estimates of populations at risk of LF with particular consideration of water resource development projects, and (ii) to assess the effects of water resource development and management on the frequency and transmission dynamics of the disease. We estimate that globally, 2 billion people are at risk of LF. Among them, there are 394.5 million urban dwellers without access to improved sanitation and 213 million rural dwellers living in close proximity to irrigation. Environmental changes due to water resource development and management consistently led to a shift in vector species composition and generally to a strong proliferation of vector populations. For example, in World Health Organization (WHO) subregions 1 and 2, mosquito densities of the Anopheles gambiae complex and Anopheles funestus were up to 25-fold higher in irrigated areas when compared with irrigation-free sites. Although the infection prevalence of LF often increased after the implementation of a water project, there was no clear association with clinical symptoms. Concluding, there is a need to assess and quantify changes of LF transmission parameters and clinical manifestations over the entire course of water resource developments. Where resources allow, integrated vector management should complement mass drug administration, and broad-based monitoring and surveillance of the disease should become an integral part of large-scale waste management and sanitation programs, whose basic rationale lies in a systemic approach to city, district, and regional level health services and disease prevention.