Global epidemiology, ecology and control of soil-transmitted helminth infections.
Global epidemiology, ecology and control of soil-transmitted helminth infections.
复制标题
全球流行病学，生态学和控制土壤传播的蠕虫感染。
DOI：
10.1016/s0065-308x(05)62007-6
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发表时间：
2006
影响因子：
--
通讯作者：
Bundy, D. A. P.
中科院分区：
文献类型：
--
作者：
Brooker, S.;Clements, A. C. A.;Bundy, D. A. P.
土壤传播的蠕虫（STH）感染是世界上最普遍的慢性人类感染之一。基于对儿童发展的明显影响，全球承诺资助和实施控制战略，重点放在以学校为基础的化疗方案。实施具有成本效益的控制的主要障碍是缺乏对感染地理分布的准确描述。近年来，在利用地理信息系统（GIS）和遥感（RS）更好地了解蠕虫生态学和流行病学以及开发低成本方法确定治疗目标人群方面取得了相当大的进展。本章探讨如何实际使用这些信息来指导大规模控制规划。卫星环境数据的使用为地理范围内的感染生态提供了新的见解，而传统方法已被证明无法解决这一问题，这反过来又使感染流行率的空间分布能够通过统计方法得到可靠的预测。地理信息系统/遥感系统越来越多地用于大规模的蠕虫控制规划，不仅包括STH感染，还包括血吸虫病、丝虫病和盘尾丝虫病。经验表明，GIS/RS为实际规模的项目设计和监测提供了一种经济有效的方法。重要的是，这种方法的使用已经开始从国际垂直项目的专业方法转变为制定公共部门控制项目的常规工具。这里使用GIS/RS来描述STH感染的全球分布，并估计撒哈拉以南非洲学龄儿童的感染人数（8,990万）和使用校本方法提供单一驱虫药治疗的年度费用（500 - 760万美元）。这是第一次在大陆尺度上明确包括感染流行率和人口的精细空间分布的估计，并表明传统方法高估了情况。结果表明，从财政角度来看，在整个大陆范围内控制寄生虫是一个可以实现的目标。
Soil-transmitted helminth (STH) infections are among the most prevalent of chronic human infections worldwide. Based on the demonstrable impact on child development, there is a global commitment to finance and implement control strategies with a focus on school-based chemotherapy programmes. The major obstacle to the implementation of cost-effective control is the lack of accurate descriptions of the geographical distribution of infection. In recent years considerable progress has been made in the use of geographical information systems (GIS) and remote sensing (RS) to better understand helminth ecology and epidemiology, and to develop low cost ways to identify target populations for treatment. This chapter explores how this information has been used practically to guide large-scale control programmes. The use of satellite-derived environmental data has yielded new insights into the ecology of infection at a geographical scale that has proven impossible to address using more traditional approaches, and has in turn allowed spatial distributions of infection prevalence to be predicted robustly by statistical approaches. GIS/RS have increasingly been used in the context of large-scale helminth control programmes, including not only STH infections but also those focusing on schistosomiasis, filariasis and onchocerciasis. The experience indicates that GIS/RS provides a cost-effective approach to designing and monitoring programs at realistic scale. Importantly, the use of this approach has begun to transition from being a specialist approach of international vertical programs to become a routine tool in developing public sector control programs. GIS/RS is used here to describe the global distribution of STH infections and to estimate the number of infections in school age children in sub-Saharan Africa (89.9 million) and the annual cost of providing a single anthelmintic treatment using a school-based approach (US$5.0-7.6 million). These are the first estimates at a continental scale to explicitly include the fine spatial distribution of infection prevalence and population, and suggest that traditional methods have overestimated the situation. The results suggest that continent-wide control of parasites is, from a financial perspective, an attainable goal.