Controlling soil-transmitted helminthiasis in pre-school-age children through preventive chemotherapy.
Controlling soil-transmitted helminthiasis in pre-school-age children through preventive chemotherapy.
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DOI：
10.1371/journal.pntd.0000126
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发表时间：
2008-03-26
影响因子：
3.8
通讯作者：
Savioli L
中科院分区：
文献类型：
--
作者：
Albonico M;Allen H;Chitsulo L;Engels D;Gabrielli AF;Savioli L
在全世界感染土壤传播蠕虫（STHs）的20亿人中，学龄前儿童占10%-20%：类蚓蛔虫（蛔虫）、鞭虫（鞭虫）和十二指肠钩虫/美洲钩虫（钩虫）。通过系统地审查已发表的文献并使用世界卫生组织总部整理的信息，本文总结了支持将学龄前儿童纳入定期驱虫规划的建议的现有证据。第一部分描述了这一年龄组的STH疾病负担，随后总结了感染如何影响铁状态、生长、维生素a状态和认知发育，以及STHs如何加剧其他高死亡率感染。第二部分探讨药物本身的安全性，单独给药或联合给药，药物功效，以及安全给药的重要性。第三部分提供以国家为基础的证据，证明经STH治疗后健康结果得到改善。最后一节介绍了各国利用其他大规模公共卫生干预措施，包括维生素A规划、免疫运动和儿童健康日，扩大学前儿童覆盖面的经验。论文最后提出了一些尚未解决的研究问题，并总结了一些仍需解决的运营挑战。
Pre-school age children account for 10%–20% of the 2 billion people worldwide who are infected with soil-transmitted helminths (STHs): Ascaris lumbricoides (roundworm), Trichuris trichiura (whipworm), and Ancylostoma duodenale/Necator americanus (hookworms). Through a systematic review of the published literature and using information collated at World Health Organization headquarters, this paper summarizes the available evidence to support the recommendation that pre-school children should be included in regular deworming programmes. The first section describes the burden of STH disease in this age group, followed by a summary of how infection impacts iron status, growth, vitamin A status, and cognitive development and how STHs may exacerbate other high mortality infections. The second section explores the safety of the drugs themselves, given alone or co-administered, drug efficacy, and the importance of safe administration. The third section provides country-based evidence to demonstrate improved health outcomes after STH treatment. The final section provides country experiences in scaling up coverage of pre-school children by using other large scale public health interventions, including vitamin A programmes, immunization campaigns, and Child Health days. The paper concludes with a number of open research questions and a summary of some of the operational challenges that still need to be addressed.
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