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[地方性热带疾病:发展中世界因被忽视疾病导致的当代健康问题]

[Endemic tropical diseases: comtemporary health problem due to abandoned diseases in the developing world].

作者信息

Ohta Nobuo

机构信息

Section of Environmental Parasitology, Tokyo Medical and Dental University.

出版信息

Kansenshogaku Zasshi. 2006 Sep;80(5):469-74. doi: 10.11150/kansenshogakuzasshi1970.80.469.

DOI:10.11150/kansenshogakuzasshi1970.80.469
PMID:17073258
Abstract

There are two kinds of infectious diseases in the world; diseases being paid attention and neglected diseases. The former diseases include HIV/AIDS, tuberculosis and malaria, the latter group include many parasitic, fungal, bacterial and some of viral infections. "Neglected Infectious Diseases", which have been renamed as Endemic Tropical Diseases by WHO, are endemic in the developing world are not newly appeared diseases, but diseases affecting humans in these decades. In fact, DALYs for several diseases in the category are big enough; more than 300 millions for soil-transmitted helminthiasis, 5 millions for lymphatic filariasis, 4-5 millions for schistosomiasis and so forth. However, those diseases were not recognized as serious health problems because of socio-economical and/or scientific reasons. Furthermore, those diseases are no fatal in the acute phases; therefore, no big attention is raised by policy makers in the world. From the view point of basic medical sciences, however, there is no enough reason for neglecting the issues of those diseases: no improved diagnostics and therapeutics have been developed in spite of the urgent necessities in endemic areas. Considering those situations, WHO has started to take action for solving the problems since beginning of the 21st century. Recently, many of developed countries are recognizing that the imbalanced input of human and financial resources only for 3 major infectious diseases, HIV/AIDS, tuberculosis and malaria, and then, various international schemes for supporting research on Neglected diseases. DNDi, Drugs for Neglected Diseases initiative, is one of the examples and it's scope is only focusing on drug development for Neglected diseases. African trypanosomiasis is one of Neglected diseases and causing serious health problem both for humans and domestic animals in Africa. No safe and effective medicine has been available but a drug with serious side effects is only the drug of choice even nowadays. Under the grant support from DNDi, a Japanese group is developing a new drug, ascofuranone, for African trypanosomiasis without any detectable side effects. Developing new prophylactic drugs for schistosomiasis and new diagnostic tools for lymphatic filariasis are underway under the support of grant for Neglected or Re-emerging infectious diseases in Japan. Considering that issues of "Neglected Infectious Diseases" are urgent to be solved and also are challenging for modern medicine and medical sciences, researchers in the developed countries including Japan should make efforts to promote more active researches in this field.

摘要

世界上有两种传染病

受到关注的疾病和被忽视的疾病。前者包括艾滋病毒/艾滋病、结核病和疟疾,后者包括许多寄生虫、真菌、细菌以及一些病毒感染。“被忽视的传染病”,世界卫生组织已将其重新命名为地方性热带病,在发展中世界呈地方性流行,并非新出现的疾病,而是近几十年来一直影响人类的疾病。事实上,该类别中几种疾病的伤残调整生命年数值相当大;土壤传播的蠕虫病超过3亿,淋巴丝虫病为500万,血吸虫病为400 - 500万等等。然而,由于社会经济和/或科学原因,这些疾病未被视为严重的健康问题。此外,这些疾病在急性期并不致命;因此,未引起世界各国政策制定者的高度关注。然而,从基础医学科学的角度来看,没有充分的理由忽视这些疾病的问题:尽管流行地区有迫切需求,但尚未开发出改进的诊断方法和治疗方法。考虑到这些情况,世界卫生组织自21世纪初开始采取行动解决这些问题。最近,许多发达国家认识到仅将人力和财力资源不均衡地投入到艾滋病毒/艾滋病、结核病和疟疾这三种主要传染病上,于是出现了各种支持被忽视疾病研究的国际计划。被忽视疾病药物研发组织(DNDi)就是其中一个例子,其范围仅专注于被忽视疾病的药物研发。非洲锥虫病是被忽视疾病之一,在非洲给人类和家畜都带来严重的健康问题。目前尚无安全有效的药物,即便在如今,唯一可供选择的药物也有严重的副作用。在DNDi的资助支持下,一个日本团队正在研发一种治疗非洲锥虫病的新药——阿斯科呋喃酮,且无任何可检测到的副作用。在日本针对被忽视或重新出现的传染病的资助支持下,正在开展血吸虫病新预防药物以及淋巴丝虫病新诊断工具的研发工作。鉴于“被忽视的传染病”问题亟待解决,且对现代医学和医学科学具有挑战性,包括日本在内的发达国家的研究人员应努力推动该领域更积极的研究。

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