Special Programme for Research and Training in Tropical Diseases, WHO, Geneva, Switzerland.
Lancet Infect Dis. 2011 Apr;11(4):322-5. doi: 10.1016/S1473-3099(10)70320-0.
The world's burden of infectious diseases can be substantially reduced by more-effective use of existing interventions. Advances in case detection, diagnosis, and treatment strategies have made it possible to consider the elimination of visceral leishmaniasis in the Indian subcontinent. The priority must now be to effectively implement existing interventions at the community level by actively finding cases in endemic villages and treating them with single-dose liposomal amphotericin B at primary-health-care centres. Once the elimination target of one case per 10,000 population has been reached, combination therapies involving miltefosine and paromomycin can be introduced to ensure long-term availability of several drugs for visceral leishmaniasis and to protect against resistance.
通过更有效地利用现有干预措施，可大大减轻传染病给全球带来的负担。在病例发现、诊断和治疗策略方面的进展，使得人们有可能考虑在南亚次大陆消除内脏利什曼病。现在的当务之急是，通过在流行地区的村庄主动发现病例并在基层医疗中心用单剂量脂质体两性霉素 B 进行治疗，在社区层面切实执行现有干预措施。一旦达到每 10000 人口 1 例的消除目标，就可以引入米替福新和巴龙霉素联合疗法，以确保几种治疗内脏利什曼病药物的长期供应，并预防耐药性的产生。
