Are we ready for Taenia solium cysticercosis elimination in sub-Saharan Africa?
Are we ready for Taenia solium cysticercosis elimination in sub-Saharan Africa?
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DOI：
10.1017/s0031182016000500
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发表时间：
2017-01-01
期刊：
影响因子：
2.4
通讯作者：
Braae, U. C.
中科院分区：
文献类型：
--
作者：
Johansen, M. V.;Trevisan, C.;Braae, U. C.
2014年11月，世界卫生组织在第四届“控制被忽视的人畜共患病-从宣传到行动”国际会议上宣布，消除猪带绦虫病/囊虫病（TSTC）的干预工具已经到位。这项工作的目的是阐明在撒哈拉以南非洲（SSA）在4年期间消除TSTC的各种控制方案的理论结果。我们目前对T.疟疾流行病学和控制主要建立在拉丁美洲的研究基础上。一个基于拉丁美洲数据的简单传播模型已被用于预测各种干预措施的效果，如对人类的大规模治疗、对猪的疫苗接种和治疗以及社区的健康教育，这可能导致不良做法的改变并降低传播风险。根据传播模型的模拟，即使是一个为期4年的综合性“一个健康”方法也未能从一个小社区消除TSTC，在所有模拟中，人类带绦虫病和猪囊虫病的流行率在方案结束后立即开始上升。我们目前对撒哈拉以南非洲TSTC的传播和负担的了解很少，虽然声称已经准备好了工具，但诊断和监测工具的选择以及控制和消除TSTC的算法和逐步方法仍然是主要挑战。
The World Health Organization announced in November 2014 at the fourth international meeting on 'the control of neglected zoonotic diseases - from advocacy to action', that intervention tools for eliminating Taenia solium taeniosis/cysticercosis (TSTC) are in place. The aim of this work was to elucidate theoretical outcomes of various control options suggested for TSTC elimination in sub-Saharan Africa (SSA) over a 4-year period. Our current knowledge regarding T. solium epidemiology and control primarily builds on studies from Latin America. A simple transmission model - built on data from Latin America - has been used to predict the effect of various interventions such as mass treatment of humans, vaccination and treatment of pigs, and health education of communities, potentially leading to change in bad practices and reducing transmission risks. Based on simulations of the transmission model, even a 4-year integrated One Health approach fails to eliminate TSTC from a small community and in all simulations, the prevalence of human taeniosis and porcine cysticercosis start to rise as soon as the programmes end. Our current knowledge regarding transmission and burden of TSTC in SSA is scarce and while claiming to be tool ready, the selection of diagnostic and surveillance tools, as well as the algorithms and stepwise approaches for control and elimination of TSTC remain major challenges.