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从蚊虫资源可利用性管理的角度,对非洲疟疾控制的历史成功经验进行合理化分析。

Rationalizing historical successes of malaria control in Africa in terms of mosquito resource availability management.

作者信息

Killeen Gerry F, Seyoum Aklilu, Knols Bart G J

机构信息

Ifakara Health Research and Development Centre, Ifakara, Kilombero District, Tanzania.

出版信息

Am J Trop Med Hyg. 2004 Aug;71(2 Suppl):87-93.

Abstract

Environmental management of mosquito resources is a promising approach with which to control malaria, but it has seen little application in Africa for more than half a century. Here we present a kinetic model of mosquito foraging for aquatic habitats and vertebrate hosts that allows estimation of malaria transmission intensity by defining the availability of these resources as the rate at which individual mosquitoes encounter and use them. The model captures historically observed responses of malaria transmission to environmental change, highlights important gaps in current understanding of vector ecology, and suggests convenient solutions. Resource availability is an intuitive concept that provides an adaptable framework for models of mosquito population dynamics, gene flow, and pathogen transmission that can be conveniently parameterized with direct field measurements. Furthermore, the model presented predicts that drastic reductions of malaria transmission are possible with environmental management and elucidates an ecologic basis for previous successes of integrated malaria control in Africa before the advent of DDT or chloroquine. Environmental management for malaria control requires specialist skills that are currently lacking in sub-Saharan Africa where they are needed most. Infrastructure and human capacity building in clinical, public health, and environmental disciplines should therefore be prioritized so that growing financial support for tackling malaria can be translated into truly integrated control programs.

摘要

蚊虫资源的环境管理是一种很有前景的疟疾控制方法,但在非洲半个多世纪以来很少得到应用。在此,我们提出了一个蚊虫寻找水生栖息地和脊椎动物宿主的动力学模型,该模型通过将这些资源的可利用性定义为单个蚊虫遇到并利用它们的速率,从而能够估计疟疾传播强度。该模型捕捉了历史上观察到的疟疾传播对环境变化的反应,突出了当前对病媒生态学理解中的重要差距,并提出了便捷的解决方案。资源可利用性是一个直观的概念,为蚊虫种群动态、基因流动和病原体传播模型提供了一个可适应的框架,该框架可以通过直接的实地测量方便地进行参数化。此外,所提出的模型预测,通过环境管理有可能大幅降低疟疾传播,并阐明了在滴滴涕或氯喹出现之前非洲综合疟疾控制取得成功的生态学基础。疟疾控制的环境管理需要撒哈拉以南非洲目前最缺乏的专业技能。因此,应优先考虑临床、公共卫生和环境学科的基础设施建设和人力能力建设,以便将日益增加的疟疾防治资金支持转化为真正的综合控制项目。

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