Utzinger J, Keiser J
Swiss Tropical Institute, P.O. Box, CH-4002 Basel, Switzerland.
Ann Trop Med Parasitol. 2006 Jul-Sep;100(5-6):517-33. doi: 10.1179/136485906X97372.
Since the launch of the Annals of Tropical Medicine and Parasitology 100 years ago, the percentage of the world's population living in urban settings has more than tripled and is now approaching 50%. Urbanization will continue at a high pace, particularly in the less developed regions of Africa and Asia. The profound demographic, ecological and socio-economic transformations that accompany the process of urbanization have important impacts on health and well-being. In industrialized countries, urbanization led to the so-called 'epidemiological transition', from acute infectious and deficiency diseases to chronic non-communicable diseases, many decades ago. In the developing world, surprisingly little research has been carried out on the health-related aspects of urbanization. In a temporal analysis of publications in the Annals of Tropical Medicine and Parasitology, for example, in which the first volume in every decade from 1907 was examined, only 16 (2.6%) of the 604 articles investigated focused on epidemiological and/or public-health issues in urban tropical settings. This review begins with the question 'what is urban?' and then provides a summary of the trends seen in urbanization, and its impacts on human health, over the past century, on both a global and regional scale. For the main tropical diseases, estimates of the at-risk populations and the numbers of cases are updated and then split into urban and non-urban categories. The inhabitants of urban slums are particularly vulnerable to many of these diseases and require special attention if internationally-set targets for development are to be met. Heterogeneity, a major feature of urban settings in the tropics that complicates all efforts at health improvement, is demonstrated in an exploration of a densely populated municipality of a large West African town. Urban planners, public-health experts and other relevant stakeholders clearly need to make much more progress in alleviating poverty and enhancing the health and well-being of urban residents, in an equity-effective and sustainable manner.
自《热带医学与寄生虫学年鉴》100年前创刊以来，居住在城市地区的世界人口比例增长了两倍多，目前已接近50%。城市化将继续快速推进，尤其是在非洲和亚洲较不发达地区。城市化进程中伴随的深刻人口、生态和社会经济变革对健康和福祉产生了重要影响。在工业化国家，城市化在几十年前就导致了所谓的“流行病学转变”，即从急性传染病和营养缺乏病转向慢性非传染性疾病。令人惊讶的是，在发展中世界，针对城市化与健康相关方面的研究极少。例如，在对《热带医学与寄生虫学年鉴》各期出版物的时间分析中，对1907年以来每十年的第一卷进行了审查，在所调查的604篇文章中，只有16篇（2.6%）关注热带城市地区的流行病学和/或公共卫生问题。本综述首先探讨“什么是城市？”这一问题，然后总结过去一个世纪在全球和区域范围内城市化的趋势及其对人类健康的影响。对于主要的热带疾病，更新了高危人群和病例数的估计，并将其分为城市和非城市类别。城市贫民窟居民特别容易感染其中许多疾病，如果要实现国际设定的发展目标，就需要给予特别关注。在对西非一个大城镇人口密集的市政当局进行的考察中，展示了异质性这一热带城市环境的主要特征，它使所有改善健康的努力都变得复杂。城市规划者、公共卫生专家和其他相关利益攸关方显然需要在以公平有效和可持续的方式减轻贫困以及增进城市居民的健康和福祉方面取得更大进展。
