Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel and University of Basel, Switzerland.
Swiss Med Wkly. 2012 Nov 22;142:w13727. doi: 10.4414/smw.2012.13727. eCollection 2012.
Branded in 2005, "neglected tropical diseases" have gained traction in terms of advocacy, interest for research, enhanced funding and political will for their control and eventual elimination. Starting with an initial set of 13 neglected tropical diseases--seven helminth, three bacterial and three protozoal infections--the list considerably expanded to more than 40 diseases that now also includes viral, fungal and ectoparasitic infections. In this review, we provide a comprehensive overview of the neglected tropical diseases, their causative agents and the current geographical distribution, including their importance for the general practitioners seeing returning travellers and migrants in Switzerland. We characterise the most important of the neglected tropical diseases in terms of at-risk population, estimated number of infections, annual mortality rates and global burden, including current knowledge gaps. With an emphasis on neglected tropical diseases due to helminths, protozoa and ectoparasites, we review common diagnostic methods and current recommendations for treatment at the population level and the individual patient, thereby juxtaposing the situation in highly endemic countries on one side, with Switzerland on the other. We highlight the clinical presentation and management of the neglected tropical diseases in general and then elaborate on two examples, strongyloidiasis and leptospirosis. Our review provides a global perspective of neglected tropical diseases and we hope that it will prove useful for the general practitioner and clinician in Switzerland and elsewhere to enhance their suspicion index, differential diagnosis, clinical management and treatment, including referral to specialised clinics and laboratories when need be.
2005 年被确定为“被忽视的热带病”，自此之后，这些疾病在宣传、研究兴趣、资金投入以及控制和最终消除这些疾病的政治意愿等方面都取得了进展。最初确定的 13 种被忽视的热带病包括 7 种蠕虫病、3 种细菌性疾病和 3 种原生动物病，该名单后来大幅扩大，包括 40 多种疾病，其中还包括病毒、真菌和外寄生虫感染。在这篇综述中，我们全面概述了被忽视的热带病及其病原体，以及它们目前的地理分布，包括这些疾病对瑞士普通医生接诊归国旅行者和移民的重要性。我们根据高危人群、估计感染人数、年死亡率和全球负担等因素，对被忽视的热带病进行了分类，包括目前的知识空白。我们重点介绍了由于蠕虫、原生动物和外寄生虫引起的被忽视的热带病，综述了常见的诊断方法和目前针对人群和个体患者的治疗建议，从而对比了高度流行国家和瑞士的情况。我们强调了被忽视的热带病的临床表现和管理，然后详细介绍了两种疾病，即钩虫病和钩端螺旋体病。我们的综述提供了全球视角的被忽视的热带病，我们希望这对瑞士和其他地方的普通医生和临床医生能够提高他们的怀疑指数、鉴别诊断、临床管理和治疗能力，包括在必要时转介到专门的诊所和实验室。
