Difficulties and strategies in the control of schistosomiasis in the Philippines
Difficulties and strategies in the control of schistosomiasis in the Philippines
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DOI：
10.1016/s0001-706x(02)00022-0
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发表时间：
2002-05-01
期刊：
影响因子：
2.7
通讯作者：
Aligui, GDL
中科院分区：
文献类型：
--
作者：
Leonardo, LR;Acosta, LP;Aligui, GDL
日本血吸虫病仍然是菲律宾的一个公共卫生问题，影响到16个地区中的10个地区，有670万人处于危险之中，其中大多数是农民和渔民。早期的努力集中在蜗牛控制在没有一种有效的药物来对付这种疾病。吡喹酮的发现将控制重点从昂贵的蜗牛控制转移到更易于管理的病例发现和治疗。目前，政府的目标是通过化学疗法降低发病率，并辅之以环境卫生、健康教育和灭螺。在过去，外部资金注入政府控制项目，帮助降低了许多高度流行地区的流行率。这种外国援助的结束严重影响了方案的执行，使人们担心许多流行地区可能死灰复燃。这种焦虑也是基于长期存在的问题，即风险人群对疾病的认识不足、安全问题加剧、贫困以及保健提供系统中权力下放的负面影响。专家们建议，国家卫生部门在处理这种疾病方面应该更加积极，确保执行，并不断寻求更好和更完善的控制方法。任何新的战略都应该考虑卫生部门的权力下放。(C)2002 Elsevier Science B.V.保留所有权利。
Schistosomiasis japonica continues to remain a public health problem in the Philippines affecting 10 out of 16 regions with 6.7 million people at risk mostly farmers and fisher folks. Early efforts focused on snail control in the absence of an effective drug against the disease. Discovery of praziquantel shifted control focus from the expensive snail control to a more manageable one involving case detection and treatment. At present, the government's objective is to reduce morbidity by chemotherapy and supplemented with environmental sanitation, health education, and mollusciciding. In the past, external funds infused into government control programs helped a lot in bringing down prevalence rates of the disease in many highly endemic areas. The end of this foreign assistance has expectedly affected implementation of the programs bringing fears of a possible resurgence in many endemic areas. Such anxiety is also founded on the perennial problems of low disease awareness among people at risk, aggravated security problem, poverty and the negative effects of a devolved set-up in the health care delivery system. Experts suggest that the national health department should be more aggressive in dealing with the disease in terms of ensuring implementation and of continuously searching for better and more improved methods of control. Any new strategy should always consider the devolved set up of the health department. (C) 2002 Elsevier Science B.V. All rights reserved.