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Seasonal dynamics, antimicrobial resistance, and genetic lineages of thermotolerant Campylobacter isolates from South American camelids 季节动态,抗菌素耐药性,以及从南美骆驼中分离的耐热弯曲杆菌的遗传谱系
Pub Date : 2026-01-01 DOI: 10.1016/j.soh.2026.100147
Aung Zaw Moe , Carsten Heydel , Henrik Wagner , Lisa Ulrich , Torsten Semmler , Kerstin Stingl , Priyanshu Singh Raikwar , Samuel K. Sheppard , Christa Ewers

Background

South American camelids (SACs) are increasingly kept as companion animals, but their role in zoonotic transmission is poorly understood. Thermotolerant Campylobacter spp. are a leading cause of bacterial zoonoses globally. This study investigated the occurrence and zoonotic potential of thermotolerant Campylobacter spp. in SACs on German farms.

Methods

Fecal swabs from up to 20 animals on 10 farms were collected across four seasons. Campylobacter spp. were isolated, and genomes were typed to assess multilocus sequence types (STs), virulence, and antimicrobial resistance.

Results

Campylobacter spp. were detected in 23/717 samples (3.2 %), including 16 Campylobacter jejuni from seven farms and seven Campylobacter coli from two farms. Detection was higher in alpacas (4.9 %, 21/427) than in llamas (0.7 %, 2/288), with higher rates in summer. Molecular typing revealed high genetic heterogeneity, though some STs recurred across timepoints, animals, and farms, suggesting potential endemic colonization. Nine distinct C. jejuni STs and two C. coli STs were identified, many belonging to clonal complexes (CCs) common in livestock and humans. All isolates carried virulence-associated genes for motility, adhesion, invasion, and toxin production, while several from CC21 harbored genes linked to Guillain-Barré syndrome. Antimicrobial susceptibility testing showed wild-type phenotypes for erythromycin, gentamicin, and chloramphenicol. Ciprofloxacin resistance, with T86I mutation in gyrA, was found in three isolates; one C. jejuni isolate carried tet(O) conferring tetracycline resistance.

Conclusion

SACs harbor Campylobacter strains related to human and livestock lineages, with virulence and resistance traits relevant for zoonotic transmission. Their presence on German farms highlights the need targeted surveillance and biosecurity within a One Health framework.
越来越多的人将南美骆驼作为伴侣动物饲养,但人们对它们在人畜共患疾病传播中的作用知之甚少。耐热弯曲杆菌是全球细菌性人畜共患病的主要原因。本研究调查了德国农场SACs中耐热弯曲杆菌的发生情况和人畜共患的可能性。方法收集10个农场4个季节20只动物的粪便拭子。分离出弯曲杆菌,并对其基因组进行分型,以评估多位点序列类型(STs)、毒力和耐药性。结果717份样品中检出弧菌23株(3.2%),其中7个农场检出空肠弯曲菌16株,2个农场检出大肠弯曲菌7株。羊驼检出率(4.9%,21/427)高于大羊驼(0.7%,2/288),夏季检出率较高。分子分型显示出较高的遗传异质性,尽管一些STs在不同时间点、动物和农场中复发,表明可能存在地方性定植。鉴定出9个不同的空肠C. STs和2个大肠C. STs,其中许多属于牲畜和人类常见的克隆复合体(CCs)。所有分离株都携带与运动性、粘附性、侵袭性和毒素产生相关的毒力基因,而来自CC21的一些分离株携带与格林-巴罗综合征相关的基因。抗生素敏感性试验显示红霉素、庆大霉素和氯霉素为野生型表型。在3株分离株中发现环丙沙星耐药,gyrA中存在T86I突变;一株空肠梭菌携带tet(O),具有四环素抗性。结论sacs携带的弯曲杆菌与人畜谱系有关,具有与人畜共患传播相关的毒力和耐药性状。它们在德国农场的出现凸显了在“同一个健康”框架下有针对性的监测和生物安全的必要性。
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引用次数: 0
Navigating the challenges in implementing financial incentives for behavior change at the intersection of human, animal, and ecosystem health: a case study 在人类、动物和生态系统健康的交叉点实施行为改变财政激励的挑战:一个案例研究
Pub Date : 2026-01-01 DOI: 10.1016/j.soh.2025.100144
John M. Kerr , Maryann G. Delea , Minwoong Chung , Jinhua Zhao , Jesse Crawford , Maria Knight Lapinski
With the global expansion of financial incentives to promote behavior change, they are being considered in One Health contexts characterized by the interdependence of human, animal, and ecosystem health. Little specific evidence exists about how to maximize the effectiveness of financial incentives and minimize negative outcomes in these complex settings. We review over two decades of research on financial incentives for behavior change to examine their potential effects on improved practices related to water, sanitation and hygiene, food safety, and animal and ecosystem health. We apply lessons from the literature to the case of Guinea worm disease, a neglected tropical disease for which financial incentives have been utilized or considered to motivate the uptake of various preventive behaviors. Guinea worm disease prevention is a useful example for considering the advantages, disadvantages, and unknowns of incorporating financial incentives into behavior change interventions because such an approach calls for changes in multiple behaviors with diverse attributes, and the use of incentives may have implications for other disease control, elimination, and eradication programs. Further, Guinea worm disease represents a classic One Health challenge with interventions necessary in human, animal, and ecological systems to reduce disease incidence. We present evidence-based recommendations for the design and use of incentives that may further facilitate effective behavior change. We also discuss potential negative outcomes from incentives, and critical unknowns such as how to design incentives for collective behavior and what happens when incentives end. We stress that financial incentives are not always appropriate; they must be considered carefully and coupled with proper communication efforts that are driven by a deep understanding of community social norms, motivations, and practices.
随着促进行为改变的财政激励在全球范围内的扩大,它们正在以人类、动物和生态系统健康相互依存为特征的“同一个健康”背景下被考虑。关于如何在这些复杂的环境中最大化财政激励的有效性并最小化负面结果,几乎没有具体的证据存在。我们回顾了二十多年来关于行为改变的财政激励的研究,以检查其对改善与水、环境卫生和个人卫生、食品安全以及动物和生态系统健康有关的做法的潜在影响。我们将文献中的经验教训应用于麦地那龙线虫病的病例,这是一种被忽视的热带病,财政激励已被利用或被认为是为了激励采取各种预防行为。麦地那龙线虫病的预防是一个有用的例子,可以考虑将财政激励纳入行为改变干预措施的优点、缺点和未知因素,因为这种方法需要改变具有不同属性的多种行为,并且激励的使用可能对其他疾病控制、消除和根除计划有影响。此外,麦地那龙线虫病是典型的“同一个健康”挑战,需要在人类、动物和生态系统中采取必要的干预措施,以减少疾病发病率。我们提出了基于证据的建议,以设计和使用激励措施,进一步促进有效的行为改变。我们还讨论了激励的潜在负面结果,以及关键的未知因素,如如何设计集体行为的激励,以及激励结束时会发生什么。我们强调,财政激励并不总是适当的;必须仔细考虑这些问题,并结合对社区社会规范、动机和实践的深刻理解所驱动的适当沟通努力。
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引用次数: 0
The 2024 WHO bacterial priority pathogens list: a critical evolution from a global One Health perspective 2024年世卫组织细菌重点病原体清单:从全球“同一个健康”的角度来看的重要演变
Pub Date : 2026-01-01 DOI: 10.1016/j.soh.2025.100145
Subhankar Mukhopadhyay , Ye Peng , Hein Min Tun
The 2024 WHO Bacterial Priority Pathogens List (WHO BPPL) is a critical tool for refining global antimicrobial resistance (AMR) strategy, prioritizing 24 bacteria with a focus on Gram-negatives and community threats like Salmonella Typhi. This perspective examines its One Health implications. While the 2024 WHO BPPL effectively guides research and development (R&D), policy, and infection control through vaccines and water, sanitation and hygiene (WASH) programs, its human-centric approach underrepresents critical agricultural and environmental AMR drivers. Surveillance biases towards high-income countries and the inherent challenges of cross-sectoral monitoring—given the distinct niches of pathogens like Enterococcus faecium and Shigella—further limit its scope. We call for integrating zoonotic and environmental metrics, strengthening global surveillance (e.g., Global Antimicrobial Resistance and Use Surveillance System [GLASS]), and accelerating development of novel therapies to advance a more equitable and holistic AMR response.
2024年世卫组织细菌重点病原体清单(世卫组织BPPL)是完善全球抗菌素耐药性(AMR)战略的重要工具,对24种细菌进行了优先排序,重点关注革兰氏阴性菌和伤寒沙门氏菌等社区威胁。这一观点考察了其“同一个健康”的含义。虽然2024年世卫组织基本方案清单通过疫苗和水、环境卫生和个人卫生(WASH)规划有效地指导了研发、政策和感染控制,但其以人为本的方法未能充分代表抗生素耐药性的关键农业和环境驱动因素。鉴于粪肠球菌和志贺氏菌等病原体的独特生态位,监测偏向于高收入国家以及跨部门监测的固有挑战进一步限制了其范围。我们呼吁整合人畜共患病和环境指标,加强全球监测(例如,全球抗菌素耐药性和使用监测系统[GLASS]),并加快新疗法的开发,以促进更公平和全面的抗菌素耐药性应对。
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引用次数: 0
One Health showcase from Asia: the Lawa model—a community-based approach to liver fluke control in Thailand 一个来自亚洲的健康展示:Lawa模式——泰国以社区为基础的肝吸虫控制方法
Pub Date : 2025-01-01 DOI: 10.1016/j.soh.2025.100108
Banchob Sripa , Sirikachorn Tangkawattana
Liver fluke infection caused by Opisthorchis viverrini is a significant public health challenge in the Lower Mekong Basin, affecting over 10 million people and leading to cholangiocarcinoma, a fatal bile duct cancer. Traditional control efforts often fail due to complex socio-cultural and ecological factors. The Lawa model, implemented in the Lawa Lake region of Khon Kaen, Thailand, adopts a One Health framework to integrate human health interventions, environmental modifications, and animal reservoir management, addressing the transmission cycle comprehensively. This approach respects the cultural context of Isan communities and leverages evidence-based, community-driven strategies. Over 15 years, the model has achieved remarkable success, reducing human infection rates from 60 % to below 5 % and eliminating infections in intermediate hosts. Key lessons include the importance of systems thinking, transdisciplinary collaboration, and community engagement in achieving sustainable health outcomes, despite challenges like cultural dietary practices and environmental disruptions such as flooding.
由 Opisthorchis viverrini 引起的肝吸虫感染是湄公河下游流域面临的一项重大公共卫生挑战,影响到 1,000 多万人,并导致胆管癌(一种致命的胆管癌)。由于复杂的社会文化和生态因素,传统的防治工作往往以失败告终。在泰国孔敬省拉瓦湖地区实施的 "拉瓦模式 "采用 "一个健康 "框架,将人类健康干预、环境改造和动物水库管理结合起来,全面解决传播循环问题。这种方法尊重伊桑社区的文化背景,并利用以证据为基础的社区驱动战略。15 年来,该模式取得了显著成功,将人类感染率从 60% 降至 5% 以下,并消除了中间宿主的感染。主要经验包括:尽管存在文化饮食习惯和洪水等环境干扰等挑战,但系统思考、跨学科合作和社区参与在实现可持续健康成果方面的重要性。
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引用次数: 0
One Health and planetary health research landscapes in the Arab world “同一个健康”和阿拉伯世界的全球健康研究景观
Pub Date : 2025-01-01 DOI: 10.1016/j.soh.2025.100105
Shaher Zyoud , Sa'ed H. Zyoud
This review explored research trends in One Health and planetary health in the Arab world, a region confronting major sustainability challenges. These fields are crucial in combating global pressing concerns like infectious diseases, biodiversity loss, antimicrobial resistance, climate change, and air pollution. The COVID-19 pandemic stressed their significance to global health and sustainable development. This analysis assessed the Arab world's contributions to these concepts applying performance analysis and visualization mapping, revealing that One Health outperformed planetary health in terms of productivity and number of contributed countries. Egypt, Saudi Arabia, and the United Arab Emirates have emerged as leading contributors to One Health and planetary health research in the Arab world. Meanwhile, the United States and the United Kingdom, as non-Arab nations, play a pivotal role in fostering collaborative efforts with the region. The trajectory of One Health research has indeed shown remarkable exponential growth, especially since the beginning of the COVID-19 pandemic in 2019, which is an indication of increasing relevance in the address of global health challenges. Conversely, planetary health presents an irregular growth pattern, with a strong point in the development of this area standing out in 2023. The unique set of social, cultural, governance, and agricultural attributes of the Arab region are joined by major environmental challenges that define the focus of both One Health and planetary health research efforts. Climate change, environmental contexts, and public health feature prominently in both One Health and planetary health, with One Health focusing mainly on infectious diseases and planetary health addressing the implications of climate change on human health. Advancing these concepts demands the establishment of a regional governing body to oversee an integrated One Health and planetary health strategy, foster regional research communities and alliances, secure political will and funding, and ensure the integration of these concepts into policy and academic frameworks.
本综述探讨了面临重大可持续性挑战的阿拉伯世界“同一个健康”和“地球健康”的研究趋势。这些领域对于应对传染病、生物多样性丧失、抗菌素耐药性、气候变化和空气污染等全球紧迫问题至关重要。2019冠状病毒病大流行强调了它们对全球卫生和可持续发展的重要性。这一分析利用绩效分析和可视化制图评估了阿拉伯世界对这些概念的贡献,结果显示,在生产力和贡献国数量方面,“同一个健康”的表现优于地球健康。埃及、沙特阿拉伯和阿拉伯联合酋长国已成为阿拉伯世界“同一个健康”和全球健康研究的主要贡献者。与此同时,美国和英国作为非阿拉伯国家,在促进与该地区的合作努力方面发挥着关键作用。“同一个健康”的研究轨迹确实呈现出显著的指数级增长,特别是自2019年COVID-19大流行开始以来,这表明该项目在应对全球卫生挑战方面的相关性日益增强。相反,行星健康呈现出不规则的增长模式,在2023年这一领域的发展有一个亮点。除了阿拉伯地区独特的社会、文化、治理和农业属性外,还面临着重大的环境挑战,这些挑战确定了“同一个健康”和“地球健康”研究工作的重点。气候变化、环境背景和公共卫生在“同一个健康”和“地球健康”中都具有突出特点,“同一个健康”主要侧重于传染病和地球健康,处理气候变化对人类健康的影响。推进这些概念需要建立一个区域理事机构,以监督“同一个健康”和“地球健康”综合战略,促进区域研究社区和联盟,确保政治意愿和资金,并确保将这些概念纳入政策和学术框架。
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引用次数: 0
A One Health call to re examine medical practice: going beyond strong anthropocentrism 同一个健康呼吁重新审视医疗实践:超越强烈的人类中心主义
Pub Date : 2025-01-01 DOI: 10.1016/j.soh.2025.100129
Moshe Porat Wojakowski , Shir Porat-Butman
One Health discourse rightly stresses human–animal–environment interdependence, yet its normative footing can be thin and often defaults to strong anthropocentrism, valuing non-human beings and ecosystems only instrumentally. This perspective focuses on clinical decision-making and proposes a shift from strong anthropocentrism to weak anthropocentrism. weak anthropocentrism maintains the human-centered mandate that underpins medicine and public health while at the same time requiring proportionality, least harm, and intergenerational responsibility that acknowledge intrinsic—not merely instrumental—value in ecological systems and non-human life. Building on One Health's systems thinking, the framework offers a pragmatic approach rather than a radical turn to biocentrism or ecocentrism, and it recognizes ongoing debates about prudential versus radical interpretations within One Health. We illustrate feasibility with green oncology, where clinically equivalent options are selected to reduce life-cycle emissions, waste, and antimicrobial pressures—showing how ecological considerations can be integrated without compromising patient or population outcomes. The proposal aligns with contemporary regulatory strategies that recommend a One Health lens and invites a practical recalibration of public health policy: expand evaluative criteria, embed ecological reasoning in decision processes, and align clinical benefit with long-term planetary stewardship. Weak anthropocentrism thus offers a workable, ethically coherent route to extend “do no harm” beyond humans while remaining faithful to the core commitments of both clinical care and public health.
“一种健康”话语正确地强调了人-动物-环境的相互依存关系,但其规范基础可能薄弱,往往默认为强烈的人类中心主义,只重视非人类和生态系统。这一观点侧重于临床决策,并提出了从强人类中心主义到弱人类中心主义的转变。弱人类中心主义坚持以人为中心的使命,支撑着医学和公共卫生,同时要求适度、伤害最小和代际责任,承认生态系统和非人类生命的内在价值——而不仅仅是工具价值。该框架以One Health的系统思维为基础,提供了一种务实的方法,而不是激进地转向生物中心主义或生态中心主义,它承认在One Health内部正在进行的关于审慎与激进解释的辩论。我们说明了绿色肿瘤学的可行性,选择临床等效的选择来减少生命周期的排放、浪费和抗微生物压力,展示了如何在不损害患者或人群结果的情况下整合生态考虑。该提案与推荐“一个健康”镜头的当代监管战略保持一致,并邀请对公共卫生政策进行实际的重新校准:扩大评估标准,在决策过程中嵌入生态推理,并将临床效益与长期的地球管理相结合。因此,弱人类中心主义提供了一条可行的、道德上连贯的路线,将“不伤害”延伸到人类之外,同时忠实于临床护理和公共卫生的核心承诺。
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引用次数: 0
Antimicrobial resistance in Salmonella: One Health perspective on global food safety challenges 沙门氏菌的抗微生物药物耐药性:全球食品安全挑战的健康视角
Pub Date : 2025-01-01 DOI: 10.1016/j.soh.2025.100117
Rahul Kumar , Nurudeen Olatunbosun Adeyemi , Sourav Chattaraj , Wiem Alloun , A.K.A.N.W.M.R.K. Thamarsha , Snežana Anđelković , Debasis Mitra , Pankaj Gautam
Antimicrobial resistance (AMR) in Salmonella is a major concern in terms of human health, environmental sustainability, and global food security. Salmonella, the world's most prevalent foodborne pathogen, has gradually gained resistance to important drugs, complicating treatment efforts and leading to rising morbidity, mortality, and economic costs. Overuse of antibiotics in human medicine and agriculture, inadequate regulatory compliance, and environmental pollution from agricultural runoff and treated sewage all contribute to the growth and spread of AMR in Salmonella. Health as well as viewpoints on environmental, animal, and human health will be required to address this complicated problem. This includes promoting reasonable antibiotic use, improving global surveillance systems, and researching novel treatments including phage therapy, probiotics, and new antibiotics. Proposals for vaccination and precise food safety standards are critical for limiting Salmonella transmission across the food chain. Despite significant progress, critical research gaps continue, specifically in understanding the molecular basis of resistance and the role of environmental practices. However, contemporary research endeavors are concentrated on identifying and comprehending the prevalence of extensively drug-resistant Salmonella strains, elucidating the bacterium's defense mechanisms against antibiotics, and investigating outbreaks associated with vegetables. Global surveillance, the development of alternative therapies, and the implementation of stricter antibiotic policies are essential strategies in addressing AMR in Salmonella. Additionally, policy design and implementation, capacity building in low- and middle-income countries, and raising public awareness all necessitate urgent global collaboration among governments, international agencies, non-governmental organizations, and the corporate sector. Stricter regulations on overuse of antibiotics in agriculture is also called for. This review highlights the importance of multi-disciplinary struggles in engaging Salmonella, as integrated resolutions through a One Health approach are crucial for ensuring food safety, preserving public health, and minimizing the worldwide threat of AMR.
沙门氏菌的抗微生物药物耐药性(AMR)是人类健康、环境可持续性和全球粮食安全方面的一个主要问题。沙门氏菌是世界上最普遍的食源性病原体,已逐渐对重要药物产生耐药性,使治疗工作复杂化,并导致发病率、死亡率和经济成本上升。在人类医学和农业中过度使用抗生素,不充分遵守法规,以及农业径流和处理过的污水造成的环境污染,都有助于沙门氏菌中抗生素耐药性的生长和传播。要解决这个复杂的问题,就需要健康以及对环境、动物和人类健康的看法。这包括促进合理使用抗生素,改善全球监测系统,以及研究新的治疗方法,包括噬菌体治疗、益生菌和新的抗生素。疫苗接种建议和精确的食品安全标准对于限制沙门氏菌在整个食物链中的传播至关重要。尽管取得了重大进展,但关键的研究差距仍然存在,特别是在了解耐药性的分子基础和环境实践的作用方面。然而,当代的研究努力集中在识别和理解广泛耐药沙门氏菌菌株的流行,阐明细菌对抗生素的防御机制,以及调查与蔬菜有关的爆发。全球监测、开发替代疗法和实施更严格的抗生素政策是解决沙门氏菌耐药性的基本策略。此外,政策设计和实施、低收入和中等收入国家的能力建设以及提高公众意识都需要政府、国际机构、非政府组织和企业部门之间的紧急全球合作。还呼吁对农业中过度使用抗生素采取更严格的规定。这篇综述强调了多学科斗争在处理沙门氏菌方面的重要性,因为通过“同一个健康”方法的综合解决方案对于确保食品安全、维护公众健康和最大限度地减少抗生素耐药性的全球威胁至关重要。
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引用次数: 0
Corrigendum to “Identification of habitat suitability for the dominant zoonotic tick species Haemaphysalis flava on Chongming Island, China”[Science in One Health 3 (2024) 100068] 中国崇明岛主要人畜共患病蜱种Haemaphysalis flava栖息地适宜性鉴定》[《同一健康科学》3 (2024) 100068]更正
Pub Date : 2025-01-01 DOI: 10.1016/j.soh.2025.100106
Si-Wei Fei , Han-Qing Zhao , Jing-Xian Yin , Zhi-Shan Sun , Jing-Bo Xue , Shan Lv , Xin-Yu Feng , Xiao-Kui Guo , Xiao-Nong Zhou , Kokouvi Kassegne
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引用次数: 0
One Health integrated surveillance: a way forward to accelerate schistosomiasis elimination in China “一个健康”综合监测:加快中国消除血吸虫病的前进之路
Pub Date : 2025-01-01 DOI: 10.1016/j.soh.2025.100114
Suying Guo , Lijuan Zhang , Yifeng Li , Shiqing Zhang , Xiaojuan Xu , Yinlong Li , Chunli Cao , Jing Xu , Shizhu Li
Surveillance is an effective approach for disease control and prevention. Being a vector-borne and zoonotic parasitic disease, schistosomiasis has been under comprehensive surveillance in China for several decades, with focus on indicators related to definitive hosts, intermediate hosts, as well as changes of influencing factors. This article reviewed the surveillance system of schistosomiasis in China from the perspective of One Health to provide evidence for the acceleration of elimination. When moving towards elimination with rare new infection occurred in humans, livestock and snails, One Health surveillance system could be the most effective approach to accelerate the process of elimination or consolidate the achievement of schistosomiasis by integrating the risk surveillance and novel diagnostic tools in the intelligent multi-point trigger infectious disease monitoring and early warning system.
监测是疾病控制和预防的有效手段。血吸虫病是一种媒介传播、人畜共患的寄生虫病,几十年来中国对血吸虫病进行了全面监测,重点关注最终宿主、中间宿主及影响因素变化等相关指标。本文从“一个健康”的视角对中国血吸虫病监测体系进行了综述,以期为加快消除血吸虫病提供依据。当在人类、牲畜和蜗牛中发生罕见的新感染时,One Health监测系统可以通过将风险监测和新型诊断工具整合到智能多点触发传染病监测和预警系统中,成为加速消除血吸虫病进程或巩固血吸虫病成果的最有效方法。
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引用次数: 0
Global, regional, and national temporal trend and patterns of change in the burden of leishmaniasis from 1990 to 2021: an analysis of the Global Burden of Disease Study 2021 1990年至2021年利什曼病负担的全球、区域和国家时间趋势和变化模式:对2021年全球疾病负担研究的分析
Pub Date : 2025-01-01 DOI: 10.1016/j.soh.2025.100123
Shunxian Zhang , Guobing Yang , Shan Lv , Lei Duan , Muxin Chen , Qin Liu , Liguang Tian , Shizhu Li , Jinxin Zheng

Background

Leishmaniasis is a globally prevalent parasitic disease caused by protozoa of the genus Leishmania. This study utilizes Global Burden of Disease Study 2021 (GBD 2021) data to systematically evaluate the global, regional, and national epidemiological trends, thereby providing a scientific basis for optimizing the prevention and control strategies for leishmania infections.

Methods

Data from the GBD 2021 database were analyzed to evaluate trends in age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life-years rate (ASDR) for leishmaniasis across global, regional, and national levels, stratified by age, sex, and sociodemographic index (SDI). A Bayesian age-period-cohort (BAPC) model was employed to project future burden. Analyses included the slope index of inequality and the concentration index to assess health disparities, frontier analysis to estimate achievable outcomes based on development levels, and decomposition analysis to identify the drivers of changes in DALYs number.

Results

From 1990 to 2021, the ASIR of leishmaniasis decreased from 17.82 to 14.34 per 100,000 population, while the ASPR increased from 62.94 to 76.96 per 100,000 population. Most strikingly, the ASMR showed a dramatic reduction from 1.05 to 0.07 per 100,000 population. However, concerning increases were observed in absolute case numbers, with incident cases rising from 1.01 to 1.10 million and prevalent cases nearly doubling from 3.18 to 6.21 million. Notably, Syria exhibited the most severe deterioration in ASDR (average annual percentage change [AAPC] = 4.78 %, 95 % confidence interval [CI]: 4.67–4.89). Frontier analysis identified several high-burden countries including South Sudan, the Syrian Arab Republic, Afghanistan, Suriname, and Sudan as persistent hotspots requiring targeted interventions. A robust inverse correlation was observed between all disease metrics (ASIR, ASPR, ASMR, ASDR, and case counts) and the SDI, with all associations demonstrating high statistical significance (P < 0.001).

Conclusions

Leishmaniasis continues to pose significant public health challenges in Southeast Asia, North Africa, and Middle East. Strengthening public health interventions, optimizing resource distribution, and focusing on health governance in low- and middle-income countries are key to addressing the ongoing burden. One Health-based integrated strategies, particularly in vector control, host management, and environmental sanitation, are essential for reducing the disease burden and achieving long-term control.
背景:利什曼病是由利什曼原虫引起的一种全球流行的寄生虫病。本研究利用全球疾病负担研究2021 (GBD 2021)数据,系统评估全球、区域和国家流行病学趋势,为优化利什曼原虫感染防控策略提供科学依据。方法分析来自GBD 2021数据库的数据,以评估全球、地区和国家各级利什曼病的年龄标准化发病率(ASIR)、年龄标准化患病率(ASPR)、年龄标准化死亡率(ASMR)和年龄标准化残疾调整生命年率(ASDR)的趋势,并按年龄、性别和社会人口指数(SDI)分层。采用贝叶斯年龄-时期-队列(BAPC)模型预测未来负担。分析包括评估健康差距的不平等斜率指数和集中指数,根据发展水平估计可实现的结果的前沿分析,以及确定DALYs数量变化驱动因素的分解分析。结果1990 - 2021年,利什曼病ASIR由17.82 / 10万人下降至14.34 / 10万人,而ASPR由62.94 / 10万人上升至76.96 / 10万人。最引人注目的是,ASMR显示了从每10万人1.05人到0.07人的急剧下降。然而,绝对病例数却出现了令人担忧的增长,发病病例从101万例增加到110万例,流行病例从318万例增加到621万例,几乎翻了一番。值得注意的是,叙利亚的ASDR恶化最为严重(年均百分比变化[AAPC] = 4.78%, 95%置信区间[CI]: 4.67-4.89)。前沿分析确定了几个高负担国家,包括南苏丹、阿拉伯叙利亚共和国、阿富汗、苏里南和苏丹,它们是需要有针对性干预的持续热点。观察到所有疾病指标(ASIR、ASPR、ASMR、ASDR和病例数)与SDI之间存在显著的负相关,且所有相关性均具有高度统计学意义(P < 0.001)。结论利什曼病在东南亚、北非和中东地区继续构成重大公共卫生挑战。加强公共卫生干预措施、优化资源分配以及注重低收入和中等收入国家的卫生治理是解决当前负担的关键。以健康为基础的综合战略,特别是在病媒控制、宿主管理和环境卫生方面,对于减轻疾病负担和实现长期控制至关重要。
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Science in One Health
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