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巴西历史上最严重的登革热疫情:监测、预防和控制。

The greatest Dengue epidemic in Brazil: Surveillance, Prevention, and Control.

机构信息

Universidade de Brasília, Faculdade de Medicina, Núcleo de Medicina Tropical, Laboratório de Parasitologia Médica e Biologia Vetores/Programa de Pós-Graduação em Medicina Tropical, Brasília, DF, Brasil.

Centro Universitário do Planalto Central Apparecido dos Santos, Faculdade de Medicina, Brasília, DF, Brasil.

出版信息

Rev Soc Bras Med Trop. 2024 Sep 20;57:e002032024. doi: 10.1590/0037-8682-0113-2024. eCollection 2024.

Abstract

In this review, we discuss dengue surveillance, prevention, and control measures in Brazil. Data on dengue epidemics between 2000 and 2024 indicates an increase in the number of dengue cases and deaths. Global climate change is a key driver of this growth. Over the past 25 years, nearly 18 million Brazilians have been infected with the dengue virus, and the highest number of dengue cases in Brazil's history is projected to reach 2024. Dengue mortality in Brazil increased geographically over time. As of June, there were approximately 6 million probable cases and 4,000 confirmed deaths in Brazil, which represents the greatest dengue epidemic to date. Several technologies have been developed to control Aedes aegypti, including the deployment of Wolbachia-infected mosquitoes, indoor residual spraying, sterile insect techniques, and mosquito-disseminated insecticides. The Ministry of Health recommends integrating these technologies into health services. Brazil is the first country to incorporate the Takeda vaccine into its public health system, and the Butantan vaccine is currently undergoing Phase 3 clinical trials. Increasing the vaccination coverage and implementing novel Ae. aegypti control technologies could reduce the number of dengue cases in Brazil in the coming years. Community activities such as home cleaning and elimination of potential mosquito breeding sites, facilitated by social media and health education initiatives, must continue to achieve this reduction. Ultimately, a multisectoral approach encompassing sanitary improvements, mosquito control, vaccination, and community mobilization is crucial in the fight against dengue epidemics.

摘要

在这篇综述中,我们讨论了巴西的登革热监测、预防和控制措施。2000 年至 2024 年的登革热疫情数据表明,登革热病例和死亡人数有所增加。全球气候变化是导致这种增长的关键因素。在过去的 25 年里,近 1800 万巴西人感染了登革热病毒,预计 2024 年巴西将出现历史上登革热病例最多的一年。巴西的登革热死亡率随着时间的推移呈现出地域上的增长。截至 6 月,巴西大约有 600 万疑似病例和 4000 例确诊死亡,这是迄今为止最大的登革热疫情。已经开发了几种控制埃及伊蚊的技术,包括释放携带沃尔巴克氏体的蚊子、室内滞留喷洒、不育昆虫技术和蚊虫传播杀虫剂。卫生部建议将这些技术纳入卫生服务中。巴西是第一个将武田疫苗纳入公共卫生系统的国家,布坦坦疫苗目前正在进行 3 期临床试验。增加疫苗接种覆盖率并实施新型埃及伊蚊控制技术,可能会在未来几年降低巴西的登革热病例数。必须通过社交媒体和健康教育活动继续开展家庭清洁和消除潜在蚊子滋生地等社区活动,以实现这一减少。最终,一个包含改善卫生条件、控制蚊子、接种疫苗和社区动员的多部门方法,对于抗击登革热疫情至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d773/11415067/7210b1d56bbd/1678-9849-rsbmt-57-e00203-2024-gf1.jpg

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