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登革热的预防与控制——隧道尽头的亮光。

Prevention and control of dengue-the light at the end of the tunnel.

机构信息

Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore.

Regional Health & Community Outreach Division, Health Promotion Board, Singapore.

出版信息

Lancet Infect Dis. 2017 Mar;17(3):e79-e87. doi: 10.1016/S1473-3099(16)30471-6. Epub 2017 Feb 7.

Abstract

Advances in the development of new dengue control tools, including vaccines and vector control, herald a new era of desperately needed dengue prevention and control. The burden of dengue has expanded for decades, and now affects more than 120 countries. Complex, large-scale global forces have and will continue to contribute to the expansion of dengue, including population growth, unplanned urbanisation, and suboptimal mosquito control in urban centres. Although no so-called magic bullets are available, there is new optimism following the first licensure of a dengue vaccine and other promising vaccine candidates, and the development of novel vector control interventions to help control dengue and other expanding mosquito-borne diseases such as Zika virus. Implementation of effective and sustainable immunisation programmes to complement existing methods will add complexity to the health systems of affected countries, which have varying levels of robustness and maturity. Long-term high prioritisation and adequate resources are needed. The way forward is full commitment to addressing a complex disease with a set of solutions integrating vaccination and vector control methods. A whole systems approach is thus needed to integrate these various approaches and strategies for controlling dengue within the goal of universal health coverage. The ultimate objective of these interventions will be to reduce the disease burden in a sustainable and equitable manner.

摘要

新的登革热控制工具的发展进展,包括疫苗和病媒控制,预示着急需登革热预防和控制的新时代。登革热的负担已经扩大了几十年,现在影响到 120 多个国家。复杂的、大规模的全球力量一直在并将继续导致登革热的扩大,包括人口增长、无计划的城市化以及城市中心蚊虫控制不力。虽然没有所谓的灵丹妙药,但在第一种登革热疫苗获得许可和其他有前途的疫苗候选物以及新型病媒控制干预措施的开发之后,人们对控制登革热和其他正在扩大的蚊媒疾病(如寨卡病毒)有了新的乐观情绪。实施有效的和可持续的免疫规划来补充现有的方法将增加受影响国家卫生系统的复杂性,这些国家的稳健性和成熟度各不相同。需要长期的高度重视和充足的资源。前进的道路是全力解决一系列整合疫苗接种和病媒控制方法的复杂疾病。因此,需要采取整体系统方法,将这些各种方法和策略整合起来,以实现全民健康覆盖的目标。这些干预措施的最终目标将是以可持续和公平的方式减轻疾病负担。

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