在埃塞俄比亚消除几内亚蠕虫病;疾病现状、根除战略和终局挑战。

Q3 Medicine
Ethiopian Medical Journal Pub Date : 2017-01-01
Habtamu Bedimo Beyene, Abyot Bekele, Amanu Shifara, Yehenew A Ebstie, Zelalem Desalegn, Zeyede Kebede, Abate Mulugeta, Kebede Deribe, Zerihun Tadesse, Tamrat Abebe, Biruck Kebede, Getaneh Abrha, Daddi Jima
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引用次数: 0

摘要

麦地那龙线虫病(Dracunculiasis)又称几内亚蠕虫病(GWD),是被忽视的热带病(NTD)之一,由一种名为麦地那龙线虫(Dracunculus medinensis)的寄生线虫引起,自古以来就被以色列人称为 "火蛇"。它通过饮用含有感染性桡足类的污染水传播给人类。鉴于根除这种疾病的可行性,1980 年启动了几内亚蠕虫根除计划(GWEP),旨在根除这种疾病。自启动以来,根除几内亚蠕虫计划在阻断传播方面取得了非凡的进展。在全球范围内,报告病例数从 1986 年 20 个国家的 350 万例减少到 2015 年仅四个国家(即南苏丹、马里、乍得和埃塞俄比亚)的 22 例。由于马里在 2016 年中断了 GWD 的传播,目前该疾病仅在南苏丹、乍得和埃塞俄比亚三个撒哈拉以南非洲国家流行。每个流行国都有自己的国家几内亚蠕虫根除计划。在埃塞俄比亚,埃塞俄比亚根除麦地那龙线虫病计划(EDEP)成立于 1993 年,该计划在阻断疾病传播方面取得了显著进展,目前已接近尾声。在主要由卡特中心、世卫组织和联合国儿童基金会提供的支持下,EDEP 在 1994 年至 2015 年期间已将 GWD 减少了 99% 以上。2015 年,仅报告了 3 例人类本地病例和 14 例动物病例(13 例狗病例和 1 例狒狒病例)。2016 年,报告了 3 例人类感染病例、14 例狗感染病例和 2 例狒狒感染病例。来自南苏丹共和国(RSS)的难民涌入、在麦地那龙线虫病传播中作用不明的动物感染增加、难以到达的社区的存在以及偏远非村庄地区安全水源的缺乏仍然是埃塞俄比亚根除麦地那龙线虫病最后阶段面临的重要挑战。本文回顾了埃塞俄比亚根除麦地那龙线虫病计划(EDEP)在根除麦地那龙线虫病方面取得的进展,以及为实现最终目标而需要进一步加强的干预战略。本报告讨论了根除战略,包括改变行为的社区教育(包括提高对报告古尼埃阿蠕虫病(GWD)和动物感染的现金奖励的认识)、病例控制、监测系统、提供安全供水和 ABATE 化学应用。报告还总结了最终目标面临的挑战以及加强根除工作的建议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Elimination of Guinea Worm Disease in Ethiopia; Current Status of the Disease's, Eradication Strategies and Challenges to the End Game.

Elimination of Guinea Worm Disease in Ethiopia; Current Status of the Disease's, Eradication Strategies and Challenges to the End Game.

Elimination of Guinea Worm Disease in Ethiopia; Current Status of the Disease's, Eradication Strategies and Challenges to the End Game.

Dracunculiasis, also named Guinea Worm Disease (GWD), is one of the Neglected Tropical Diseases (NTDs) caused by a parasitic nematode known as Dracunculus medinensis and has been known since antiquity as 'fiery serpent' from Israelites. It is transmitted to humans via drinking contaminated water containing infective copepods. Given, its feasibility for eradication, the Guinea Worm Eradication Program (GWEP) was launched in 1980 with the aim of eradicating the disease. Since its inception, GWEP has made an extraordinary progress in interrupting transmission. Globally, the number of reported cases reduced from 3.5 million in 20 countries in 1986 to only 22 cases in 2015 from only four countries namely South Sudan, Mali, Chad and Ethiopia. Since Mali has interrupted transmission of GWD in 2016, currently, the disease remains endemic in only three sub-Saharan African countries namely, South Sudan, Chad and Ethiopia. Each endemic country has its own national Guinea Worm Eradication Program. In Ethiopia, the Ethiopian Dracunculiasis Eradication Program (EDEP) which was established in 1993 has made remarkable move towards interruption of disease transmission and now the endgame is fast approaching. The EDEP with support mainly from The Carter Center, WHO, and UNICEF has reduced GWD by more than 99% from 1994 to 2015. In 2015, only 3 indigenous cases in humans and 14 in animals (13 in dogs and 1 in baboon) were reported. In 2016, 3 human cases, 14 dogs and 2 baboon infections were reported.. Refugee influx from the Republic of South Sudan (RSS), increased animal infections with unknown role in transmission of Dracunculiasis, the presence of hard to reach communities and lack of safe water sources in remote non-village areas remain among important challenges at this final stage of GWD eradication in Ethiopia. This paper reviews progress made towards Guinea Worm Eradication with a focus on the experience of the Ethiopian Dracunculiasis Eradication Program (EDEP), and intervention strategies that need further intensification to realize the endgame. Eradication strategies encompassing community education for behavioral change including raising awareness towards cash reward for reporting Guniea Worm Disease (GWD) and animal infection, case containment, surveillance systems, provision of safe water supply, and ABATE chemical application are discussed. It also summarizes challenges the end game faces and recommendations to strengthen the eradication effort.

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来源期刊
Ethiopian Medical Journal
Ethiopian Medical Journal Medicine-Medicine (all)
CiteScore
0.40
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期刊介绍: The Ethiopian Medical Journal (EMJ) is the official Journal of the Ethiopian Medical Association (EMA) and devoted to the advancement and dissemination of knowledge pertaining to the broad field of medicine in Ethiopia and other developing countries. Prospective contributors to the Journal should take note of the instructions of Manuscript preparation and submission to EMJ as outlined below.
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