Walsh J A, Warren K S
N Engl J Med. 1979 Nov 1;301(18):967-74. doi: 10.1056/NEJM197911013011804.
Priorities among the infectious diseases affecting the three billion people in the less developed world have been based on prevalence, morbidity, mortality and feasibility of control. With these priorities in mind a program of selective primary health care is compared with other approaches and suggested as the most cost-effective form of medical intervention in the least developed countries. A flexible program delivered by either fixed or mobile units might include measles and diphtheria-pertussis-tetanus vaccination, treatment for febrile malaria and oral rehydration for diarrhea in children, and tetanus toxoid and encouragement of breast feeding in mothers. Other interventions might be added on the basis of regional needs and new developments. For major diseases for which control measures are inadequate, research is an inexpensive approach on the basis of cost per infected person per year.
在影响欠发达世界30亿人口的传染病中,其优先次序是基于疾病的流行率、发病率、死亡率以及控制的可行性来确定的。基于这些优先次序,将选择性初级卫生保健项目与其他方法进行了比较,并建议其作为最不发达国家最具成本效益的医疗干预形式。由固定或移动单位提供的灵活项目可能包括麻疹和白喉-百日咳-破伤风疫苗接种、儿童高热疟疾治疗和腹泻口服补液,以及母亲的破伤风类毒素接种和鼓励母乳喂养。其他干预措施可根据区域需求和新进展加以补充。对于控制措施不足的主要疾病,从每年每名感染者的成本来看,研究是一种成本低廉的方法。