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首页> 外文期刊>Current Science: A Fortnightly Journal of Research >RHD in India: are we ready to shift from secondary prophylaxis to vaccinating high-risk children?
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RHD in India: are we ready to shift from secondary prophylaxis to vaccinating high-risk children?

机译：印度的RHD：我们准备好从二级预防转为给高危儿童接种疫苗吗？

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摘要

Rheumatic fever (RF) and rheumatic heart disease (RHD) continue to be important public health problems in the developing world. Although the disease burden appears to have declined in parts of India that have experienced an improvement in human development, there are many areas where the disease burden may be high. There is paucity of epidemiological data from poorly served rural populations, urban slums and tribal pockets, where the disease prevalence is expected to be high. Penicillin prophylaxis, particularly secondary prophylaxis has remained the mainstay for prevention of RF and RHD. However, this has not made significant difference to the disease burden over the years, particularly in high-prevalence regions. An effective vaccine against group A streptococcus (GAS) has the potential of reducing RF-RHD disease burden. However, there are a number of difficulties that need to be overcome before an effective vaccine is made available. Very few vaccines have reached the stage of clinical trials. A number of questions remain about their usefulness for streptococcal strains found in the developing world. There is also the practical issue of identifying the population at risk in the developing world, given the changing epidemiology of the disease.This article attempts to review the epidemiology of RF-RHD in India today and identify potential problems relating to the use of a vaccine against GAS.
机译：风湿热（RF）和风湿性心脏病（RHD）在发展中国家仍然是重要的公共卫生问题。尽管在人类发展得到改善的印度部分地区，疾病负担似乎有所下降，但在许多地区，疾病负担可能很高。从服务水平低下的农村人口，城市贫民窟和部落地区获得的流行病学数据很少，这些地方的疾病流行率很高。预防青霉素，尤其是继发性预防仍然是预防RF和RHD的主要手段。但是，多年来，尤其是在高流行地区，这并未对疾病负担产生重大影响。针对A组链球菌（GAS）的有效疫苗具有减轻RF-RHD疾病负担的潜力。但是，在获得有效疫苗之前，有许多困难需要克服。很少有疫苗达到临床试验阶段。关于它们对发展中国家发现的链球菌菌株的有用性还有许多问题。鉴于该疾病的流行病学不断变化，在发展中国家确定危险人群还有一个实际问题。本文试图回顾当今印度RF-RHD的流行病学并找出与疫苗使用相关的潜在问题反对GAS。

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