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中国 NIPD-CTDR 对淋巴丝虫病消除规划和消除后监测的贡献。

Contributions to the lymphatic filariasis elimination programme and post-elimination surveillance in China by NIPD-CTDR.

机构信息

National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China.

National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Chinese Center for Tropical Diseases Research; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, People's Republic of China.

出版信息

Adv Parasitol. 2020;110:145-183. doi: 10.1016/bs.apar.2020.04.007. Epub 2020 May 18.

Abstract

China was once one of the most heavily endemic for lymphatic filariasis (LF), with a heavy disease burden. Due to decades of sustained efforts, LF was eliminated from China in 2007. The historical tales in the control and elimination of LF in China and current post-elimination surveillance are reviewed and concluded. In the course of LF control and elimination, National Technical Steering Group for Filariasis Control and Research, and Collaborating Research Group on the Transmission Threshold of Filariasis, led by the National Institute of Parasitic Diseases, carried out researches, developed control measures, and applied in practical control and surveillance. The main of the results include: in theoretical study, (1) formulating the microfilaria rate below 1% as the transmission threshold of filariasis, (2) developing anti-filarial drugs and establishing animal model for drug screening, (3) studying the vectorial capacity of mosquitoes transmitted filariasis; in clinical diagnostic and therapy, (1) developing antigens for serological diagnostics, (2) studying different administration regimes for alleviating the side-response of diethylcarbamazine (DEC), (3) studying on the recurrence of acute adenolymphangitis and lymphadenitis of malayan filariasis, (4) observing lymphoedema of the lower extremity using lymphangiography; in practical control and surveillance, (1) establishing the control strategy taking elimination of infection source as the major focus, (2) formulating safe, feasible and effective DEC-mass drug administration, (3) revealing the transmission pattern of filariasis at the post-control phase, (4) establishing comprehensive active surveillance system, (5) formulating the criteria of basic elimination and elimination of filariasis. In the post-elimination surveillance phase, special monitoring and investigation in key areas were conducted for clearing way potential residual infection sources. Two schemes on LF surveillance in the post-elimination phase and caring for chronic filariasis patients were issued to maintain the diagnosis and treatment skills of filariasis all levels of disease control and prevention workers in future. Also, the Notifiable Diseases Reporting System, which included LF in 2004, plays an important role in LF post-elimination surveillance to prevent LF resurgence in China. The strategies and measures of LF control, elimination and post-elimination surveillance in China provide valuable practical experience and promote the progress of Global Programme of Elimination of Lymphatic Filariasis in worldwide.

摘要

中国曾是淋巴丝虫病(LF)流行较为严重的国家之一,疾病负担沉重。经过几十年的持续努力,中国于 2007 年消除了 LF。本文回顾和总结了中国 LF 防治的历史故事和当前消除后的监测情况。在 LF 防治过程中,国家寄生虫病防治所国家丝虫病技术指导组和合作研究组开展了研究,制定了防治措施,并应用于实际防治和监测。主要成果包括:理论研究方面,(1)提出微丝蚴率低于 1%作为丝虫病传播阈值;(2)开发抗丝虫药物,建立药物筛选动物模型;(3)研究蚊媒传播丝虫病的媒介能力。临床诊断和治疗方面,(1)开发血清学诊断抗原;(2)研究不同的二乙卡巴嗪(DEC)给药方案以减轻其副作用;(3)研究马来丝虫急性淋巴管炎和淋巴结炎的复发;(4)淋巴管造影观察下肢淋巴水肿。在实际防治和监测方面,(1)建立以消除传染源为重点的防治策略;(2)制定安全、可行、有效的 DEC 群体药物治疗方案;(3)揭示消除后阶段丝虫病的传播模式;(4)建立全面的主动监测系统;(5)制定基本消除和消除丝虫病的标准。在消除后监测阶段,对重点地区进行了特殊监测和调查,以清除潜在的残留感染源。发布了 LF 消除后监测阶段的两个监测方案和慢性丝虫病患者的护理方案,以保持各级疾病预防控制人员对丝虫病的诊断和治疗技能。此外,包括 LF 在内的 2004 年传染病报告系统在 LF 消除后监测中发挥了重要作用,防止 LF 在中国死灰复燃。中国 LF 防治、消除和消除后监测的策略和措施为全球消除淋巴丝虫病规划提供了宝贵的实践经验,并推动了其在全球范围内的进展。

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