Ehrenberg John P, Ault Steven K
Area of Disease Prevention and Control, Pan American Health Organization/World Health Organization, Washington, DC 20037, USA.
BMC Public Health. 2005 Nov 11;5:119. doi: 10.1186/1471-2458-5-119.
People living in poverty throughout the developing world are heavily burdened with neglected communicable diseases and often marginalized by the health sector. These diseases are currently referred to as Neglected Diseases of Neglected Populations. The neglected diseases create social and financial burdens to the individual, the family, the community, and the nation.
Numerous studies of successful individual interventions to manage communicable disease determinants in various types of communities have been published, but few have applied multiple interventions in an integrated, coordinated manner. We have identified a series of successful interventions and developed three hypothetical scenarios where such interventions could be applied in an integrated, multi-disease, inter-programmatic, and/or inter-sectoral approach for prevention and control of neglected diseases in three different populations: a slum, an indigenous community, and a city with a mix of populations.
The objective of this paper is to identify new opportunities to address neglected diseases, improve community health and promote sustainable development in neglected populations by highlighting examples of key risk and protective factors for neglected diseases which can be managed and implemented through multi-disease-based, integrated, inter-programmatic, and/or inter-sectoral approaches. Based on a literature review, analysis and development of scenarios we visualize how multiple interventions could manage multiple disease problems and propose these as possible strategies to be tested. We seek to stimulate intra- and inter-sectoral dialogue which will help in the construction of new strategies for neglected diseases (particularly for the parasitic diseases) which could benefit the poor and marginalized based on the principle of sustainability and understanding of key determinants of health, and lead to the establishment of pilot projects and activities which can contribute to the achievement of the Millennium Development Goals.
生活在发展中世界贫困地区的人们承受着被忽视的传染病的沉重负担,并且常常被卫生部门边缘化。这些疾病目前被称为被忽视人群的被忽视疾病。这些被忽视疾病给个人、家庭、社区和国家带来了社会和经济负担。
已经发表了许多关于在各类社区成功进行个体干预以管理传染病决定因素的研究,但很少有研究以综合、协调的方式应用多种干预措施。我们确定了一系列成功的干预措施,并制定了三种假设情景,在这些情景中,可以以综合、多病种、跨项目和/或跨部门的方法,在三种不同人群(贫民窟、土著社区以及人口混杂的城市)中应用这些干预措施来预防和控制被忽视疾病。
本文的目的是通过突出被忽视疾病的关键风险和保护因素的实例,确定应对被忽视疾病、改善社区健康以及促进被忽视人群可持续发展的新机会,这些因素可以通过基于多病种的、综合的、跨项目和/或跨部门的方法进行管理和实施。基于文献综述、情景分析和制定,我们设想了多种干预措施如何能够解决多种疾病问题,并将这些作为可能的策略提出以供测试。我们力求激发部门内部和部门之间的对话,这将有助于构建针对被忽视疾病(特别是寄生虫病)的新策略,这些策略基于可持续性原则以及对健康关键决定因素的理解,能够使穷人和边缘化人群受益,并促成有助于实现千年发展目标的试点项目和活动的建立。