Nakagawa Jun, Ehrenberg John P, Nealon Joshua, Fürst Thomas, Aratchige Padmasiri, Gonzales Glenda, Chanthavisouk Chitsavang, Hernandez Leda M, Fengthong Tayphasavanh, Utzinger Jürg, Steinmann Peter
World Health Organization, Regional Office for the Western Pacific, Division of Combating Communicable Diseases, P.O. Box 2932, 1000 Manila, Philippines.
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland; University of Basel, P.O. Box, CH-4003 Basel, Switzerland.
Acta Trop. 2015 Jan;141(Pt B):407-18. doi: 10.1016/j.actatropica.2013.05.010. Epub 2013 Jun 18.
Neglected tropical diseases (NTDs) cause serious health, social and economic burdens in the countries of the World Health Organization Western Pacific Region. Among the NTDs, helminth infections are particularly prominent with regard to the number of infected individuals and health impact. Co-endemicity is common among impoverished and marginalized populations. To achieve effective and sustainable control of helminth NTDs, a deeper understanding of the social-ecological systems governing their endemicity and strategies beyond preventive chemotherapy are required to tackle the multiple causes of infection and re-infection. We discuss the feasibility of implementing multi-disease, multi-sectoral intervention packages for helminth NTDs in the Western Pacific Region. After reviewing the main determinants for helminth NTD endemicity and current control strategies, key control activities that involve or concern other programmes within and beyond the health sector are discussed. A considerable number of activities that have an impact on more than one helminth NTD are identified in a variety of sectors, suggesting an untapped potential for synergies. We also highlight the challenges of multi-sectoral collaboration, particularly of involving non-health sectors. We conclude that multi-sectoral collaboration for helminth NTD control is feasible if the target diseases and sectors are carefully selected. To do so, an incentive analysis covering key stakeholders in the sectors is crucial, and the disease-control strategies need to be well understood. The benefits of multi-disease, multi-sectoral approaches could go beyond immediate health impacts by contributing to sustainable development, raising educational attainment, increasing productivity and reducing health inequities.
被忽视的热带病给世界卫生组织西太平洋区域各国造成了严重的健康、社会和经济负担。在这些被忽视的热带病中，蠕虫感染在感染人数和对健康的影响方面尤为突出。贫困和边缘化人群中多种疾病共同流行的情况很常见。为了有效且可持续地控制蠕虫类被忽视的热带病，需要更深入地了解影响其流行的社会生态系统，并采取除预防性化疗之外的策略来应对感染和再感染的多种成因。我们讨论了在西太平洋区域实施针对蠕虫类被忽视的热带病的多病种、多部门干预方案的可行性。在回顾了蠕虫类被忽视的热带病流行的主要决定因素和当前的控制策略之后，我们讨论了涉及卫生部门内外其他项目或与之相关的关键控制活动。在各个部门都发现了大量对不止一种蠕虫类被忽视的热带病有影响的活动，这表明存在尚未开发的协同增效潜力。我们还强调了多部门合作面临的挑战，尤其是让非卫生部门参与的挑战。我们的结论是，如果仔细选择目标疾病和部门，蠕虫类被忽视的热带病控制的多部门合作是可行的。要做到这一点，对各部门关键利益相关者进行激励分析至关重要，而且需要充分理解疾病控制策略。多病种、多部门方法的益处可能不仅限于对健康的直接影响，还能为可持续发展做出贡献、提高教育水平、提高生产力并减少健康不平等。
