根除弓形虫病的项目建设第四部分：公共卫生策略的理解与发展及“以村为单位”的进展

Building Programs to Eradicate Toxoplasmosis Part IV: Understanding and Development of Public Health Strategies and Advances "Take a Village".

作者信息

Felín Mariangela Soberón, Wang Kanix, Moreira Aliya, Grose Andrew, Leahy Karen, Zhou Ying, Clouser Fatima Alibana, Siddiqui Maryam, Leong Nicole, Goodall Perpetua, Michalowski Morgan, Ismail Mahmoud, Christmas Monica, Schrantz Stephen, Caballero Zuleima, Norero Ximena, Estripeaut Dora, Ellis David, Raggi Catalina, Castro Catherine, Moossazadeh Davina, Ramirez Margarita, Pandey Abhinav, Ashi Kevin, Dovgin Samantha, Dixon Ashtyn, Li Xuan, Begeman Ian, Heichman Sharon, Lykins Joseph, Villalobos-Cerrud Delba, Fabrega Lorena, Montalvo José Luis Sanchez, Mendivil Connie, Quijada Mario R, Fernández-Pirla Silvia, de La Guardia Valli, Wong Digna, de Guevara Mayrene Ladrón, Flores Carlos, Borace Jovanna, García Anabel, Caballero Natividad, Rengifo-Herrera Claudia, de Saez Maria Theresa Moreno, Politis Michael, Ross Stephanie, Dogra Mimansa, Dhamsania Vishan, Graves Nicholas, Kirchberg Marci, Mathur Kopal, Aue Ashley, Restrepo Carlos M, Llanes Alejandro, Guzman German, Rebellon Arturo, Boyer Kenneth, Heydemann Peter, Noble A Gwendolyn, Swisher Charles, Rabiah Peter, Withers Shawn, Hull Teri, Frim David, McLone David, Su Chunlei, Blair Michael, Latkany Paul, Mui Ernest, Vasconcelos-Santos Daniel Vitor, Villareal Alcibiades, Perez Ambar, Galvis Carlos Andrés Naranjo, Montes Mónica Vargas, Perez Nestor Ivan Cardona, Ramirez Morgan, Chittenden Cy, Wang Edward, Garcia-López Laura Lorena, Padrieu Guillermo, Muñoz-Ortiz Juliana, Rivera-Valdivia Nicolás, Bohorquez-Granados María Cristina, de-la-Torre Gabriela Castaño, Hernandez Juan David Valencia, Celis-Giraldo Daniel, Dávila Juan Alejandro Acosta, Torres Elizabeth, Oquendo Manuela Mejia, Arteaga-Rivera José Y, Nicolae Dan L, Rzhetsky Andrey, Roizen Nancy, Stillwaggon Eileen, Sawers Larry, Peyron Francois, Wallon Martine, Chapey Emanuelle, Levigne Pauline, Charter Carmen, De Frias Migdalia, Montoya Jose, Press Cindy, Ramirez Raymund, Contopoulos-Ioannidis Despina, Maldonado Yvonne, Liesenfeld Oliver, Gomez Carlos, Wheeler Kelsey, Zehar Samantha, McAuley James, Limonne Denis, Houze Sandrine, Abraham Sylvie, Piarroux Raphael, Tesic Vera, Beavis Kathleen, Abeleda Ana, Sautter Mari, El Mansouri Bouchra, El Bachir Adlaoui, Amarir Fatima, El Bissati Kamal, Holfels Ellen, Frim David, McLone David, Penn Richard, Cohen William, de-la-Torre Alejandra, Britton Gabrielle, Motta Jorge, Ortega-Barria Eduardo, Romero Isabel Luz, Meier Paul, Grigg Michael, Gómez-Marín Jorge, Kosagisharaf Jagannatha Rao, Llorens Xavier Sáez, Reyes Osvaldo, McLeod Rima

机构信息

Toxoplasmosis Programs and Initiatives in Panama, Ciudad de Panama, Panama.

Institute for Genomics and Systems Biology, The University of Chicago, Chicago, IL USA.

出版信息

Curr Pediatr Rep. 2022;10(3):125-154. doi: 10.1007/s40124-022-00268-x. Epub 2022 Aug 16.

DOI:10.1007/s40124-022-00268-x

PMID:35991908

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9379243/

Abstract

PURPOSE OF REVIEW

Review international efforts to build a global public health initiative focused on toxoplasmosis with spillover benefits to save lives, sight, cognition and motor function benefiting maternal and child health.

RECENT FINDINGS

Multiple countries' efforts to eliminate toxoplasmosis demonstrate progress and context for this review and new work.

SUMMARY

Problems with potential solutions proposed include accessibility of accurate, inexpensive diagnostic testing, pre-natal screening and facilitating tools, missed and delayed neonatal diagnosis, restricted access, high costs, delays in obtaining medicines emergently, delayed insurance pre-approvals and high medicare copays taking considerable physician time and effort, harmful shortcuts being taken in methods to prepare medicines in settings where access is restricted, reluctance to perform ventriculoperitoneal shunts promptly when needed without recognition of potential benefit, access to resources for care, especially for marginalized populations, and limited use of recent advances in management of neurologic and retinal disease which can lead to good outcomes.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40124-022-00268-x.

摘要

综述目的

回顾国际上为建立一项全球公共卫生倡议所做的努力，该倡议聚焦于弓形虫病，具有附带益处，可挽救生命、视力、认知和运动功能，从而惠及母婴健康。

总结

所提出的潜在解决方案存在诸多问题，包括准确、廉价诊断检测的可及性、产前筛查及辅助工具、新生儿诊断漏诊和延迟、获取受限、成本高昂、紧急获取药物延迟、保险预批准延迟以及高额医疗保险自付费用，这需要医生投入大量时间和精力；在资源受限环境中制备药物的方法存在有害的捷径；在需要时不愿及时进行脑室腹腔分流术而未认识到潜在益处；获得护理资源的机会，尤其是对边缘化人群而言；以及对神经和视网膜疾病管理方面最新进展的利用有限，而这些进展本可带来良好结果。