Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India.
Department of Global Health, Medicine (Infectious Disease), Paediatrics & Epidemiology, University of Washington, Seattle, USA; DeWorm3, Division of Life Sciences, Natural History Museum, London, UK.
Indian J Med Res. 2018 Jun;147(6):533-544. doi: 10.4103/ijmr.IJMR_881_18.
Soil-transmitted helminth (STH) infections continue to be a major global cause of morbidity, with a large proportion of the burden of STH infections occurring in India. In addition to direct health impacts of these infections, including anaemia and nutritional deficiencies in children, these infections also significantly impact economic development, as a result of delays in early childhood cognitive development and future income earning potential. The current World Health Organization strategy for STH is focused on morbidity control through the application of mass drug administration to all pre-school-aged and school-aged children. In India, the control of STH-related morbidity requires mobilization of significant human and financial resources, placing additional burdens on limited public resources. Infected adults and untreated children in the community act as a reservoir of infection by which treated children get rapidly reinfected. As a result, deworming programmes will need to be sustained indefinitely in the absence of other strategies to reduce reinfection, including water, hygiene and sanitation interventions (WASH). However, WASH interventions require sustained effort by the government or other agencies to build infrastructure and to promote healthy behavioural modifications, and their effectiveness is often limited by deeply entrenched cultural norms and behaviours. Novel strategies must be explored to provide a lasting solution to the problem of STH infections in India other than the indefinite provision of deworming for morbidity control.
土壤传播性蠕虫（STH）感染仍然是全球发病率的主要原因，其中印度的 STH 感染负担很大。除了这些感染对儿童健康的直接影响，包括贫血和营养缺乏外，这些感染还会因儿童早期认知发育和未来收入潜力的延迟而对经济发展产生重大影响。目前，世界卫生组织（世卫组织）针对 STH 的战略侧重于通过向所有学龄前和学龄儿童普遍提供驱虫药物来控制发病率。在印度，控制 STH 相关发病率需要调动大量的人力和财力资源，这给有限的公共资源带来了额外的负担。社区中受感染的成年人和未经治疗的儿童是感染的传染源，接受治疗的儿童会迅速再次感染。因此，如果没有其他减少再感染的策略，包括水、环境卫生和个人卫生干预措施（WASH），驱虫方案将需要无限期持续下去。然而，WASH 干预措施需要政府或其他机构持续努力来建立基础设施和促进健康的行为改变，而其效果往往受到根深蒂固的文化规范和行为的限制。必须探索新的策略，为印度的 STH 感染问题提供持久的解决方案，而不是无限期地提供驱虫药物来控制发病率。
