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首页> 外文期刊>Infectious Diseases of Poverty >Moving from control to elimination of schistosomiasis in sub-Saharan Africa: time to change and adapt strategies
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Moving from control to elimination of schistosomiasis in sub-Saharan Africa: time to change and adapt strategies

机译：从控制到消除血吸虫病在撒哈拉以南非洲：时间来改变和适应战略

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Schistosomiasis is a water borne parasitic disease of global importance and with ongoing control the disease endemic landscape is changing. In sub-Saharan Africa, for example, the landscape is becoming ever more heterogeneous as there are several species of Schistosoma that respond in different ways to ongoing preventive chemotherapy and the inter-sectoral interventions currently applied. The major focus of preventive chemotherapy is delivery of praziquantel by mass drug administration to those shown to be, or presumed to be, at-risk of infection and disease. In some countries, regional progress may be uneven but in certain locations there are very real prospects to transition from control into interruption of transmission, and ultimately elimination. To manage this transition requires reconsideration of some of the currently deployed diagnostic tools used in surveillance and downward realignment of existing prevalence thresholds to trigger mass treatment. A key challenge will be maintaining and if possible, expanding the current donation of praziquantel to currently overlooked groups, then judging when appropriate to move from mass drug administration to selective treatment. In so doing, this will ensure the health system is adapted, primed and shown to be cost-effective to respond to these changing disease dynamics as we move forward to 2020 targets and beyond.
机译：血吸虫病是一种具有全球重要性的水传播性寄生虫病，在不断的控制下，该病的流行状况正在发生变化。例如，在撒哈拉以南非洲，由于多种血吸虫物种以不同方式对正在进行的预防性化学疗法和目前应用的部门间干预做出反应，因此景观变得越来越异质。预防性化学疗法的主要重点是通过大量药物给药将吡喹酮递送至已显示或假定存在感染和疾病风险的患者。在某些国家，区域进步可能不平衡，但是在某些地区，从控制到过渡到传播并最终消除的前景非常真实。要管理此过渡，需要重新考虑用于监视的一些当前部署的诊断工具，并向下调整现有患病率阈值以触发大规模治疗。一项关键挑战将是维持，如果可能的话，将目前对吡喹酮的捐赠扩大到目前被忽视的人群，然后判断何时从大规模药物管理转向选择性治疗。这样，当我们朝着2020年及以后的目标迈进时，这将确保卫生系统适应，适应并证明具有成本效益，以应对这些不断变化的疾病动态。

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