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21世纪在流行国家和非流行国家获得恰加斯病/感染的诊断和治疗。

Access to diagnosis and treatment of Chagas disease/infection in endemic and non-endemic countries in the XXI century.

作者信息

Villa Luís, Morote Sílvia, Bernal Oscar, Bulla Daniel, Albajar-Vinas Pedro

机构信息

Médicos Sin Fronteras, Barcelona, Catalunya, Espana.

出版信息

Mem Inst Oswaldo Cruz. 2007 Oct 30;102 Suppl 1:87-94. doi: 10.1590/s0074-02762007005000081. Epub 2007 Nov 5.

Abstract

In this article, Médicos Sin Fronteras (MSF) Spain faces the challenge of selecting, piecing together, and conveying in the clearest possible way, the main lessons learnt over the course of the last seven years in the world of medical care for Chagas disease. More than two thousand children under the age of 14 have been treated; the majority of whom come from rural Latin American areas with difficult access. It is based on these lessons learnt, through mistakes and successes, that MSF advocates that medical care for patients with Chagas disease be a reality, in a manner which is inclusive (not exclusive), integrated (with medical, psychological, social, and educational components), and in which the patient is actively followed. This must be a multi-disease approach with permanent quality controls in place based on primary health care (PHC). Rapid diagnostic tests and new medications should be available, as well as therapeutic plans and patient management (including side effects) with standardised flows for medical care for patients within PHC in relation to secondary and tertiary level, inclusive of epidemiological surveillance systems.

摘要

在本文中,无国界医生组织(MSF)西班牙分部面临着一项挑战,即挑选、整合并以尽可能清晰的方式传达过去七年在恰加斯病医疗领域所汲取的主要经验教训。超过两千名14岁以下儿童接受了治疗;其中大多数来自拉丁美洲农村地区,就医困难。基于这些通过错误与成功所学到的经验教训,无国界医生组织倡导,对恰加斯病患者的医疗应成为现实,其方式应具有包容性(而非排他性)、综合性(涵盖医疗、心理、社会和教育等方面),且患者应得到积极随访。这必须是一种基于初级卫生保健(PHC)并设有永久质量控制措施的多疾病治疗方法。应提供快速诊断测试和新药物,以及治疗方案和患者管理(包括副作用),并针对初级卫生保健中的患者制定标准化的医疗流程,涉及二级和三级医疗层面,包括流行病学监测系统。

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