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布鲁氏菌病在发展中国家仍是一种被忽视的疾病:呼吁采取跨学科行动。

Brucellosis remains a neglected disease in the developing world: a call for interdisciplinary action.

机构信息

The University of Georgia, College of Veterinary Medicine, Athens, GA, 30602, USA.

Global One Health, Office of the Dean, College of Veterinary Medicine & Biomedical Sciences, Texas A&M Veterinary Medical Center, Texas A&M University, 4461 TAMU, College Station, TX, 77843-4461, USA.

出版信息

BMC Public Health. 2018 Jan 11;18(1):125. doi: 10.1186/s12889-017-5016-y.

Abstract

BACKGROUND

Brucellosis is an endemic zoonotic disease in most of the developing world that causes devastating losses to the livestock industry and small-scale livestock holders. Infected animals exhibit clinical signs that are of economic significance to stakeholders and include reduced fertility, abortion, poor weight gain, lost draught power, and a substantial decline in milk production. In humans, brucellosis typically manifests as a variety of non-specific clinical signs. Chronicity and recurring febrile conditions, as well as devastating complications in pregnant women are common sequelae.

DISCUSSION

In regions where the disease is endemic, brucellosis has far-reaching and deleterious effects on humans and animals alike. Deeply entrenched social misconceptions and fear of government intervention contribute to this disease continuing to smolder unchecked in most of the developing world, thereby limiting economic growth and inhibiting access to international markets. The losses in livestock productivity compromise food security and lead to shifts in the cognitive competency of the working generation, influence the propagation of gender inequality, and cause profound emotional suffering in farmers whose herds are affected. The acute and chronic symptoms of the disease in humans can result in a significant loss of workdays and a decline in the socioeconomic status of infected persons and their families from the associated loss of income. The burden of the disease to society includes significant human healthcare costs for diagnosis and treatment, and non-healthcare costs such as public education efforts to reduce disease transmission.

CONCLUSION

Brucellosis places significant burdens on the human healthcare system and limits the economic growth of individuals, communities, and nations where such development is especially important to diminish the prevalence of poverty. The implementation of public policy focused on mitigating the socioeconomic effects of brucellosis in human and animal populations is desperately needed. When developing a plan to mitigate the associated consequences, it is vital to consider both the abstract and quantifiable effects. This requires an interdisciplinary and collaborative, or One Health, approach that consists of public education, the development of an infrastructure for disease surveillance and reporting in both veterinary and medical fields, and campaigns for control in livestock and wildlife species.

摘要

背景

布鲁氏菌病是大多数发展中国家流行的动物源性传染病,给畜牧业和小型畜牧业者造成了巨大的损失。受感染的动物表现出对利益相关者具有经济意义的临床症状,包括繁殖力下降、流产、体重增加不良、失去牵引力和产奶量大幅下降。在人类中,布鲁氏菌病通常表现为多种非特异性临床症状。慢性和复发性发热以及孕妇出现严重并发症是常见的后遗症。

讨论

在疾病流行的地区,布鲁氏菌病对人类和动物都有深远的、有害的影响。根深蒂固的社会误解和对政府干预的恐惧导致这种疾病在大多数发展中国家继续不受控制地蔓延,从而限制了经济增长,阻碍了进入国际市场的机会。牲畜生产力的损失危及粮食安全,并导致工作年龄段人群认知能力下降,影响性别不平等的传播,并给受感染的农民带来深刻的情感痛苦,因为他们的畜群受到影响。人类患该病的急性和慢性症状可导致大量工作日损失,并导致感染者及其家庭的社会经济地位下降,从而导致收入损失。该疾病给社会带来的负担包括诊断和治疗方面的大量人类医疗保健费用以及非医疗保健费用,例如减少疾病传播的公共教育工作。

结论

布鲁氏菌病给人类医疗保健系统带来了巨大负担,并限制了个人、社区和国家的经济增长,在这些地方,这种发展对于减少贫困的流行尤为重要。迫切需要实施以减轻人类和动物种群中布鲁氏菌病的社会经济影响为重点的公共政策。在制定减轻相关后果的计划时,必须考虑到抽象和量化的影响。这需要采用跨学科和协作的方法,即“One Health”方法,包括公共教育、兽医和医学领域疾病监测和报告基础设施的发展以及在牲畜和野生动物物种中开展控制运动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15c0/5765637/4a13db62001f/12889_2017_5016_Fig1_HTML.jpg

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