Molyneux D H
Liverpool School of Tropical Medicine, U.K.
Ann Trop Med Parasitol. 1997 Oct;91(7):827-39. doi: 10.1080/00034989760581.
The statuses of vector-borne diseases have changed over recent years. How a few such diseases have changed and the primary causes of change (urbanization, increased conflict, changes in water-resource management, ecological and environmental change, and reduced health service resourcing) are the subjects of the present review. The key impacts which these primary causes have on selected vectors and the infections they transmit are tabulated. The success of vector-control programmes against onchocerciasis and Chagas disease is discussed, and the methods used to evaluate the epidemiological impact of such controls are described. Bednet programmes for control of malaria are recognized as a potential future means of reducing morbidity and mortality in children. In contrast to the success achieved in limiting Simulium and Triatoma populations through vertical programmes, control of tsetse, whilst successful in Uganda, has not been utilized to stem recent epidemics of sleeping sickness in resource-stressed settings in Central Africa. Vector-borne diseases will continue to be a problem because of the adaptability of vectors, the potential problems of managing effective vector controls within decentralized health systems, and the influence of activities outside the health sector itself. Changes beyond the health sector can increase the problem posed by a vector and increase the frequency of transmission.
近年来，媒介传播疾病的状况发生了变化。几种此类疾病如何变化以及变化的主要原因（城市化、冲突增加、水资源管理变化、生态和环境变化以及卫生服务资源减少）是本综述的主题。这些主要原因对选定媒介及其传播的感染的关键影响以表格形式列出。讨论了针对盘尾丝虫病和恰加斯病的病媒控制计划的成效，并描述了用于评估此类控制措施流行病学影响的方法。用于控制疟疾的蚊帐计划被认为是未来降低儿童发病率和死亡率的一种潜在手段。与通过垂直计划成功限制蚋和锥蝽种群数量形成对比的是，采采蝇控制虽然在乌干达取得了成功，但在资源紧张的中非地区，尚未被用于遏制近期昏睡病的流行。由于病媒的适应性、在分散的卫生系统内管理有效病媒控制措施的潜在问题以及卫生部门自身以外活动的影响，媒介传播疾病仍将是一个问题。卫生部门以外的变化可能会加剧病媒带来的问题，并增加传播频率。
