Verjee Mohamud A
Weill Cornell Medicine - Qatar, Qatar Foundation - Education City, Doha, Qatar.
Res Rep Trop Med. 2019 Dec 31;10:153-163. doi: 10.2147/RRTM.S204345. eCollection 2019.
Tropical diseases remain severe threats to global health with acute or chronic debility. Public health issues are regularly monitored and reported by the WHO. Conditions with high prevalence and virulence such as Schistosomiasis or Malaria still need active treatment. Advances over the decades in the treatment and management of Schistosomiasis have reduced morbidity and mortality in patients. However, poverty, adverse environments, lack of education and awareness, with parasites and vectors that can thrive if uncontrolled, remain issues for the successful global eradication of Schistosomiasis. From the disease's discovery in 1850, the author relates historical details to its current status. Several countries previously affected, including Japan and Tunisia, have eliminated the disease while others seek the same goal. Africa remains the most severely affected continent with vulnerable women and children, although the infection persists in South America and the Far East of Asia as well. Realistic improvements for continuing health conditions are vogue and emphasized for those at risk or afflicted by the infection, illustrating success models of concerted efforts of extirpation. Constant proximity to infected water, with a parasite host, are hurdles in reducing exposure. Effective medication for acute treatment is available, and prophylaxis by vaccination is promising. Where endemic Schistosomiasis is prevalent, significant morbidity and mortality have far-reaching complications in multiple human organ systems, including irreversible pulmonary hypertension, renal, genitourinary, central nervous system conditions, and neoplasia. Two hundred and thirty million people are estimated to have contracted Schistosomiasis globally, with up to 700 million still at risk of infection, and 200,000 deaths occur annually. The disease may be more prevalent than thought after newer tests have shown increased sensitivity to pathological antigens. The author discusses infectivity risks, investigations, prognosis, treatment, and management, as well as morbidity and mortality.
热带疾病仍然是对全球健康的严重威胁,会导致急慢性身体虚弱。世界卫生组织定期监测和报告公共卫生问题。血吸虫病或疟疾等高流行率和高致病性的疾病仍需积极治疗。几十年来,血吸虫病治疗和管理方面的进展降低了患者的发病率和死亡率。然而,贫困、恶劣环境、缺乏教育和意识,以及如果不加控制就会大量繁殖的寄生虫和病媒,仍然是全球成功根除血吸虫病的难题。作者从1850年该疾病被发现开始,讲述了其历史细节及当前状况。包括日本和突尼斯在内的几个曾受影响的国家已消除了该疾病,而其他国家也在追求同样的目标。非洲仍然是受影响最严重的大陆,妇女和儿童尤为脆弱,不过南美洲和亚洲远东地区也存在血吸虫感染情况。针对处于感染风险或已感染人群,改善健康状况的切实可行的措施备受关注并得到强调,展现了协同根除努力的成功模式。持续接触受感染水源以及寄生虫宿主,是减少接触的障碍。有有效的急性治疗药物,通过疫苗接种进行预防也很有前景。在血吸虫病流行地区,显著的发病率和死亡率会在多个人体器官系统引发深远的并发症,包括不可逆转的肺动脉高压、肾脏、泌尿生殖系统、中枢神经系统疾病以及肿瘤。据估计,全球有2.3亿人感染了血吸虫病,多达7亿人仍有感染风险,每年有20万人死亡。新的检测方法显示对病理抗原的敏感性提高后,该疾病的实际流行情况可能比预想的更严重。作者讨论了感染风险、调查、预后、治疗和管理,以及发病率和死亡率。