Pheby Derek F H, Araja Diana, Berkis Uldis, Brenna Elenka, Cullinan John, de Korwin Jean-Dominique, Gitto Lara, Hughes Dyfrig A, Hunter Rachael M, Trepel Dominic, Wang-Steverding Xia
Society and Health, Buckinghamshire New University, High Wycombe HP11 2JZ, UK.
Department of Dosage Form Technology, Faculty of Pharmacy, Riga Stradins University, Dzirciema Street 16, LV-1007 Riga, Latvia.
Medicina (Kaunas). 2021 Apr 16;57(4):388. doi: 10.3390/medicina57040388.
This report addresses the extent to which there may be scope for preventive programmes for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), and, if so, what economic benefits may accrue from the implementation of such programmes. We consider the economic case for prevention programmes, whether there is scope for preventive programmes for ME/CFS, and what are the health and economic benefits to be derived from the implementation of such programmes. We conclude that there is little scope for primary prevention programmes, given that ME/CFS is attributable to a combination of host and environmental risk factors, with host factors appearing to be most prominent, and that there are few identified modifiable risk factors that could be the focus of such programmes. The exception is in the use of agricultural chemicals, particularly organophosphates, where there is scope for intervention, and where Europe-wide programmes of health education to encourage safe use would be beneficial. There is a need for more research on risk factors for ME/CFS to establish a basis for the development of primary prevention programmes, particularly in respect of occupational risk factors. Secondary prevention offers the greatest scope for intervention, to minimise diagnostic delays associated with prolonged illness, increased severity, and increased costs.
本报告探讨了针对肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)的预防计划可能存在的空间,以及如果存在,实施此类计划可能带来哪些经济效益。我们考虑预防计划的经济依据,ME/CFS是否有预防计划的空间,以及实施此类计划可带来哪些健康和经济效益。我们得出结论,鉴于ME/CFS可归因于宿主和环境风险因素的综合作用,其中宿主因素似乎最为突出,且几乎没有已确定的可改变风险因素可成为此类计划的重点,因此一级预防计划的空间很小。唯一的例外是农用化学品的使用,特别是有机磷,在这方面有干预空间,且全欧洲范围的健康教育计划以鼓励安全使用将是有益的。需要对ME/CFS的风险因素进行更多研究,以建立制定一级预防计划的基础,特别是在职业风险因素方面。二级预防提供了最大的干预空间,以尽量减少与病程延长、病情加重和成本增加相关的诊断延迟。