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关于猴痘的未解答问题的有趣见解:探讨卫生政策的影响和考虑。

Intriguing insight into unanswered questions about Mpox: exploring health policy implications and considerations.

机构信息

College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.

King Edward Medical University, Lahore, Pakistan.

出版信息

Health Res Policy Syst. 2024 Mar 22;22(1):37. doi: 10.1186/s12961-024-01123-9.

Abstract

The 2022 multi-country Monkeypox (Mpox) outbreak has added concerns to scientific research. However, unanswered questions about the disease remain. These unanswered questions lie in different aspects, such as transmission, the affected community, clinical presentations, infection and prevention control and treatment and vaccination. It is imperative to address these issues to stop the spread and transmission of disease. We documented unanswered questions with Mpox and offered suggestions that could help put health policy into practice. One of those questions is why gay, bisexual or other men who have sex with men (gbMSM) are the most affected community, underscoring the importance of prioritizing this community regarding treatment, vaccination and post-exposure prophylaxis. In addition, destigmatizing gbMSM and implementing community-based gbMSM consultation and action alongside ethical surveillance can facilitate other preventive measures such as ring vaccination to curb disease transmission and track vaccine efficacy. Relevant to that, vaccine and drug side effects have implied the questionability of their use and stimulated the importance of health policy development regarding expanded access and off-label use, expressing the need for safe drug and vaccine development manufacturing. The possibility of reverse zoonotic has also been raised, thus indicating the requirement to screen not only humans, but also their related animals to understand the real magnitude of reverse zoonosis and its potential risks. Implementing infection prevention and control measures to stop the virus circulation at the human-animal interface that includes One Health approach is essential.

摘要

2022 年多国猴痘(Mpox)疫情爆发,这给科研工作增添了新的忧虑。然而,目前仍有一些关于该疾病的问题尚未得到解答。这些悬而未决的问题存在于不同方面,如传播途径、受影响的群体、临床表现、感染防控、治疗和疫苗接种等。解决这些问题对于阻止疾病的传播和扩散至关重要。我们记录了与猴痘相关的未解答问题,并提出了一些建议,以帮助将卫生政策付诸实践。其中一个问题是,为什么男同性恋、双性恋或其他与男性发生性关系的男性(gbMSM)是受影响最严重的群体,这突显了在治疗、疫苗接种和暴露后预防方面优先考虑这一群体的重要性。此外,消除对 gbMSM 的污名化,实施以社区为基础的 gbMSM 咨询和行动,并结合伦理监测,可以促进其他预防措施,如环疫苗接种,以遏制疾病传播并跟踪疫苗的效果。与此相关的是,疫苗和药物的副作用引发了对其使用的质疑,这也凸显了制定扩大获取途径和超说明书使用的卫生政策的重要性,强调了安全药物和疫苗研发制造的必要性。病毒可能出现反向人畜共患的情况,这表明不仅需要对人类进行筛查,还需要对相关动物进行筛查,以了解反向人畜共患病的真实规模及其潜在风险。实施感染预防和控制措施,以阻止病毒在人类与动物之间的传播,包括采用“同一健康”方法,这是至关重要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b75/10960492/2f80544287cf/12961_2024_1123_Fig1_HTML.jpg

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