Schistosomiasis elimination: lessons from the past guide the future
Schistosomiasis elimination: lessons from the past guide the future
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DOI：
10.1016/s1473-3099(10)70099-2
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发表时间：
2010-10-01
影响因子：
56.3
通讯作者：
Ross, Allen G.
中科院分区：
文献类型：
--
作者：
Gray, Darren J.;McManus, Donald P.;Ross, Allen G.
血吸虫病是一种被忽视的主要热带病，有2亿多人受到感染，近8亿人面临感染风险。疾病负担估计超过7 000万残疾调整生命年。驱虫药吡喹酮在杀死成年血吸虫方面非常有效，但它不能杀死发育中的血吸虫，因此不能防止再次感染。因此，目前在亚洲和撒哈拉以南非洲以吡喹酮为基础的控制规划从长期来看并不有效或可持续。控制被忽视的热带病，包括血吸虫病，是若干捐助机构的供资重点，到2013年承诺提供3.5亿多美元。在此，我们提出一个论点，即捐助者的资金将更有效地用于制定一个多方面的综合控制方案，这将比目前以化疗为基础的方案对疾病传播产生更大和更持久的影响。研制一种阻断传播的疫苗也非常重要。一个包含疫苗的多方面综合控制规划，即使只是部分有效，也有可能消除血吸虫病。这种综合办法模式有可能改善世界上10亿最贫穷人口的健康，其效果不容低估。
Schistosomiasis is a major neglected tropical disease, with more than 200 million people infected and close to 800 million at risk. The disease burden is estimated to exceed 70 million disability-adjusted life-years. The anthelmintic drug praziquantel is highly effective in killing adult schisitosome worms, but it is unable to kill developing schistosomes and so does not prevent reinfection. As a result, current praziquantel-based control programmes in Asia and sub-Saharan Africa are not effective or sustainable in the long term. The control of neglected tropical diseases, including schistosomiasis, is a funding priority for several donor agencies, with over US$350 million committed until 2013. Here we put forward an argument that donor funds would be more effectively spent on the development of a multifaceted, integrated control programme, which would have a greater and longer lasting effect on disease transmission than the current chemotherapy-based programmes. The development of a transmission-blocking vaccine is also of great importance. A multi-faceted integrated control programme that incorporates a vaccine, even if only partly effective, has the potential to eliminate schistosomiasis. This integrated-approach model has the potential to improve the health of a billion of the world's poorest people and its effect cannot be underestimated.