Epidermal parasitic skin diseases: a neglected category of poverty-associated plagues
Epidermal parasitic skin diseases: a neglected category of poverty-associated plagues
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DOI：
10.2471/blt.07.047308
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发表时间：
2009-02-01
期刊：
影响因子：
--
通讯作者：
Heukelbach, Jorg
中科院分区：
文献类型：
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作者：
Feldmeier, Hermann;Heukelbach, Jorg
表皮寄生性皮肤病（EPSD）是一类异质性传染病，其中寄生虫与宿主的相互作用仅限于皮肤上层。六种主要的 EPSD 是疥疮、虱病（头炎、体虱和阴虱）、蜱虫病和钩虫相关的皮肤幼虫移行症。我们总结了目前对 EPSD 的认识，表明这些疾病广泛传播，多寄生很常见，并且存在显着的原发性和继发性发病率。我们表明，贫困有利于动物宿主的存在，确保持续传播，促进传播传染源的非典型方法并增加接触机会。这导致资源匮乏人群中 EPSD 感染的流行率和强度异常高。耻辱感、缺乏获得医疗保健的机会以及寻求医疗保健的行为缺陷是 EPSD 经常未经治疗而进展的原因，也是资源匮乏人群中严重发病率常见的原因。许多发展中国家持续不受控制的城市化使得 EPSD 可能仍然是生活在极端贫困中的人们最重要的寄生虫病。我们主张将 EPSD 的控制纳入针对丝虫病和肠道蠕虫病等其他被忽视疾病的干预措施中。
Epidermal parasitic skin diseases (EPSD) are a heterogeneous category of infectious diseases in which parasite-host interactions are confined to the upper layer of the skin. The six major EPSD are scabies, pediculosis (capitis, corporis and pubis), tungiasis and hookworm-related cutaneous larva migrans. We summarize the current knowledge on EPSD and show that these diseases are widespread, polyparasitism is common, and significant primary and secondary morbidity occurs. We show that poverty favours the presence of animal reservoirs, ensures ongoing transmission, facilitates atypical methods of spreading infectious agents and increases the chances of exposure. This results in an extraordinarily high prevalence and intensity of infestation of EPSD in resource-poor populations. Stigma, lack of access to health care and deficient behaviour in seeking health care are the reasons why EPSD frequently progress untreated and why in resource-poor populations severe morbidity is common. The ongoing uncontrolled urbanization in many developing countries makes it likely that EPSD will remain the overriding parasitic diseases for people living in extreme poverty. We advocate integrating control of EPSD into intervention measures directed against other neglected diseases such as filarlasis and intestinal helminthiases.