Centre for Immunity, Infection and Evolution, Institute of Immunology and Infection Research, University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom.
Centre for Immunity, Infection and Evolution, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Ashworth Laboratories, Edinburgh, United Kingdom.
PLoS Negl Trop Dis. 2018 Feb 8;12(2):e0006144. doi: 10.1371/journal.pntd.0006144. eCollection 2018 Feb.
Schistosomiasis affects over 200 million people worldwide, most of whom are children. Research and control strategies directed at preschool-aged children (PSAC), i.e., ≤5 years old, have lagged behind those in older children and adults. With the recent WHO revision of the schistosomiasis treatment guidelines to include PSAC, and the recognition of gaps in our current knowledge on the disease and its treatment in this age group, there is now a concerted effort to address these shortcomings. Global and national schistosome control strategies are yet to include PSAC in treatment schedules. Maximum impact of schistosome treatment programmes will be realised through effective treatment of PSAC. In this review, we (i) discuss the current knowledge on the dynamics and consequences of paediatric schistosomiasis and (ii) identify knowledge and policy gaps relevant to these areas and to the successful control of schistosome infection and disease in this age group. Herein, we highlight risk factors, immune mechanisms, pathology, and optimal timing for screening, diagnosis, and treatment of paediatric schistosomiasis. We also discuss the tools required for treating schistosomiasis in PSAC and strategies for accessing them for treatment.
血吸虫病影响全球超过 2 亿人，其中大多数是儿童。针对学龄前儿童（PSAC），即≤5 岁儿童的研究和控制策略落后于大龄儿童和成人。最近，世界卫生组织修订了血吸虫病治疗指南，将 PSAC 纳入其中，并且认识到我们目前对该年龄段疾病及其治疗的知识存在差距，现在正在共同努力解决这些不足。全球和国家血吸虫病控制战略尚未将 PSAC 纳入治疗计划。通过对 PSAC 进行有效治疗，可以实现血吸虫病治疗计划的最大影响。在这篇综述中，我们（i）讨论了儿童血吸虫病的动力学和后果的现有知识，（ii）确定了与这些领域以及成功控制该年龄段血吸虫感染和疾病相关的知识和政策差距。在此，我们强调了儿童血吸虫病的危险因素、免疫机制、病理学以及筛查、诊断和治疗的最佳时机。我们还讨论了治疗 PSAC 中血吸虫病所需的工具以及获得这些工具进行治疗的策略。
