A One Health approach toward the control and elimination of soil-transmitted helminthic infections in endemic areas

Jolly Joe Lapat , Jimmyy Opee , Monica Clara Apio , Susan Akello , Christine Lakop Ojul , Robert Onekalit , Oumo Joseph Francis , Dorah Lalweny , Katerega J.P. Latigo , Sarah Lebu , Emmanuel Ochola , Felix Bongomin
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Abstract

Soil-transmitted helminths (STHs) pose significant health challenges, particularly in developing countries. Over 2 billion people are estimated to have been infected with at least one STH species. These parasites rely on the soil for part of their life cycle and are transmitted to humans through ova ingestion or skin penetration. Key risk factors include poor water, sanitation, hygiene practices, limited healthcare access, and poverty. Globally, STHs are primarily controlled through chemo-preventive deworming of high-risk groups in moderate (where prevalence of STHs is between 20 % and 50 %) to highly endemic areas (prevalence >50 %). Despite the use of deworming to control the STHs in endemic areas, infections still occur. The aim of this article is to explore the potential for enhancing STH control and elimination as Neglected Tropical Diseases (NTDs) in endemic areas through an integrated approach—the One Health approach. The current control program has a single strategy of chemoprophylaxis; in the integrated approach to control of STHs, the parasite control strategies besides being based on the epidemiology of the parasite (endemicity), also include strategies based on the biology (transmission cycle) of the parasites and human behavior patterns in endemic areas. Through the involvement of local communities, healthcare authorities, and stakeholders, participatory approaches foster collaborative efforts to devise and implement control measures. By integrating this integrated approach into existing healthcare and educational initiatives, more effective results can be achieved. The promotion of health education, clean water access, improved sanitation, and hygiene awareness can further enhance control strategies and reduce STH prevalence sustainably. Here, we highlight the benefits of adopting an integrated (One Health) approach to tackle STHs in endemic areas. Through community empowerment and multi-sectorial collaboration, we can strengthen our collective efforts to combat STHs and alleviate the burden of these NTDs.

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采取 "一体健康 "方法控制和消除流行地区的土壤传播蠕虫感染
土壤传播蠕虫(STHs)对健康构成重大挑战,尤其是在发展中国家。据估计,超过 20 亿人至少感染过一种 STH。这些寄生虫的部分生命周期依赖于土壤,并通过摄入卵子或皮肤渗透传播给人类。主要风险因素包括水质差、环境卫生差、个人卫生习惯差、医疗服务有限以及贫困。在全球范围内,性传播疾病主要是通过对中度流行地区(性传播疾病发病率在 20% 到 50% 之间)到高度流行地区(发病率为 50%)的高危人群进行化学预防性驱虫来控制的。尽管在流行地区使用驱虫药来控制性传播疾病,但感染仍时有发生。本文旨在探讨通过综合方法--"一体健康 "方法--在流行地区加强控制和消除作为被忽视的热带疾病(NTDs)的性传播疾病的潜力。目前的控制计划只有单一的化学预防策略;在控制性传播疾病的综合方法中,寄生虫控制策略除了基于寄生虫的流行病学(地方病)外,还包括基于寄生虫生物学(传播周期)和流行地区人类行为模式的策略。通过当地社区、医疗保健机构和利益相关者的参与,参与式方法促进了设计和实施控制措施的合作努力。通过将这种综合方法与现有的医疗保健和教育措施相结合,可以取得更有效的成果。推广健康教育、清洁用水、改善环境卫生和提高个人卫生意识可以进一步加强控制策略,持续降低性传播疾病的流行率。在此,我们强调在性传播疾病流行地区采用综合("一体健康")方法应对性传播疾病的益处。通过社区赋权和多部门合作,我们可以加强集体努力,防治性传播疾病,减轻这些非传染性疾病的负担。
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