Integrating vector control across diseases.
Integrating vector control across diseases.
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DOI：
10.1186/s12916-015-0491-4
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发表时间：
2015-10-01
期刊：
影响因子：
9.3
通讯作者：
Lindsay SW
中科院分区：
文献类型：
--
作者：
Golding N;Wilson AL;Moyes CL;Cano J;Pigott DM;Velayudhan R;Brooker SJ;Smith DL;Hay SI;Lindsay SW
病媒传播疾病在地球仪的总体疾病负担中占很大比例，占传染病负担的10%以上。尽管对其中许多疾病采取了有效的干预措施，但由于缺乏资源，这些疾病无法得到有效控制。众所周知，许多现有的病媒控制干预措施对多种疾病都有效，因此，将病媒控制方案结合起来，同时应对多种疾病，可以提高成本效益，从而可持续地减少疾病。在资源匮乏的情况下，疫苗和大规模药物管理方案的跨疾病整合非常成功，为跨疾病病媒控制开创了先例。虽然针对多种疾病有意识地实施病媒控制方案尚未进行大规模试验，但一些“意外”跨疾病病媒控制的例子表明了这种方法的潜力。结合当代高分辨率的主要病媒传播病原体的全球地图，使我们能够量化其分布的重叠，并估计共同面临多种疾病风险的人群。这种分析表明，全球80%以上的人口生活在世界上有一种病媒传播疾病风险的地区，世界一半以上的人口生活在至少两种不同病媒传播疾病对健康构成威胁的地区。将关于共同流行的信息与对有效防治这些疾病的病媒控制方法重叠的评估相结合，使我们能够突出这种整合的机会。疟疾、利什曼病、淋巴丝虫病和登革热是综合病媒控制的主要对象。所有这四种疾病在分布上都有相当大的重叠，越来越多的证据表明，经杀虫剂处理的蚊帐、纱窗和窗帘在控制所有病媒方面是有效的。交叉病媒控制方案在现实世界中的有效性只能通过大规模试验来评估，但有明确的证据表明，这种方法有可能利用有限的可用资金实现更大的总体健康效益。本文的在线版本（doi：10.1186/s12916-015-0491-4）包含补充材料，可供授权用户使用。
Vector-borne diseases cause a significant proportion of the overall burden of disease across the globe, accounting for over 10 % of the burden of infectious diseases. Despite the availability of effective interventions for many of these diseases, a lack of resources prevents their effective control. Many existing vector control interventions are known to be effective against multiple diseases, so combining vector control programmes to simultaneously tackle several diseases could offer more cost-effective and therefore sustainable disease reductions. The highly successful cross-disease integration of vaccine and mass drug administration programmes in low-resource settings acts a precedent for cross-disease vector control. Whilst deliberate implementation of vector control programmes across multiple diseases has yet to be trialled on a large scale, a number of examples of ‘accidental’ cross-disease vector control suggest the potential of such an approach. Combining contemporary high-resolution global maps of the major vector-borne pathogens enables us to quantify overlap in their distributions and to estimate the populations jointly at risk of multiple diseases. Such an analysis shows that over 80 % of the global population live in regions of the world at risk from one vector-borne disease, and more than half the world’s population live in areas where at least two different vector-borne diseases pose a threat to health. Combining information on co-endemicity with an assessment of the overlap of vector control methods effective against these diseases allows us to highlight opportunities for such integration. Malaria, leishmaniasis, lymphatic filariasis, and dengue are prime candidates for combined vector control. All four of these diseases overlap considerably in their distributions and there is a growing body of evidence for the effectiveness of insecticide-treated nets, screens, and curtains for controlling all of their vectors. The real-world effectiveness of cross-disease vector control programmes can only be evaluated by large-scale trials, but there is clear evidence of the potential of such an approach to enable greater overall health benefit using the limited funds available. The online version of this article (doi:10.1186/s12916-015-0491-4) contains supplementary material, which is available to authorized users.