Novartis Institute for Tropical Diseases, Emeryville, California, United States of America.
Alliance for International Medical Action (ALIMA), Dakar, Senegal.
PLoS Negl Trop Dis. 2021 Mar 11;15(3):e0009057. doi: 10.1371/journal.pntd.0009057. eCollection 2021 Mar.
Cryptosporidium is a widely distributed enteric parasite that has an increasingly appreciated pathogenic role, particularly in pediatric diarrhea. While cryptosporidiosis has likely affected humanity for millennia, its recent "emergence" is largely the result of discoveries made through major epidemiologic studies in the past decade. There is no vaccine, and the only approved medicine, nitazoxanide, has been shown to have efficacy limitations in several patient groups known to be at elevated risk of disease. In order to help frontline health workers, policymakers, and other stakeholders translate our current understanding of cryptosporidiosis into actionable guidance to address the disease, we sought to assess salient issues relating to clinical management of cryptosporidiosis drawing from a review of the literature and our own field-based practice. This exercise is meant to help inform health system strategies for improving access to current treatments, to highlight recent achievements and outstanding knowledge and clinical practice gaps, and to help guide research activities for new anti-Cryptosporidium therapies.
隐孢子虫是一种广泛分布的肠道寄生虫,其致病作用日益受到重视,尤其是在小儿腹泻中。虽然隐孢子虫病可能已经影响了人类几千年,但它最近的“出现”主要是由于过去十年的重大流行病学研究中的发现。目前尚无疫苗,唯一批准的药物硝唑尼特在已知处于疾病高发风险的几个患者群体中已显示出疗效有限。为了帮助一线卫生工作者、政策制定者和其他利益攸关方将我们目前对隐孢子虫病的理解转化为解决该疾病的可行指导,我们从文献回顾和我们自己的实地实践中评估了与隐孢子虫病临床管理相关的突出问题。这项工作旨在帮助为改善获得现有治疗方法的机会制定卫生系统战略,突出最近的成就以及突出知识和临床实践差距,并帮助指导新的抗隐孢子虫治疗研究活动。