Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, CA, USA.
Research Laboratory in Parasitology and Mollusc Biology, Federal University of Ceará, Fortaleza, Brazil.
Lancet Infect Dis. 2022 Nov;22(11):e327-e335. doi: 10.1016/S1473-3099(22)00221-3. Epub 2022 May 17.
Schistosomiasis is a helminthiasis infecting approximately 250 million people worldwide. In 2001, the World Health Assembly (WHA) 54.19 resolution defined a new global strategy for control of schistosomiasis through preventive chemotherapy programmes. This resolution culminated in the 2006 WHO guidelines that recommended empirical treatment by mass drug administration with praziquantel, predominately to school-aged children in endemic settings at regular intervals. Since then, school-based and community-based preventive chemotherapy programmes have been scaled-up, reducing schistosomiasis-associated morbidity. Over the past 15 years, new scientific evidence-combined with a more ambitious goal of eliminating schistosomiasis and an increase in the global donated supply of praziquantel-has highlighted the need to update public health guidance worldwide. In February, 2022, WHO published new guidelines with six recommendations to update the global public health strategy against schistosomiasis, including expansion of preventive chemotherapy eligibility from the predominant group of school-aged children to all age groups (2 years and older), lowering the prevalence threshold for annual preventive chemotherapy, and increasing the frequency of treatment. This Review, written by the 2018-2022 Schistosomiasis Guidelines Development Group and its international partners, presents a summary of the new WHO guideline recommendations for schistosomiasis along with their historical context, supporting evidence, implications for public health implementation, and future research needs.
血吸虫病是一种寄生虫病,全球约有 2.5 亿人受到感染。2001 年,世界卫生大会(WHA)第 54.19 号决议通过预防性化疗方案,为控制血吸虫病制定了新的全球战略。该决议最终促成了 2006 年世卫组织的指南,该指南建议采用大规模药物治疗,即对流行地区的学龄儿童定期进行吡喹酮经验性治疗。自那时以来,以学校和社区为基础的预防性化疗方案得到了扩展,降低了与血吸虫病相关的发病率。在过去的 15 年中,新的科学证据——再加上消除血吸虫病的更具雄心的目标以及全球捐赠的吡喹酮供应增加——凸显了更新全球公共卫生指导的必要性。2022 年 2 月,世卫组织发布了新的指南,提出了 6 项建议,以更新全球防治血吸虫病公共卫生战略,包括将预防性化疗的资格从主要的学龄儿童群体扩大到所有年龄组(2 岁及以上),降低年度预防性化疗的流行阈值,并增加治疗频率。本综述由 2018-2022 年血吸虫病指南制定小组及其国际合作伙伴撰写,概述了世卫组织关于血吸虫病的新指南建议,以及其历史背景、支持证据、对公共卫生实施的影响和未来研究需求。