The global atlas of podoconiosis.
The global atlas of podoconiosis.
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DOI：
10.1016/s2214-109x(17)30140-7
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发表时间：
2017-05
期刊：
影响因子：
--
通讯作者：
Davey G
中科院分区：
文献类型：
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作者：
Deribe K;Cano J;Newport MJ;Pullan RL;Noor AM;Enquselassie F;Murray CJL;Hay SI;Brooker SJ;Davey G
随着麦地那龙线虫病（麦地那龙线虫病）和脊髓灰质炎的即将消灭，世界即将取得历史性的公共卫生成功。自从世界卫生大会于1981年呼吁根除麦地那龙线虫病和1988年呼吁根除脊髓灰质炎以来，已经取得了惊人的进展。2016年，三个国家仅报告了25例麦地那龙线虫病人间病例，仅在三个国家发现了3例野生脊灰病毒传播，全世界报告了37例脊灰病例。4 .除了这些成就之外，在消除鲜为人知的足癣病（地方性非丝虫病象皮病）方面也取得了进展。5 .消除工作的关键是需要了解疾病的地理分布，以确定潜在风险地区，并为评估消除工作制定基准。6足癣病的全球负担目前尚未明确界定，尽管现有估计表明，全球有400万人患有足癣病，7主要分布在非洲、中美洲和南美洲以及东南亚的热带国家。热带非洲国家的疾病负担最重。文献检索确定了32个已知或疑似足癣病流行的国家。在非洲，安哥拉、布隆迪、喀麦隆、佛得角、乍得、刚果民主共和国、赤道几内亚、埃塞俄比亚、肯尼亚、马达加斯加、莫桑比克、尼日尔、尼日利亚、卢旺达、<s:1>刚果<s:1>和Príncipe、苏丹、坦桑尼亚和乌干达报告了该病。据报道，在巴西、哥伦比亚、哥斯达黎加、厄瓜多尔、萨尔瓦多、法属圭亚那、危地马拉、洪都拉斯、墨西哥、秘鲁和苏里南的拉丁美洲高地都有Podoconiosis。在亚洲，尽管丝虫病象皮病在印度占主导地位，但在该国西北部以及斯里兰卡和印度尼西亚也有足癣病的报告。8然而，由于诊断方面的挑战和怀疑指数低，足癣病的报告可能不足。足癣病是一种与环境有关的疾病，由长期赤脚接触红粘土引起。6,9,10因此，环境因素，如土壤，以及其他影响土壤生成的气候因素，可以帮助预测足癣病的发生。贫困和无法获得足部卫生用水也加剧了个人易患该病的情况。11我们已经收到了来自惠康基金会的资助，用于开发足癣病的全球地图集。我们的目标是推进关于该疾病的地理分布和空间流行病学的新知识。这项工作的第一步将是通过采用证据共识方法（全面查阅文献并与卫生部联系）来确定疾病的地理缺失。13,14该项目还将使用环境预测指标来确定发生足癣病的环境适宜性。在我们之前在埃塞俄比亚的工作中，我们已经确定了驱动足癣病空间分布的重要协变量。使用增强回归树模型，我们绘制了足癣病的环境限制图，以高精度确定足癣病的存在或不存在。6 .一旦在其他国家得到验证，该模式将有可能在全球范围内确定足癣病的环境限制，从而将调查工作定位于高度优先的国家。以人群为基础的调查是绘制足癣病地图的重要数据来源。15根据足癣风险分层进行的调查也很重要。这种调查将提供具有统计能力和空间代表性的抽样，从而捕捉环境风险。
The world stands on the edge of an historic public health success with the imminent eradication of dracunculiasis (guinea-worm disease) and polio. Since the World Health Assembly called for the eradication of dracunculiasis in 19861 and poliomyelitis in 1988, 2 astonishing progress has been made. In 2016, only 25 human cases of dracunculiasis were reported from three countries, 3 transmission of wild poliovirus was found in only three countries, and 37 cases of polio were reported worldwide. 4 In addition to these achievements, there has been progress in the elimination of the littleknown disease podoconiosis (endemic non-filarial elephantiasis). 5 Essential to this elimination effort is the need to understand the geography of the disease to identify potentially at-risk areas and set a benchmark for evaluating elimination efforts. 6 The global burden of podoconiosis is not at present clearly defined, although available estimates suggest that globally there are 4 million people with podoconiosis, 7 mainly in tropical countries of Africa, Central and South America, and southeast Asia. Tropical African countries bear the highest disease burden. A literature search identifies 32 countries as being either known or suspected to be endemic for podoconiosis. In Africa, the disease has been reported in Angola, Burundi, Cameroon, Cape Verde, Chad, Democratic Republic of Congo, Equatorial Guinea, Ethiopia, Kenya, Madagascar, Mozambique, Niger, Nigeria, Rwanda, São Tomé and Príncipe, Sudan, Tanzania, and Uganda. Podoconiosis has been reported in the Latin American highlands in Brazil, Colombia, Costa Rica, Ecuador, El Salvador, French Guiana, Guatemala, Honduras, Mexico, Peru, and Suriname. In Asia, although filarial elephantiasis predominates in India, podoconiosis has been reported in the northwestern part of the country, as well as in Sri Lanka and Indonesia. 8 However, under-reporting of podoconiosis is possible because of diagnostic challenges and a low index of suspicion. Podoconiosis is an environment-related disease, caused by longterm barefoot exposure to red clay soil. 6, 9, 10 Therefore, environmental factors, such as soil, and other climatic factors that affect the generation of soil, can help predict the occurrence of podoconiosis. An individual’s vulnerability to the disease is also aggravated by poverty and insufficient access to water for foot hygiene. 11We have received funding from the Wellcome Trust12 to develop a global atlas of podoconiosis. We aim to advance new knowledge on the geographical distribution and spatial epidemiology of the disease. A first step in this work will be to establish the geographical absence of disease by applying an evidence consensus approach (thorough literature searches and contacting ministries of health). 13, 14 The project will also use environmental predictors to determine environmental suitability for the occurrence of podoconiosis. In our previous work in Ethiopia we have identified important covariates that drive the spatial distribution of podoconiosis. Using boosted regression tree modelling, we mapped the environmental limits of podoconiosis, with high accuracy for determining the presence or absence of podoconiosis. 6 Once validated in other countries this model will have the potential to define the environmental limits of podoconiosis globally, thus targeting survey efforts to high-priority countries. Population-based surveys are important sources of data for mapping of podoconiosis. 15 Surveys informed by podoconiosis risk stratification will also be important. Such surveys will provide statistically powered and spatially representative sampling, which will capture environmental risk …