Final report of the Conference on the eradicability of Onchocerciasis.
Final report of the Conference on the eradicability of Onchocerciasis.
复制标题
大会可生动性的最终报告。
DOI：
10.1186/1475-2883-2-2
复制
发表时间：
2003-02-07
期刊：
影响因子：
--
通讯作者：
Hopkins D
中科院分区：
文献类型：
--
作者：
Dadzie Y;Neira M;Hopkins D
来自不同学科的64名专家出席了2002年1月22日至24日在佐治亚州亚特兰大卡特中心举行的关于消除盘尾丝虫病的会议。会议由卡特中心和世界卫生组织组织，由比尔和梅林达·盖茨基金会资助，讨论了一个问题：“盘尾丝虫病（河盲症）是否可以用现有的知识和工具根除？“美国前总统吉米·卡特于1月24日参加了最后一次全体会议的一部分。会议包括由特邀专家发言者作一系列介绍（附录C），并在四个工作组中进行进一步审议（附录D），然后对主要结论进行全体讨论。专题介绍强调了非洲和美洲盘尾丝虫病在流行病学和昆虫学方面的差异。虽然盘尾丝虫病在非洲覆盖广泛的地区，并与惊人的人类和苍蝇种群迁移和非常有效的黑蝇媒介有关，但在美洲，盘尾丝虫病仅在有限的疫源地发现。在美洲，人类和苍蝇种群的迁移并不是主要问题，那里的大多数黑蝇物种都是低效的，尽管也发现了一些高效的黑蝇。在西非盘尾丝虫病控制方案中，有效地实施了病媒控制，取得了显著成效，在原方案地区的大部分地区阻断了传播。伊维菌素的使用产生了不同的结果：虽然伊维菌素治疗在所有流行地区控制盘尾丝虫病这一公共卫生问题方面都是有效的，但其阻断传播的潜力在低度和中度流行地区更有希望。非洲盘尾丝虫病控制计划（APOC）支持OCP以外的非洲流行病国家的盘尾丝虫病控制，将其主要控制工具伊维菌素应用于通过盘尾丝虫病快速流行病学绘图（REMO）确定的高风险地区的社区。和地理信息系统（GIS）。在美洲，通过美洲消除盘尾丝虫病方案（OEPA）的支持，一项每年两次对所有流行社区至少85%的合格人口进行伊维菌素治疗的战略显示出非常好的效果，有望有效地消除该区域的盘尾丝虫病，会议得出结论认为，由于非洲在消除盘尾丝虫病方面存在重大障碍，使用现有工具无法根除盘尾丝虫病。然而，会议还得出结论认为，在大多数（如果不是全部）美洲，可能还有也门和非洲的一些地点，使用现有工具可以消除盘尾丝虫病的传播。会议建议，在阻断传播可行且具有成本效益的情况下，方案应利用一切适当和可用的干预措施，以实现这一目标，以便最终消除盘尾丝虫并停止干预措施。虽然目前在非洲大部分地区无法阻断盘尾丝虫病的传播，但会议建议努力保护西非过去25年来通过盘尾丝虫病控制方案而没有盘尾丝虫病传播的地区。在非洲其余的高度和中度地方病疫源地，继续每年分发伊维菌素将使盘尾丝虫病得到控制，使其不再成为公共卫生问题或经济发展的制约因素。
Sixty-four experts from a variety of disciplines attended a Conference on the Eradicability of Onchocerciasis at The Carter Center, in Atlanta GA, held January 22-24, 2002. The Conference, which was organized by The Carter Center and the World Health Organization, with funding from the Bill & Melinda Gates Foundation, addressed the question: "Is onchocerciasis (River Blindness) eradicable with current knowledge and tools?" Former US President Jimmy Carter attended part of the final plenary proceedings on January 24. The Conference consisted of a series of presentations by invited expert speakers (Appendix C) and further deliberations in four workgroups (Appendix D) followed by plenary discussion of major conclusions. The presentations underlined epidemiological and entomological differences between onchocerciasis in Africa and the Americas. Whilst onchocerciasis in Africa covers extensive areas and is associated with striking human and fly population migrations and remarkably efficient black fly vectors, in the Americas onchocerciasis is found in limited foci. Human and fly population migration are not major problems in the Americas, where most black fly species are inefficient, though some efficient black flies are also found there. Vector control has been effectively applied in the Onchocerciasis Control Program in West Africa (OCP) with remarkable results, interrupting transmission in most parts of the original Program area. The use of ivermectin has given variable results: while ivermectin treatment has been effective in all endemic areas in controlling onchocerciasis as a public health problem, its potential for interrupting transmission is more promising in hypo- and mesoendemic areas. The African Program for Onchocerciasis Control (APOC), which supports onchocerciasis control in endemic African countries outside the OCP, applies ivermectin, its principal control tool, to communities in high-risk areas as determined by rapid epidemiological mapping of onchocerciasis (REMO) and Geographic Information Systems (GIS). In the Americas, through support of the Onchocerciasis Elimination Program in the Americas (OEPA), a strategy of bi-annual ivermectin treatment of at least 85% of the eligible populations in all endemic communities is showing very good results and promises to be effective in eliminating onchocerciasis in the region.The Conference concluded that onchocerciasis is not eradicable using current tools due to the major barriers to eradication in Africa. However, the Conference also concluded that in most if not all the Americas, and possibly Yemen and some sites in Africa, transmission of onchocerciasis can be eliminated using current tools. The Conference recommended that where interruption of transmission is feasible and cost effective, programs should aim for that goal using all appropriate and available interventions so that the Onchocerca volvulus can eventually be eliminated and interventions halted. Although interruption of transmission of onchocerciasis cannot currently be achieved in most of Africa, the Conference recommended that efforts be made to preserve areas in West Africa made free of onchocerciasis transmission through the Onchocerciasis Control Program over the past 25 years. In the remaining hyper and mesoendemic foci in Africa, continued annual distribution of ivermectin will keep onchocerciasis controlled to a point where it is no longer a public health problem or constraint to economic development.