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利什曼病:当前面临的挑战及消除的前景,特别关注南亚地区

Leishmaniasis: current challenges and prospects for elimination with special focus on the South Asian region.

作者信息

Karunaweera Nadira D, Ferreira Marcelo U

机构信息

Department of Parasitology, Faculty of Medicine,University of Colombo,Sri Lanka.

Department of Parasitology,Institute of Biomedical Sciences, University of São Paulo,Brazil.

出版信息

Parasitology. 2018 Apr;145(4):425-429. doi: 10.1017/S0031182018000471. Epub 2018 Apr 12.

Abstract

Leishmania donovani, the most virulent species of Leishmania, is found in the South Asian region that harbours the majority of visceral leishmaniasis (VL) cases in the world. The traditionally accepted relationships between the causative species of Leishmania and the resultant disease phenotype have been challenged during recent years and have underscored the importance of revisiting the previously established taxonomy with revisions to its classification. The weak voice of the afflicted with decades of neglect by scientists and policy makers have led to the miserably inadequate and slow advancements in product development in the fields of diagnostics, chemotherapeutics and vector control that continue to hinder the effective management and control of this infection. Limitations notwithstanding, the regional drive for the elimination of VL initiated over a decade ago that focused on India, Nepal and Bangladesh, the three main afflicted countries in the Indian subcontinent is therefore, commendable, with the subsequent status reviews and restructuring of strategies possibly even more so. However, the renewed efforts would need to be combined with plans to combat new challenges in the South-Asian region that includes the emergence of atypical parasite variants, in order to realistically achieve the set goal of regional elimination of VL.

摘要

杜氏利什曼原虫是利什曼原虫中致病性最强的物种,存在于南亚地区,该地区是世界上大多数内脏利什曼病(VL)病例的所在地。近年来,利什曼原虫致病物种与所导致疾病表型之间传统上被认可的关系受到了挑战,这凸显了重新审视先前确立的分类法并对其分类进行修订的重要性。患者数十年来一直被科学家和政策制定者忽视,这导致在诊断、化疗和病媒控制领域的产品开发进展极其不足且缓慢,持续阻碍着对这种感染的有效管理和控制。尽管存在局限性,但十多年前发起的以印度、尼泊尔和孟加拉国这三个印度次大陆主要受灾国家为重点的消除内脏利什曼病区域行动值得称赞,随后的状况审查和战略调整或许更是如此。然而,新的努力需要与应对南亚地区新挑战的计划相结合,这些挑战包括非典型寄生虫变种的出现,以便切实实现区域消除内脏利什曼病的既定目标。

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