Walker Martin, Lambert Sébastien, Neves M Inês, Worsley Andrew D, Traub Rebecca, Colella Vito
Department of Pathobiology and Populations Sciences, Royal Veterinary College, Hatfield, United Kingdom.
Department of Infectious Disease Epidemiology, London Centre for Neglected Tropical Disease Research, Imperial College London, London, United Kingdom.
Front Med (Lausanne). 2023 Mar 7;10:1092030. doi: 10.3389/fmed.2023.1092030. eCollection 2023.
Hookworm disease is a major global public health concern, annually affecting 500-700 million of the world's poorest people. The World Health Organization is targeting the elimination of hookworm as a public health problem by 2030 using a strategy of mass drug administration (MDA) to at-risk human populations. However, in Southeast Asia and the Pacific the zoonotic hookworm species, , is endemic in dogs and commonly infects people. This presents a potential impediment to the effectiveness of MDA that targets only humans. Here, we develop a novel multi-host (dog and human) transmission model of and compare the effectiveness of human-only and "One Health" (human plus dog) MDA strategies under a range of eco-epidemiological assumptions. We show that One Health interventions-targeting both dogs and humans-could suppress prevalence in humans to ≤ 1% by the end of 2030, even with only modest coverage (25-50%) of the animal reservoir. With increasing coverage, One Health interventions may even interrupt transmission. We discuss key unresolved questions on the eco-epidemiology of , the challenges of delivering MDA to animal reservoirs, and the growing importance of One Health interventions to human public health.
钩虫病是一个重大的全球公共卫生问题,每年影响着全球5亿至7亿最贫困人口。世界卫生组织的目标是到2030年通过对高危人群采用大规模药物驱虫(MDA)策略来消除作为公共卫生问题的钩虫。然而,在东南亚和太平洋地区,人兽共患钩虫物种在狗中呈地方性流行,且常感染人类。这对仅针对人类的大规模药物驱虫策略的有效性构成了潜在障碍。在此,我们建立了一种新型的多宿主(狗和人类)传播模型,并在一系列生态流行病学假设下比较了仅针对人类和“同一健康”(人类加狗)大规模药物驱虫策略的有效性。我们表明,即使仅对动物宿主进行适度覆盖(25%-50%),“同一健康”干预措施(针对狗和人类)到2030年底也可将人类中的流行率抑制至≤1%。随着覆盖范围的扩大,“同一健康”干预措施甚至可能阻断传播。我们讨论了关于该钩虫生态流行病学的关键未解决问题、对动物宿主进行大规模药物驱虫的挑战以及“同一健康”干预措施对人类公共卫生日益增长的重要性。