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Why reinvent the wheel? Lessons in schistosomiasis control from the past
PLOS Neglected Tropical Diseases ( IF 3.8 ) Pub Date : 2017-10-26 , DOI: 10.1371/journal.pntd.0005812
Clive Shiff

Schistosomiasis has been of concern to local health authorities for most of the last century, and in spite of a lack of effective chemotherapy, the disease was dealt with quite effectively in many endemic countries by snail control and environmental management [1]. Much of this work was reported in journals prior to the electronic era but, sadly, seems to have been subsequently ignored. For many years, there followed a global hiatus on schistosomiasis control, and much of the local expertise was lost, but many things have changed more recently, mainly with the advent of generic and affordable praziquantel. With the increased availability of this drug, there has been an increasing interest in readdressing schistosomes as well as other neglected tropical diseases (NTDs). The strategic approach for this had been based almost exclusively on chemotherapy. Recently, however, questions arose about this strategy with evidence that chemotherapy alone was not succeeding [2]. Additional strategies were needed, and the “Towards Elimination of Schistosomiasis” (TES) 2017 Conference in Cameroon stressed an integrated PHASE strategy. This was in line with the WHO-NTD and WHO-AFRO 2014–2020 Regional Strategy on NTDs and directed emphasis on transmission control. Subsequently, this emphasis was discussed in a comprehensive review [3] that stressed the importance of such additions to any elimination programme. In reality, this means focusing on the aquatic snail hosts where and when transmission occurs, defining other risk factors such as water contact and latrine design and identifying improved sanitation and health education as essential components for elimination. For schistosomiasis reduction during the mid-20th century, transmission control was used extensively, but these facts are not well reported. Recent reviews have attempted to cover previous research [4,5], but sadly, they have left major knowledge gaps, particularly from Africa. These omissions also occurred in a recent WHO pamphlet on molluscicides [6]. Sadly, search engines used to retrieve information appear to miss much done by 5 African research institutes active from 1950 to 1990. It seems appropriate to take a look back to a time when fieldwork was a focus of research and transmission control was emphasised.



中文翻译:

为什么要重新发明轮子?过去血吸虫病控制的经验教训

在上个世纪的大部分时间里,血吸虫病一直是地方卫生当局关注的问题,尽管缺乏有效的化学疗法,但在许多流行国家中,通过蜗牛控制和环境管理可以有效地治疗血吸虫病[1]。在电子时代之前,许多工作都在期刊上进行了报道,但遗憾的是,随后似乎被忽略了。多年来,随之而来的是全球范围内血吸虫病控制的中断,许多地方专业知识的流失了,但是最近许多事情发生了变化,主要是随着通用和价格合理的吡喹酮的出现。随着这种药物可用性的增加,人们对解决血吸虫以及其他被忽视的热带病(NTD)的兴趣也越来越高。为此的战略方法几乎完全基于化学疗法。然而,最近,关于这种策略的质疑出现了,有证据表明仅靠化学疗法不能成功[2]。还需要其他策略,在喀麦隆举行的“迈向消除血吸虫病”(TES)2017年会议强调了一项综合的PHASE策略。这符合WHO-NTD和WHO-AFRO 2014-2020年NTD区域战略,并直接强调了传播控制。随后,在全面审查中讨论了这种重点[3],强调了对任何消除方案进行这种补充的重要性。实际上,这意味着要关注发生传播的时间和地点的水生蜗牛宿主,确定其他危险因素,例如水接触和厕所设计,并确定改善的卫生条件和健康教育,作为消除这些疾病的重要组成部分。为了减少20世纪中叶的血吸虫病,广泛采用了传播控制,但尚未充分报道这些事实。最近的评论试图覆盖以前的研究[4,5],但可悲的是,它们留下了主要的知识空白,特别是来自非洲的知识空白。这些遗漏也发生在最近的世界卫生组织关于杀软体动物剂的小册子中[6]。令人遗憾的是,用于检索信息的搜索引擎似乎错过了5家活跃于1950年至1990年的非洲研究机构所做的很多工作。回想一下以野外工作为研究重点和传输控制为重点的时代似乎是适当的。为了减少20世纪中叶的血吸虫病,广泛采用了传播控制,但尚未充分报道这些事实。最近的评论试图覆盖以前的研究[4,5],但可悲的是,它们留下了主要的知识空白,尤其是来自非洲的知识空白。这些遗漏也发生在最近的世界卫生组织关于杀软体动物剂的小册子中[6]。令人遗憾的是,用于检索信息的搜索引擎似乎错过了5家活跃于1950年至1990年的非洲研究机构所做的很多工作。回想一下以野外工作为研究重点和传输控制为重点的时代似乎是适当的。为了减少20世纪中叶的血吸虫病,广泛采用了传播控制,但尚未充分报道这些事实。最近的评论试图覆盖以前的研究[4,5],但可悲的是,它们留下了主要的知识空白,尤其是来自非洲的知识空白。这些遗漏也发生在最近的世界卫生组织关于杀软体动物剂的小册子中[6]。令人遗憾的是,用于检索信息的搜索引擎似乎错过了5家活跃于1950年至1990年的非洲研究机构所做的很多工作。回想一下以野外工作为研究重点和传输控制为重点的时代似乎是适当的。特别是来自非洲。这些遗漏也发生在最近的世界卫生组织关于杀软体动物剂的小册子中[6]。可悲的是,用于检索信息的搜索引擎似乎错过了1950年至1990年期间活跃的5家非洲研究机构所做的许多工作。回顾一下以实地工作为研究重点和传输控制为重点的时代似乎是适当的。特别是来自非洲。这些遗漏也发生在最近的世界卫生组织关于杀软体动物剂的小册子中[6]。可悲的是,用于检索信息的搜索引擎似乎错过了1950年至1990年期间活跃的5家非洲研究机构所做的许多工作。回顾一下以实地工作为研究重点和传输控制为重点的时代似乎是适当的。

更新日期:2017-10-27
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