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2019 年 1 月至 2020 年 6 月全球根治麦地那龙线虫病进展。

Progress Toward Global Eradication of Dracunculiasis, January 2019-June 2020.

出版信息

MMWR Morb Mortal Wkly Rep. 2020 Oct 30;69(43):1563-1568. doi: 10.15585/mmwr.mm6943a2.

Abstract

Dracunculiasis (Guinea worm disease) is caused by the parasite Dracunculus medinensis and is acquired by drinking water containing copepods (water fleas) infected with D. medinensis larvae. The worm typically emerges through the skin on a lower limb approximately 1 year after infection, resulting in pain and disability (1). There is no vaccine or medicine to treat the disease; eradication efforts rely on case containment* to prevent water contamination. Other interventions to prevent infection include health education, water filtration, chemical treatment of unsafe water with temephos (an organophosphate larvicide to kill copepods), and provision of safe drinking water (1,2). The worldwide eradication campaign began in 1980 at CDC (1). In 1986, with an estimated 3.5 million cases occurring each year in 20 African and Asian countries (3), the World Health Assembly (WHA) called for dracunculiasis elimination (4). The global Guinea Worm Eradication Program (GWEP), led by the Carter Center and supported by the World Health Organization (WHO), United Nations Children's Fund, CDC, and other partners, began assisting ministries of health in countries with dracunculiasis. This report, based on updated health ministry data (4), describes progress made during January 2019-June 2020 and updates previous reports (2,4,5). With only 54 human cases reported in 2019, 19 human cases reported during January 2019-June 2020, and only six countries currently affected by dracunculiasis (Angola, Chad, Ethiopia, Mali, South Sudan, and importations into Cameroon), the achievement of eradication is within reach, but it is challenged by civil unrest, insecurity, and lingering epidemiologic and zoologic concerns, including 2,000 reported animal cases in 2019 and 1,063 animal cases in 2020, mostly in dogs. All national GWEPs remain fully operational, with precautions taken to ensure safety of program staff members and community members in response to the coronavirus disease 2019 (COVID-19) pandemic.

摘要

麦地那龙线虫病(几内亚线虫病)由麦地那龙线虫寄生虫引起,通过饮用含有感染麦地那龙线虫幼虫的桡足类(水蚤)的水而感染。感染后,寄生虫通常在 1 年后通过皮肤在下肢出现,导致疼痛和残疾(1)。目前尚无治疗该疾病的疫苗或药物;消除努力依赖于病例控制*,以防止水污染。其他预防感染的干预措施包括健康教育、水过滤、使用对硫磷(一种有机磷杀幼虫剂,可杀死桡足类)对不安全水进行化学处理,以及提供安全饮用水(1,2)。全球消除运动于 1980 年在疾病预防控制中心(1)开始。1986 年,在 20 个非洲和亚洲国家,估计每年有 350 万人感染这种疾病(3),世界卫生大会(WHA)呼吁消除麦地那龙线虫病(4)。由卡特中心领导、世界卫生组织(WHO)、联合国儿童基金会、疾病预防控制中心和其他合作伙伴支持的全球麦地那龙线虫消除规划(GWEP)开始协助有麦地那龙线虫病的国家的卫生部。本报告根据最新的卫生部数据(4),介绍了 2019 年 1 月至 2020 年 6 月期间取得的进展,并更新了以往的报告(2,4,5)。由于 2019 年仅报告了 54 例人类病例,2019 年 1 月至 2020 年 6 月期间报告了 19 例人类病例,目前只有六个国家受到麦地那龙线虫病的影响(安哥拉、乍得、埃塞俄比亚、马里、南苏丹和喀麦隆的输入病例),因此消除该疾病的目标已经在望,但受到内乱、不安全和持续存在的流行病学和动物学问题的挑战,包括 2019 年报告的 2000 例动物病例和 2020 年的 1063 例动物病例,其中大部分是狗。所有国家的 GWEP 仍然全面运作,并采取了预防措施,以确保在应对 2019 冠状病毒病(COVID-19)大流行时方案工作人员和社区成员的安全。

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