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部门间协调在控制传染病中的重要性,特别提及坦桑尼亚的鼠疫

Importance of intersectoral co-ordination in the control of communicable diseases, with special reference to plague in Tanzania.

作者信息

Kilonzo B S

机构信息

Rodent Research Unit, Sokoine University of Agriculture, Morogoro, Tanzania.

出版信息

Cent Afr J Med. 1994 Jul;40(7):186-92.

PMID:7812993
Abstract

Human health, agriculture, including livestock, energy, education, wildlife, construction, forestry and trade sectors are inter-related and their co-ordination is an important pre-requisite for successful control of most communicable diseases including plague. Similar linkage between research, policy, training and extension activities in each sector are essential for any successful control strategy. Inadequate agricultural produce, inaccessibility of people to the available food and ignorance on proper preparation and usage of available food materials are responsible for malnutrition, and malnourished people are very vulnerable to disease. Irrigation schemes facilitate breeding of various disease vectors and transmission of some communicable diseases. Forests are ecologically favourable for some disease vectors and reservoirs for tsetse flies and rodents, while deforestation leads to soil erosion, lack of rainfall and consequently reduced productivity in agriculture which may result in poor nutrition of the population. Wildlife and livestock serve as reservoirs and/or carriers of various zoonoses including plague, trypanosomiasis and rabies. Lack of proper co-ordination of these sectors in communicable disease control programmes can result in serious and undesirable consequences. Indiscriminate killing of rodents in order to minimize food damage by these vermin forces their flea ectoparasites to seek alternative hosts, including man, a development which may result in transmission of plague from rodents to man. Similarly, avoidance of proper quarantine during plague epidemics, an undertaking which is usually aimed at maintaining economic and social links with places outside the affected focus, can result in the disease becoming widespread and consequently make any control strategies more difficult and expensive.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

人类健康、农业(包括畜牧业)、能源、教育、野生动物、建筑、林业和贸易部门相互关联,它们之间的协调是成功控制包括鼠疫在内的大多数传染病的重要前提。每个部门的研究、政策、培训和推广活动之间的类似联系对于任何成功的控制策略都至关重要。农产品不足、人们无法获得现有食物以及对现有食物材料的正确制备和使用缺乏了解,是导致营养不良的原因,而营养不良的人极易患病。灌溉计划有利于各种病媒的繁殖和一些传染病的传播。森林在生态上有利于某些病媒生存,是采采蝇和啮齿动物的宿主,而森林砍伐会导致水土流失、降雨不足,进而导致农业生产力下降,可能致使民众营养不良。野生动物和家畜是包括鼠疫、锥虫病和狂犬病在内的各种人畜共患病的宿主和/或传播媒介。在传染病控制计划中,这些部门缺乏适当协调可能会导致严重且不良的后果。为减少这些害虫对食物的破坏而随意捕杀啮齿动物,会迫使它们的跳蚤体外寄生虫寻找包括人类在内的替代宿主,这一情况可能导致鼠疫从啮齿动物传播给人类。同样,在鼠疫流行期间不进行适当检疫,这一举措通常旨在维持与疫区以外地区的经济和社会联系,可能会导致疾病蔓延,从而使任何控制策略都更加困难且成本更高。(摘要截选于250字)

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