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人兽共患内脏利什曼病的预防控制:疗效与经济评估

The Preventive Control of Zoonotic Visceral Leishmaniasis: Efficacy and Economic Evaluation.

作者信息

Shimozako Helio Junji, Wu Jianhong, Massad Eduardo

机构信息

Faculty of Medicine, University of São Paulo and LIM 01-HCFMUSP, Avenida Dr. Arnaldo 455, 01246-903 São Paulo, SP, Brazil.

Centre for Disease Modelling, York Institute for Health Research, York University, 4700 Keele Street, Toronto, ON, Canada M3J 1P3.

出版信息

Comput Math Methods Med. 2017;2017:4797051. doi: 10.1155/2017/4797051. Epub 2017 May 15.

Abstract

Zoonotic Visceral Leishmaniasis (ZVL) is one of the world's deadliest and neglected infectious diseases, according to World Health Organization. This disease is one of major human and veterinary medical significance. The sandfly and the reservoir in urban areas remain among the major challenges for the control activities. In this paper, we evaluated five control strategies (positive dog elimination, insecticide impregnated dog collar, dog vaccination, dog treatment, and sandfly population control), considering disease control results and cost-effectiveness. We elaborated a mathematical model based on a set of differential equations in which three populations were represented (human, dog, and sandfly). Humans and dogs were divided into susceptible, latent, clinically ill, and recovery categories. Sandflies were divided into noninfected, infected, and infective. As the main conclusions, the insecticide impregnated dog collar was the strategy that presented the best combination between disease control and cost-effectiveness. But, depending on the population target, the control results and cost-effectiveness of each strategy may differ. More and detailed studies are needed, specially one which optimizes the control considering more than one strategy in activity.

摘要

根据世界卫生组织的说法,人兽共患内脏利什曼病(ZVL)是世界上最致命且被忽视的传染病之一。这种疾病具有重大的人类和兽医医学意义。城市地区的白蛉和储存宿主仍然是控制活动面临的主要挑战之一。在本文中,我们评估了五种控制策略(阳性犬只扑杀、杀虫剂浸渍犬项圈、犬只疫苗接种、犬只治疗以及白蛉种群控制),同时考虑了疾病控制结果和成本效益。我们基于一组微分方程构建了一个数学模型,其中代表了三个种群(人类、犬只和白蛉)。人类和犬只被分为易感、潜伏、临床患病和康复类别。白蛉被分为未感染、感染和具有传染性。作为主要结论,杀虫剂浸渍犬项圈是在疾病控制和成本效益之间呈现最佳组合的策略。但是,根据目标人群的不同,每种策略的控制结果和成本效益可能会有所不同。需要进行更多详细的研究,特别是优化考虑多种策略同时实施的控制研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4efc/5447317/61381902ab31/CMMM2017-4797051.001.jpg

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