Innovation for the 'Bottom 100 Million': Eliminating Neglected Tropical Diseases in the Americas
Innovation for the 'Bottom 100 Million': Eliminating Neglected Tropical Diseases in the Americas
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DOI：
10.1007/978-1-4614-4726-9_1
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发表时间：
2013-01-01
期刊：
影响因子：
--
通讯作者：
Bottazzi, Maria E.
中科院分区：
文献类型：
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作者：
Hotez, Peter J.;Dumonteil, Eric;Bottazzi, Maria E.
据估计，拉丁美洲和加勒比地区有1亿人每天生活费不足2美元，而美国还有4600万人生活在该国的贫困线以下。几乎所有“最底层1亿人”都患有至少一种被忽视的热带病，包括该区域一半最贫穷的人感染了钩虫，10%感染了恰加斯病，高达1- 2%的人感染了登革热、血吸虫病和/或利什曼病。在美国，南美锥虫病、囊虫病、弓形虫病和滴虫病等被忽视的热带病在贫困人口中也很常见。由于这些被忽视的热带病对孕产妇和儿童健康以及职业生产力的影响，使该区域最贫穷的人陷入贫困。通过大规模给药，美洲的一些被忽视热带病已接近消除，包括淋巴丝虫病、盘尾丝虫病、沙眼，可能还有麻风病。此外，血吸虫病可能很快在加勒比地区被消灭。然而，对于其他被忽视的热带病，包括钩虫感染、恰加斯病、登革热、血吸虫病和利什曼病，将需要新一代“扶贫疫苗”。多国制药公司正在开发几种登革热疫苗，而与巴西和墨西哥等发展中国家的制造商合作，正在通过非营利性产品开发伙伴关系（pdp）开发其他疫苗。Sabin疫苗研究所PDP正在开发一种主要预防性的二价重组人钩虫疫苗，该疫苗即将在巴西进入1期临床试验，并正在与几个墨西哥机构合作开发一种新的治疗性恰加斯病疫苗。将对血清阳性患者接种恰加斯病疫苗，以延迟或预防恰加斯心肌病的发病（二级预防）。MDA和开发新的扶贫疫苗共同为美洲主要被忽视热带病实施有效控制和消除战略提供了机会。
An estimated 100 million people in the Latin American and Caribbean (LAC) region live on less than US$2 per day, while another 46 million people in the US live below that nation's poverty line. Almost all of the 'bottom 100 million' people suffer from at least one neglected tropical disease (NTD), including one-half of the poorest people in the region infected with hookworms, 10 % with Chagas disease, and up to 1-2 % with dengue, schistosomiasis, and/or leishmaniasis. In the US, NTDs such as Chagas disease, cysticercosis, toxocariasis, and trichomoniasis are also common among poor populations. These NTDs trap the poorest people in the region in poverty, because of their impact on maternal and child health, and occupational productivity. Through mass drug administration (MDA), several NTDs are on the verge of elimination in the Americas, including lymphatic filariasis, onchocerciasis, trachoma, and possibly leprosy. In addition, schistosomiasis may soon be eliminated in the Caribbean. However, for other NTDs including hookworm infection, Chagas disease, dengue, schistosomiasis, and leishmaniasis, a new generation of 'anti-poverty vaccines' will be required. Several vaccines for dengue are under development by multinational pharmaceutical companies, whereas others are being pursued through non-profit product development partnerships (PDPs), in collaboration with developing country manufacturers in Brazil and Mexico. The Sabin Vaccine Institute PDP is developing a primarily preventive bivalent recombinant human hookworm vaccine, which is about to enter phase 1 clinical testing in Brazil, as well as a new therapeutic Chagas disease vaccine in collaboration with several Mexican institutions. The Chagas disease vaccine would be administered to seropositive patients to delay or prevent the onset of Chagasic cardiomyopathy (secondary prevention). Together, MDA and the development of new anti-poverty vaccines afford an opportunity to implement effective control and elimination strategies for the major NTDs in the Americas.