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我们准备好在撒哈拉以南非洲消除猪带绦虫囊尾蚴病了吗?

Are we ready for Taenia solium cysticercosis elimination in sub-Saharan Africa?

作者信息

Johansen Maria Vang, Trevisan Chiara, Gabriël Sarah, Magnussen Pascal, Braae Uffe Christian

机构信息

Section for Parasitology and Aquatic Diseases,Department of Veterinary Disease Biology,Faculty of Health and Medical Sciences,University of Copenhagen,Dyrlægevej 100,DK-1870 Frederiksberg C,Denmark.

Department of Biomedical Sciences,Institute of Tropical Medicine,Antwerp,Belgium.

出版信息

Parasitology. 2017 Jan;144(1):59-64. doi: 10.1017/S0031182016000500. Epub 2016 Apr 20.

Abstract

The World Health Organization announced in November 2014 at the fourth international meeting on 'the control of neglected zoonotic diseases - from advocacy to action', that intervention tools for eliminating Taenia solium taeniosis/cysticercosis (TSTC) are in place. The aim of this work was to elucidate theoretical outcomes of various control options suggested for TSTC elimination in sub-Saharan Africa (SSA) over a 4-year period. Our current knowledge regarding T. solium epidemiology and control primarily builds on studies from Latin America. A simple transmission model - built on data from Latin America - has been used to predict the effect of various interventions such as mass treatment of humans, vaccination and treatment of pigs, and health education of communities, potentially leading to change in bad practices and reducing transmission risks. Based on simulations of the transmission model, even a 4-year integrated One Health approach fails to eliminate TSTC from a small community and in all simulations, the prevalence of human taeniosis and porcine cysticercosis start to rise as soon as the programmes end. Our current knowledge regarding transmission and burden of TSTC in SSA is scarce and while claiming to be tool ready, the selection of diagnostic and surveillance tools, as well as the algorithms and stepwise approaches for control and elimination of TSTC remain major challenges.

摘要

世界卫生组织于2014年11月在第四届“被忽视的人畜共患疾病控制——从宣传到行动”国际会议上宣布,消除猪带绦虫病/囊尾蚴病(TSTC)的干预工具已经具备。这项工作的目的是阐明在撒哈拉以南非洲(SSA)为期4年的时间里,为消除TSTC而建议的各种控制方案的理论结果。我们目前关于猪带绦虫流行病学和控制的知识主要基于拉丁美洲的研究。一个基于拉丁美洲数据建立的简单传播模型已被用于预测各种干预措施的效果,如对人类进行群体治疗、对猪进行疫苗接种和治疗以及对社区进行健康教育,这些措施可能会导致不良行为的改变并降低传播风险。基于传播模型的模拟结果,即使采用为期4年的综合“同一健康”方法也无法从小社区中消除TSTC,并且在所有模拟中,一旦项目结束,人类绦虫病和猪囊尾蚴病的患病率就开始上升。我们目前关于SSA地区TSTC传播和负担的知识匮乏,虽然声称已准备好工具,但选择诊断和监测工具以及控制和消除TSTC的算法和逐步方法仍然是重大挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73a5/5264655/fec633469c7c/S0031182016000500_fig1.jpg

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