Department of Production Animal Studies, Faculty of Veterinary Sciences, University of Pretoria, South Africa.
Wildlife Conservation Medicine Foundation, South Africa.
Trans R Soc Trop Med Hyg. 2021 May 8;115(5):538-550. doi: 10.1093/trstmh/trab039.
Zoonoses pose major threats to the health of humans, domestic animals and wildlife, as seen in the COVID-19 pandemic. Zoonoses are the commonest source of emerging human infections and inter-species transmission is facilitated by anthropogenic factors such as encroachment and destruction of wilderness areas, wildlife trafficking and climate change. South Africa was selected for a 'One Health' study to identify research priorities for control of zoonoses due to its complex disease burden and an overstretched health system.
A multidisciplinary group of 18 experts identified priority zoonotic diseases, knowledge gaps and proposed research priorities for the next 5 y. Each priority was scored using predefined criteria by another group of five experts and then weighted by a reference group (n=28) and the 18 experts.
Seventeen diseases were mentioned with the top five being rabies (14/18), TB (13/18), brucellosis (11/18), Rift Valley fever (9/11) and cysticercosis (6/18). In total, 97 specific research priorities were listed, with the majority on basic epidemiological research (n=57), such as measuring the burden of various zoonoses (n=24), followed by 20 on development of new interventions. The highest research priority score was for improving existing interventions (0.77/1.0), followed by health policy and systems research (0.72/1.0).
Future zoonotic research should improve understanding of zoonotic burden and risk factors and new interventions in public health. People with limited rural services, immunocompromised, in informal settlements and high-risk occupations, should be the highest research priority.
正如 COVID-19 大流行所显示的那样，人畜共患病对人类、家畜和野生动物的健康构成重大威胁。人畜共患病是新发人类感染最常见的来源，人为因素（如侵占和破坏荒野地区、野生动植物贸易和气候变化）促进了物种间的传播。南非因疾病负担复杂和医疗体系超负荷运转而被选为“同一健康”研究的对象，以确定控制人畜共患病的研究重点。
一个由 18 名专家组成的多学科小组确定了优先的人畜共患病、知识差距和未来 5 年的研究重点。每个重点都由另一组五名专家使用预先定义的标准进行评分，然后由参考小组（n=28）和 18 名专家进行加权。
提到了 17 种疾病，其中前五名是狂犬病（14/18）、结核病（13/18）、布鲁氏菌病（11/18）、裂谷热（9/11）和囊尾蚴病（6/18）。总共列出了 97 项具体的研究重点，其中大部分是基础流行病学研究（n=57），如测量各种人畜共患病的负担（n=24），其次是 20 项新干预措施的开发。最高的研究重点是改进现有的干预措施（0.77/1.0），其次是卫生政策和系统研究（0.72/1.0）。
未来的人畜共患病研究应提高对人畜共患病负担和风险因素以及公共卫生新干预措施的认识。农村服务有限、免疫功能低下、居住在非正式住区和从事高风险职业的人应成为最高的研究重点。
