Epidemiology and control of human gastrointestinal parasites in children.
Epidemiology and control of human gastrointestinal parasites in children.
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DOI：
10.1586/eri.09.119
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发表时间：
2010-02
影响因子：
5.7
通讯作者：
Olliaro PL
中科院分区：
文献类型：
--
作者：
Harhay MO;Horton J;Olliaro PL
在人类胃肠道中发现的寄生虫可以大致分为两类，原生动物和蠕虫。土壤传播的蠕虫(蛔虫、钩虫和鞭虫)最为流行，估计感染全球人口的六分之一。生活在撒哈拉以南非洲的儿童感染率最高，其次是亚洲，然后是拉丁美洲和加勒比地区。通过越来越多地与捐助者、政府和当地社区协调行动的多项倡议的努力，目前全球运送毒品以控制毒品的势头处于历史最高水平。他们一起向儿童提供了大量的药物，特别是驱虫药，通过全国性的年度或两年一次的大规模药物管理，基本上是通过学校协调的。然而，这些地区数量大得多且增长迅速的儿童人口仍然得不到治疗，并遭受不止一种寄生虫的折磨。大规模药物管理具有深刻的控制潜力，但也不是没有相当大的挑战和关切。一个主要的障碍是资金。除了采购和部署药物(以及维持这些供应链)之外，刺激研究和开发管道，支持完善治疗的必要临床试验，需要大量资金和资源，而这些资金和资源目前并不存在。有限的化疗选择引起了人们对过度使用而产生耐药性的担忧，然而，令人满意的药物流行病学和耐药性监测需要比一般情况下更发达的卫生基础设施。此外，有限的药典不包括任何有效的二线选择，如果出现耐药性，研究和开发管道严重受阻。在这里，我们讨论了主要的胃肠道原虫和蠕虫，回顾了它们对儿童健康的影响，流行病学的变化以及这与它们的控制之间的关系。
Parasites found in the human gastrointestinal tract can be largely categorized into two groups, protozoa and helminths. The soil-transmitted helminths (Ascaris lumbricoides, hookworm and Trichuris trichiura) are the most prevalent, infecting an estimated one-sixth of the global population. Infection rates are highest in children living in sub-Saharan Africa, followed by Asia and then Latin America and the Caribbean. The current momentum towards global drug delivery for their control is at a historical high through the efforts of numerous initiatives increasingly acting in coordination with donors, governments and local communities. Together, they have delivered enormous quantities of drugs, especially anthelmintics to children through nationwide annual or biannual mass drug administration largely coordinated through schools. However, a much larger and rapidly growing childhood population in these regions remains untreated and suffering from more than one parasite. Mass drug administration has profound potential for control but is not without considerable challenges and concerns. A principal barrier is funding. Stimulating a research and development pipeline, supporting the necessary clinical trials to refine treatment, in addition to procuring and deploying drugs (and sustaining these supply chains), requires substantial funding and resources that do not presently exist. Limited options for chemotherapy raise concerns about drug resistance developing through overuse, however, satisfactory pharmacoepidemiology and monitoring for drug resistance requires more developed health infrastructures than are generally available. Further, the limited pharmacopeia does not include any effective second-line options if resistance emerges, and the research and development pipeline is severely depressed. Herein, we discuss the major gastrointestinal protozoa and helminths reviewing their impact on child health, changing epidemiology and how this relates to their control.
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影响因子：
--
作者：
Asojo, Oluwatoyin A.;Homma, Kohei;Hotez, Peter J.
通讯作者：
Hotez, Peter J.
影响因子：
12.8
作者：
Antonio Castro-Hermida, Jose;Garcia-Presedo, Ignacio;Mezo, Mercedes
通讯作者：
Mezo, Mercedes
影响因子：
12.8
作者：
Antonio Castro-Hermida, Jose;Garcia-Presedo, Ignacio;Mezo, Mercedes
通讯作者：
Mezo, Mercedes
影响因子：
11.8
作者：
Barnett, ED
通讯作者：
Barnett, ED
DOI：
10.1016/0035-9203(95)90101-9
发表时间：
1995-09-01
影响因子：
2.2
作者：
ALBONICO, M;SMITH, PG;SAVIOLI, L
通讯作者：
SAVIOLI, L