Jannin Jean, Gabrielli Albis Francesco
World Health Organization, Control of Neglected Tropical Diseases, Geneva, Switzerland.
Handb Clin Neurol. 2013;114:3-8. doi: 10.1016/B978-0-444-53490-3.00001-7.
Neglected tropical diseases are a group of mostly infectious diseases that thrive among poor populations in tropical countries. A significant proportion of the conditions affecting the neurological system in such countries can be attributed to neglected tropical diseases of helminth, protozoan, bacterial, or viral origin. The neurological burden of neglected tropical diseases has not been thoroughly investigated yet, but is expected to be significant; its full appreciation, estimation, and recognition present significant challenges, as shown by the case of the "silent epidemic" of epilepsy. While tropical infections involving the nervous system are today largely preventable or treatable, as vaccines or chemotherapeutic agents are available to kill or neutralize the responsible agents, associated morbidity - when established - cannot be cured. In resource-poor settings it is likely that many infections will not be treated and will therefore progress into their advanced and severe stages, thus being increasingly associated with irreversible morbidity; this is also the case for neurological morbidity, which often entails permanent disability. Public health should aim at reducing the burden of tropical neurological diseases through interventions addressing the infection, the associated morbidity, and the disability deriving from it.
被忽视的热带病是一类主要在热带国家贫困人口中肆虐的传染病。在这些国家，相当一部分影响神经系统的病症可归因于源自蠕虫、原生动物、细菌或病毒的被忽视的热带病。被忽视的热带病对神经系统造成的负担尚未得到充分研究，但预计相当严重；对其全面评估、估算和认知面临重大挑战，癫痫“无声流行”的案例就表明了这一点。虽然如今涉及神经系统的热带感染在很大程度上是可预防或可治疗的，因为有疫苗或化疗药物可杀死或中和致病因子，但相关发病情况一旦出现就无法治愈。在资源匮乏的地区，很可能许多感染得不到治疗，从而发展到晚期和严重阶段，进而越来越多地与不可逆的发病情况相关联；神经系统发病情况也是如此，往往会导致永久性残疾。公共卫生应旨在通过针对感染、相关发病情况及其导致的残疾采取干预措施，减轻热带神经系统疾病的负担。
