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拉丁美洲的人类迁徙、人为变化与虫媒疾病

Human migrations, anthropogenic changes, and insect-borne diseases in Latin America.

作者信息

Wilke André B B, Farina Priscilla, Ajelli Marco, Canale Angelo, Dantas-Torres Filipe, Otranto Domenico, Benelli Giovanni

机构信息

Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA.

Department of Agriculture, Food and Environment, University of Pisa, Pisa, Italy.

出版信息

Parasit Vectors. 2025 Jan 9;18(1):4. doi: 10.1186/s13071-024-06598-7.

Abstract

Rapid urbanization and migration in Latin America have intensified exposure to insect-borne diseases. Malaria, Chagas disease, yellow fever, and leishmaniasis have historically afflicted the region, while dengue, chikungunya, and Zika have been described and expanded more recently. The increased presence of synanthropic vector species and spread into previously unaffected areas due to urbanization and climate warming have intensified pathogen transmission risks. This review examines recent outbreaks and reemergence of insect-borne diseases through five case studies: (i) malaria transmission linked to political instability and large-scale migration through the Amazon jungle; (ii) the expansion of triatomine bug habitats into overcrowded, substandard urban settlements, increasing Chagas disease incidence; (iii) the influence of movement and ecotourism in the Amazonia on yellow fever transmission in peri-urban areas; (iv) the spread of visceral leishmaniasis driven by deforestation and human-canine movement; and (v) dengue outbreaks in rural Amazon regions, spurred by urbanization and rural development. The findings underscore the complex interactions among vectors, pathogens, and shifting environmental and social conditions, complicating predictability and control. Addressing the social, economic, and political determinants of health is crucial to reducing disease transmission. Key measures include scaling vaccine coverage, especially for dengue and yellow fever; developing vaccines and treatments for neglected diseases; improving housing and sanitation; strengthening vector surveillance and control; fostering community engagement; enhancing data-driven interventions.

摘要

拉丁美洲快速的城市化和移民加剧了人们对虫媒疾病的暴露风险。疟疾、恰加斯病、黄热病和利什曼病长期以来一直困扰着该地区,而登革热、基孔肯雅热和寨卡病毒病则是近年来才被发现并传播开来。由于城市化和气候变暖,与人类共生的病媒物种增多并扩散到以前未受影响的地区,这加剧了病原体传播的风险。本综述通过五个案例研究,审视了虫媒疾病最近的暴发和再度出现的情况:(i)与政治动荡以及通过亚马逊丛林的大规模移民相关的疟疾传播;(ii)锥蝽栖息地扩展到过度拥挤、不合标准的城市住区,导致恰加斯病发病率上升;(iii)亚马逊地区的人员流动和生态旅游对城郊地区黄热病传播的影响;(iv)森林砍伐和人与犬的流动导致内脏利什曼病的传播;以及(v)城市化和农村发展引发的亚马逊农村地区登革热疫情。研究结果强调了病媒、病原体与不断变化的环境和社会条件之间复杂的相互作用,使得疾病的可预测性和控制变得更加复杂。解决健康问题的社会、经济和政治决定因素对于减少疾病传播至关重要。关键措施包括扩大疫苗接种覆盖率,尤其是针对登革热和黄热病;研发被忽视疾病的疫苗和治疗方法;改善住房和卫生条件;加强病媒监测和控制;促进社区参与;加强数据驱动的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92d5/11721252/d8360925ecbf/13071_2024_6598_Fig1_HTML.jpg

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