Lo Nathan C, Addiss David G, Hotez Peter J, King Charles H, Stothard J Russell, Evans Darin S, Colley Daniel G, Lin William, Coulibaly Jean T, Bustinduy Amaya L, Raso Giovanna, Bendavid Eran, Bogoch Isaac I, Fenwick Alan, Savioli Lorenzo, Molyneux David, Utzinger Jürg, Andrews Jason R
Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA; Division of Epidemiology, Stanford University School of Medicine, Stanford, CA, USA.
Children Without Worms, Task Force for Global Health, Decatur, GA, USA.
Lancet Infect Dis. 2017 Feb;17(2):e64-e69. doi: 10.1016/S1473-3099(16)30535-7. Epub 2016 Nov 30.
In 2001, the World Health Assembly (WHA) passed the landmark WHA 54.19 resolution for global scale-up of mass administration of anthelmintic drugs for morbidity control of schistosomiasis and soil-transmitted helminthiasis, which affect more than 1·5 billion of the world's poorest people. Since then, more than a decade of research and experience has yielded crucial knowledge on the control and elimination of these helminthiases. However, the global strategy has remained largely unchanged since the original 2001 WHA resolution and associated WHO guidelines on preventive chemotherapy. In this Personal View, we highlight recent advances that, taken together, support a call to revise the global strategy and guidelines for preventive chemotherapy and complementary interventions against schistosomiasis and soil-transmitted helminthiasis. These advances include the development of guidance that is specific to goals of morbidity control and elimination of transmission. We quantify the result of forgoing this opportunity by computing the yearly disease burden, mortality, and lost economic productivity associated with maintaining the status quo. Without change, we estimate that the population of sub-Saharan Africa will probably lose 2·3 million disability-adjusted life-years and US$3·5 billion of economic productivity every year, which is comparable to recent acute epidemics, including the 2014 Ebola and 2015 Zika epidemics. We propose that the time is now to strengthen the global strategy to address the substantial disease burden of schistosomiasis and soil-transmitted helminthiasis.
2001年,世界卫生大会(WHA)通过了具有里程碑意义的WHA 54.19号决议,以在全球范围内扩大大规模施用驱虫药物,用于控制血吸虫病和土壤传播的蠕虫病的发病率,这些疾病影响着全球超过15亿最贫困人群。自那时以来,十多年的研究和经验产生了关于控制和消除这些蠕虫病的关键知识。然而,自2001年最初的WHA决议以及世界卫生组织(WHO)关于预防性化疗的相关指南以来,全球战略在很大程度上保持不变。在这篇个人观点文章中,我们强调了近期的进展,这些进展综合起来支持呼吁修订针对血吸虫病和土壤传播的蠕虫病的预防性化疗及补充干预措施的全球战略和指南。这些进展包括制定针对发病率控制和传播消除目标的具体指南。我们通过计算维持现状所带来的年度疾病负担、死亡率和经济生产力损失,来量化放弃这一机会的结果。如果不做出改变,我们估计撒哈拉以南非洲地区的人口每年可能会损失230万个伤残调整生命年以及35亿美元的经济生产力,这与近期的急性疫情相当,包括2014年的埃博拉疫情和2015年的寨卡疫情。我们认为现在是时候加强全球战略,以应对血吸虫病和土壤传播的蠕虫病所带来的巨大疾病负担了。