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Addressing Chagas disease from a One Health perspective: risk factors, lessons learned and prevention of oral transmission outbreaks in Colombia 从 "一体健康 "的角度应对南美锥虫病:哥伦比亚口腔传播爆发的风险因素、经验教训和预防。
Pub Date : 2024-01-01 DOI: 10.1016/j.soh.2024.100066
Mario J. Olivera , Claudia Yaneth Rincón Acevedo , Antonio José Olivera , Sergio Mendez-Cardona , Mauricio Javier Vera Soto

Background

Chagas disease (CD) is transmitted by vectors but can also be transmitted orally through contaminated food, drinks, or meat. The One Health perspective aims to understand the complex interaction between human, animal, and environmental health in controlling disease. This study analyzed risk factors and drew lessons from past outbreaks of orally transmitted CD to develop effective preventive strategies.

Methods

A simultaneous mixed methods study was conducted. The study consisted of two phases: an ecological epidemiological analysis at the municipal level using secondary data spanning from 1992 to 2023, and semistructured interviews with health providers and policymakers at the national level in Colombia. The results from both phases were triangulated to gain a comprehensive understanding of the topic.

Results

A total of 64 outbreaks, infecting 302 individuals, were reported. Most of these outbreaks (89.2%) were classified as family-related, and they occurred most frequently during the months of April to June (46.6%). It is worth noting that a significant number of these outbreaks took place in municipalities that lacked vector control plans. Risk factors for oral transmission included the location of food preparation, poor housing quality, food preparation water source, the presence of vectors/marsupials, forest type, and climatic variables. Interviews conducted emphasized the importance of implementing outbreak plans and providing staff training to effectively address the issue.

Conclusion

A One Health approach strengthening prevention, surveillance, case management and cross-sectoral collaboration is needed to control outbreaks and reduce transmission in Colombia. Preparedness plans and education of health professionals are also important. This study identified modifiable risk factors to guide public health interventions.

背景恰加斯病(CD)通过病媒传播,但也可通过受污染的食物、饮料或肉类经口传播。统一健康 "观点旨在了解人类、动物和环境健康在控制疾病方面的复杂互动关系。本研究分析了风险因素,并从过去爆发的口源性 CD 中吸取教训,以制定有效的预防策略。研究分为两个阶段:利用 1992 年至 2023 年的二手数据,在城市层面进行生态流行病学分析;在哥伦比亚国家层面对医疗服务提供者和政策制定者进行半结构式访谈。对这两个阶段的结果进行了三角测量,以全面了解这一主题。这些疫情大部分(89.2%)被归类为与家庭有关的疫情,最常发生在 4 月至 6 月(46.6%)。值得注意的是,这些疫情有相当一部分发生在缺乏病媒控制计划的城市。经口传播的风险因素包括食物准备地点、住房质量差、食物准备水源、存在病媒/有袋动物、森林类型和气候变量。访谈强调了实施疫情爆发计划和提供人员培训以有效解决这一问题的重要性。结论 哥伦比亚需要采取 "统一健康 "方法,加强预防、监测、病例管理和跨部门合作,以控制疫情爆发和减少传播。准备计划和对卫生专业人员的教育也很重要。这项研究确定了可改变的风险因素,以指导公共卫生干预措施。
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引用次数: 0
Identification of habitat suitability for the dominant zoonotic tick species Haemaphysalis flava on Chongming Island, China 中国崇明岛主要人畜共患病蜱类 Haemaphysalis flava 的栖息地适宜性鉴定
Pub Date : 2024-01-01 DOI: 10.1016/j.soh.2024.100068
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

Haemaphysalis ticks are pathogenic vectors that threaten human and animal health and were identified in Chongming, the third largest island in China. To understand the distribution of these ticks and determine their potential invasion risk, this study aimed to identify the habitat suitability of the dominant tick H. flava based on natural environmental factors. Geographic information system (GIS) images were combined with sample points from tick investigations to map the spatial distribution of H. flava. Data on 19 bioclimatic variables, environmental variables, and satellite-based landscapes of Chongming Island were retrieved to create a landcover map related to natural environmental determinants of H. flava. These data included 38 sites associated with the vectors to construct species distribution models with MaxEnt, a model based on the maximum entropy principle, and to predict habitat suitability for H. flava on Chongming Island in 2050 and 2070 under different climate scenarios. The model performed well in predicting the H. flava distribution, with a training area under the curve of 0.84 and a test area under the curve of 0.73. A habitat suitability map of the whole study area was created for H. flava. The resulting map and natural environment analysis highlighted the importance of the normalized difference vegetation index and precipitation in the driest month for the bioecology of H. flava, with 141.61 km2 (11.77%), 282.94 km2 (23.35%), and 405.30 km2 (33.69%) of highly, moderately, and poorly suitable habitats, respectively. The distribution decreased by 135.55 km2 and 138.82 km2 in 2050 and 2070, respectively, under the shared socioeconomic pathway (SSP) 1.2.6 climate change scenario. However, under SSP 5.8.5, the total area will decrease by 128.5 km2 in 2050 and increase by 151.64 km2 in 2070. From a One Health perspective, this study provides good knowledge that will guide tick control efforts to prevent the spread of Haemaphysalis ticks or transmission risk of Haemaphysalis-borne infections at the human-animal-environment interface on the island.

Haemaphysalis蜱是威胁人类和动物健康的病媒,在中国第三大岛崇明发现了这种蜱虫。为了了解这些蜱虫的分布情况并确定其潜在的入侵风险,本研究旨在根据自然环境因素确定主要蜱虫 H. flava 的栖息地适宜性。地理信息系统(GIS)图像与蜱虫调查的样本点相结合,绘制了H. flava的空间分布图。通过检索崇明岛的 19 个生物气候变量、环境变量和基于卫星的地貌数据,绘制了与 H. flava 的自然环境决定因素相关的土地覆盖图。这些数据包括与矢量相关的38个地点,利用基于最大熵原理的MaxEnt模型构建物种分布模型,并预测2050年和2070年不同气候情景下崇明岛花叶蟾蜍的栖息地适宜性。该模型在预测H. flava分布方面表现良好,训练曲线下面积为0.84,测试曲线下面积为0.73。为 H. flava 绘制了整个研究区域的栖息地适宜性地图。所绘制的地图和自然环境分析结果表明,归一化差异植被指数和最干旱月份的降水量对花叶蟾蜍的生物生态具有重要意义,高度、中度和低度适宜栖息地的面积分别为 141.61 平方公里(11.77%)、282.94 平方公里(23.35%)和 405.30 平方公里(33.69%)。在共同社会经济路径(SSP)1.2.6 气候变化情景下,2050 年和 2070 年的分布面积分别减少了 135.55 平方公里和 138.82 平方公里。然而,根据 SSP 5.8.5,2050 年总面积将减少 128.5 平方公里,2070 年将增加 151.64 平方公里。从 "一体健康 "的角度来看,这项研究提供了很好的知识,将指导蜱虫控制工作,以防止 Haemaphysalis 蜱虫的传播,或在岛上人-动物-环境交界处由 Haemaphysalis 传播的感染风险。
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引用次数: 0
One Health as a potential platform to rescue the neglected fruit trees in Yucatan, Mexico 将 "同一健康 "作为拯救墨西哥尤卡坦半岛被忽视果树的潜在平台
Pub Date : 2024-01-01 DOI: 10.1016/j.soh.2024.100073
John P. Ehrenberg , Afona Chernet , Manuel Luján , Jürg Utzinger

Neglected and underutilized species of plants (NUS) have been identified by the Food and Agriculture Organization as valuable resources for fighting poverty, hunger and malnutrition as they can help make agricultural production systems more sustainable and resilient. Adaptation of NUS to changing environments over several millennia has rendered most of these plants resistant to pests and climate change. In this paper, we explore the potential values of some of the Mayan fruit trees justifying conservation efforts in their native habitats. Our research was primarily based on a scoping review using Google Scholar. We considered articles published in English, Spanish and Portuguese. Our review rendered two sets of articles including those focusing on the nutritional and medicinal properties of NUS and their products, and those focusing on their uses in traditional medicine. Both sets of papers strongly support arguments for conservation of NUS. Additionally, our scoping review expands and includes a case study on the conservation of NUS, highlighting the critical role of civil society on how it can spearhead rescue efforts of botanical resources through the creation of what is possibly the first arboretum of its kind in the Americas. Among the project's key selling points was not only the rescue of an important component of Yucatan's cultural heritage but its nutritional value as well as its potential medicinal properties. Our paper is not prescriptive on how to preserve or even commercially exploit NUS. It is intended as a thought-provoking piece on the potential of a One Health approach as a multisectoral platform to support conservation efforts, while stimulating greater interest in the subject and encouraging more action from the academic and pharmaceutical sectors as well as civil society.

被忽视和利用不足的植物物种(NUS)已被联合国粮食及农业组织确定为消除贫困、饥饿和营养不良的宝贵资源,因为它们有助于提高农业生产系统的可持续性和复原力。几千年来,NUS 对不断变化的环境的适应性使这些植物大多具有抗虫害和抵御气候变化的能力。本文探讨了一些玛雅果树的潜在价值,以证明在其原生栖息地开展保护工作的合理性。我们的研究主要基于使用谷歌学术进行的范围审查。我们考虑了以英语、西班牙语和葡萄牙语发表的文章。我们的综述包括两组文章,其中一组侧重于 NUS 及其产品的营养和药用特性,另一组侧重于它们在传统医学中的用途。这两组文章都强烈支持保护 NUS 的论点。此外,我们的范围界定审查还扩展并纳入了一项关于保护 NUS 的案例研究,强调了民间社会的关键作用,即民间社会如何通过创建可能是美洲首个同类植物园来带头拯救植物资源。该项目的主要卖点之一不仅是抢救尤卡坦文化遗产的重要组成部分,还包括其营养价值和潜在的药用价值。我们的论文并没有对如何保护甚至商业利用 NUS 做出规定。本文旨在发人深省地说明 "一个健康 "方法作为支持保护工作的多部门平台的潜力,同时激发人们对这一主题的更大兴趣,鼓励学术界、医药界和民间社会采取更多行动。
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引用次数: 0
Building a pathway to One Health surveillance and response in Asian countries 在亚洲国家建立 "一个健康 "监测和响应途径
Pub Date : 2024-01-01 DOI: 10.1016/j.soh.2024.100067
Roger Morris , Shiyong Wang

To detect and respond to emerging diseases more effectively, an integrated surveillance strategy needs to be applied to both human and animal health. Current programs in Asian countries operate separately for the two sectors and are principally concerned with detection of events that represent a short-term disease threat. It is not realistic to either invest only in efforts to detect emerging diseases, or to rely solely on event-based surveillance. A comprehensive strategy is needed, concurrently investigating and managing endemic zoonoses, studying evolving diseases which change their character and importance due to influences such as demographic and climatic change, and enhancing understanding of factors which are likely to influence the emergence of new pathogens. This requires utilisation of additional investigation tools that have become available in recent years but are not yet being used to full effect. As yet there is no fully formed blueprint that can be applied in Asian countries. Hence a three-step pathway is proposed to move towards the goal of comprehensive One Health disease surveillance and response.

为了更有效地检测和应对新出现的疾病,需要对人类健康和动物健康采取综合监测战略。亚洲国家目前的计划将这两个领域分开运作,主要关注对代表短期疾病威胁的事件的检测。只投资于检测新出现疾病的工作,或只依赖于基于事件的监测,都是不现实的。需要制定一项综合战略,同时调查和管理地方性人畜共患病,研究因人口和气候变化等影响因素而改变其特征和重要性的演变中疾病,并加强对可能影响新病原体出现的因素的了解。这就需要利用近年来出现的、但尚未充分发挥作用的其他调查工具。到目前为止,还没有一个完全成型的蓝图可以应用于亚洲国家。因此,我们提出了一个三步走的路径,以实现 "一个健康 "疾病综合监测和应对的目标。
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引用次数: 0
Synergistic integration of climate change and zoonotic diseases by artificial intelligence: a holistic approach for sustainable solutions 人工智能(AI)对气候变化和人畜共患疾病的协同整合:可持续解决方案的整体方法
Pub Date : 2024-01-01 DOI: 10.1016/j.soh.2024.100070
Robert Bergquist, Jin-Xin Zheng, Xiao-Nong Zhou

Artificial intelligence (AI) is a rapidly evolving field that can impel research in communicable diseases with respect to climate projections, ecological indicators and environmental impact, at the same time revealing new, previously overlooked events. A number of zoonotic and vector-borne diseases already show signs of expanding their northern geographical ranges and appropriate risk assessment and decision support are urgently needed. The deployment of AI-enabled monitoring systems tracking animal populations and environmental changes is of immense potential in the study of transmission under different climate scenarios. In addition, AI's capability to identify new treatments should not only accelerate drug and vaccine discovery but also help predicting their effectiveness, while its contribution to genetic pathogen speciation would assist the evaluation of spillover risks with regard to viral infections from animals to human. Close collaboration between AI experts, epidemiologists and other stakeholders is not only crucial for responding to challenges interconnected with a variety of variables effectively, but also necessary to warrant responsible AI use. Despite its wider successful implementation in many fields, AI should be seen as a complement to, rather than a replacement of, traditional public health measures.

人工智能(AI)是一个快速发展的领域,它可以在气候预测、生态指标和环境影响方面推动传染病的研究,同时揭示新的、以前被忽视的事件。一些人畜共患病和病媒传染的疾病已经显示出扩大其北方地理范围的迹象,因此迫切需要适当的风险评估和决策支持。部署人工智能监测系统,跟踪动物种群和环境变化,在研究不同气候条件下的传播情况方面具有巨大潜力。此外,人工智能识别新疗法的能力不仅可以加速药物和疫苗的发现,还有助于预测其有效性,而其对遗传病原体物种的贡献将有助于评估病毒从动物传染给人类的外溢风险。人工智能专家、流行病学家和其他利益相关者之间的密切合作不仅对有效应对与各种变量相互关联的挑战至关重要,而且对负责任地使用人工智能也是必要的。尽管人工智能在许多领域得到了广泛的成功应用,但仍应将其视为传统公共卫生措施的补充而非替代。
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引用次数: 0
Advancing One Health education: integrative pedagogical approaches and their impacts on interdisciplinary learning 推进 "一体健康 "教育:综合教学法及其对跨学科学习的影响
Pub Date : 2024-01-01 DOI: 10.1016/j.soh.2024.100079
Chang Cai , Yong-Sam Jung , Richard Van Vleck Pereira , Michael S.M. Brouwer , Junxia Song , Bennie Irve Osburn , Joanna McKenzie , Wim H.M. van der Poel , Yingjuan Qian
One Health is an integrative approach that emphasizes the interconnectedness of human, animal, and environmental health, advocating for collaborative, multidisciplinary efforts to address health challenges, particularly amid globalization and emerging threats. This paper examines the integration of One Health principles into global health education, highlighting the importance of interdisciplinary collaboration and innovative pedagogical approaches. It evaluates various teaching methods, including problem-based learning (PBL), team-based learning (TBL), simulation-based education (SBE), case-based learning (CBL), interdisciplinary workshops and seminars (IWS), and service-learning (SL), analyzing their strengths and weaknesses in fostering interdisciplinary understanding and practical application of One Health concepts. While these methods enhance learning by promoting critical thinking, collaboration, and real-world application, they also face challenges such as resource constraints, variability in group dynamics, and the complexity of assessing long-term learning outcomes. The paper also discusses the role of global partnerships, such as the Global One Health Research Partnership (GOHRP), in advancing One Health education through collaborative research and educational initiatives. Addressing challenges in curriculum integration and interdisciplinary collaboration is crucial for the effective implementation of One Health education, ensuring that future health professionals are equipped to tackle complex global health challenges.
一体健康 "是一种综合方法,强调人类、动物和环境健康之间的相互联系,主张通过多学科合作来应对健康挑战,尤其是在全球化和新威胁的背景下。本文探讨了将 "同一健康 "原则纳入全球健康教育的问题,强调了跨学科合作和创新教学方法的重要性。它评估了各种教学方法,包括基于问题的学习(PBL)、基于团队的学习(TBL)、基于模拟的教育(SBE)、基于案例的学习(CBL)、跨学科讲习班和研讨会(IWS)以及服务学习(SL),分析了它们在促进跨学科理解和 "一个健康 "概念的实际应用方面的优缺点。虽然这些方法通过促进批判性思维、合作和实际应用来提高学习效果,但它们也面临着资源限制、小组动态变化以及长期学习成果评估的复杂性等挑战。本文还讨论了全球合作伙伴关系(如全球统一健康研究合作伙伴关系,GOHRP)在通过合作研究和教育计划推进统一健康教育方面的作用。应对课程整合和跨学科合作方面的挑战,对于有效实施 "一体健康 "教育,确保未来的卫生专业人员具备应对复杂的全球卫生挑战的能力至关重要。
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引用次数: 0
Modern technologies and solutions to enhance surveillance and response systems for emerging zoonotic diseases 加强新发动物传染病监测和应对系统的现代技术和解决方案
Pub Date : 2024-01-01 DOI: 10.1016/j.soh.2023.100061
Li Zhang, Wenqiang Guo, Chenrui Lv

Background

Zoonotic diseases originating in animals pose a significant threat to global public health. Recent outbreaks, such as coronavirus disease 2019 (COVID-19), have caused widespread illness, death, and socioeconomic disruptions worldwide. To cope with these diseases effectively, it is crucial to strengthen surveillance capabilities and establish rapid response systems.

Aim

The aim of this review to examine the modern technologies and solutions that have the potential to enhance zoonotic disease surveillance and outbreak responses and provide valuable insights into how cutting-edge innovations could be leveraged to prevent, detect, and control emerging zoonotic disease outbreaks. Herein, we discuss advanced tools including big data analytics, artificial intelligence, the Internet of Things, geographic information systems, remote sensing, molecular diagnostics, point-of-care testing, telemedicine, digital contact tracing, and early warning systems.

Results

These technologies enable real-time monitoring, the prediction of outbreak risks, early anomaly detection, rapid diagnosis, and targeted interventions during outbreaks. When integrated through collaborative partnerships, these strategies can significantly improve the speed and effectiveness of zoonotic disease control. However, several challenges persist, particularly in resource-limited settings, such as infrastructure limitations, costs, data integration and training requirements, and ethical implementation.

Conclusion

With strategic planning and coordinated efforts, modern technologies and solutions offer immense potential to bolster surveillance and outbreak responses, and serve as a critical resource against emerging zoonotic disease threats worldwide.

背景源于动物的人畜共患病对全球公共卫生构成了重大威胁。最近爆发的疫情,如 2019 年冠状病毒病(COVID-19),在全球范围内造成了广泛的疾病、死亡和社会经济混乱。本综述旨在研究有可能加强人畜共患病监测和疫情应对的现代技术和解决方案,并就如何利用尖端创新技术预防、检测和控制新出现的人畜共患病疫情提供有价值的见解。在此,我们将讨论包括大数据分析、人工智能、物联网、地理信息系统、遥感、分子诊断、护理点检测、远程医疗、数字接触追踪和预警系统在内的先进工具。如果通过合作伙伴关系加以整合,这些战略可以大大提高人畜共患病控制的速度和效果。然而,一些挑战依然存在,特别是在资源有限的环境中,如基础设施限制、成本、数据整合和培训要求以及伦理实施等。 结论:通过战略规划和协调努力,现代技术和解决方案为加强监测和疫情应对提供了巨大的潜力,并成为应对全球新出现的人畜共患病威胁的重要资源。
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引用次数: 0
Microbiome One Health model for a healthy ecosystem 微生物群 "一体健康 "模式打造健康生态系统
Pub Date : 2024-01-01 DOI: 10.1016/j.soh.2024.100065
Antonietta Tomasulo , Barbara Simionati , Sonia Facchin

The attention on microbiome research and its translation to application deployment is escalating along with diffused hype. There is real excitement in this new science, leveraging the growing potential of advances in molecular biology and sequencing techniques. Yet, despite the substantial efforts provided by the scientific communities, the true significance of research achievements requires coordinated and constructive actions across interdisciplinary fields. Individual researchers, universities, small and large companies, venture capitalists, and governments play a fundamental role in fostering collaboration and promoting knowledge that will benefit each other and sustain global prosperity. Making meaningful connections across different fields and getting a new perspective on how technological developments interrelate are the main drivers for creativity and progress.

To help the broader innovation community focus on potentially new cross-sectorial developments, the One Health-microbiome-centric approach, defined here as “Microbiome One Health, is considered as the efficient, holistic approach to product and service exploitations meant to preserve human well-being within a healthy ecosystem. The model opposes the biomedical system and generalizes the “One World-One Health ™” concept. The focus will be given to Nutrition as a driver of health and the food system for its commercial exploitation microbiome-centric, specifically at the interface of human/animal/agricultural. Remarkably, at the interface of humans/animals, the interaction with pets, specifically dogs, has been recognized as a driving force of novel microbiome exploitation.

人们对微生物组研究及其应用部署的关注与日俱增。利用分子生物学和测序技术进步所带来的日益增长的潜力,这门新科学确实令人兴奋。然而,尽管科学界做出了巨大努力,研究成果的真正意义仍需要跨学科领域的协调和建设性行动。研究人员个人、大学、大小公司、风险资本家和政府在促进合作和推广知识方面发挥着根本性的作用,这将使彼此受益并维持全球繁荣。为了帮助更广泛的创新社区关注潜在的跨部门新发展,"一个健康"--以微生物组为中心的方法(在此定义为 "微生物组一个健康")被认为是一种高效、全面的产品和服务开发方法,旨在维护健康生态系统中的人类福祉。该模式与生物医学系统相对立,是对 "一个世界-一个健康™"概念的概括。重点将放在作为健康驱动力的营养和以微生物为中心进行商业开发的食品系统上,特别是在人类/动物/农业的交界处。值得注意的是,在人类/动物的界面上,与宠物(特别是狗)的互动已被认为是开发新型微生物组的推动力。
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引用次数: 0
A bibliometric analysis of One Health approach in research on antimicrobial resistance 抗菌药耐药性研究中的 "一体健康 "方法文献计量分析
Pub Date : 2024-01-01 DOI: 10.1016/j.soh.2024.100077
Zheyi Fang , Shiyi Tu , Jiayan Huang

Background

Antimicrobial resistance (AMR) is a global public health threat that requires actions through One Health intervention. This study aims to trace the historical development of One Health research on AMR to provide evidence supporting future research and actions.

Methods

A bibliometric analysis is conducted with One Health articles in the field of antimicrobial resistance (AMR-OH articles) retrieved from the Web of Science Core Collection (WoSCC). AMR-OH articles refer to articles in the field of AMR that simultaneously involve elements from human health and at least one other domain, including animals, environment, or plants. Three research periods were identified based on the development of global actions in combating AMR. Descriptive analysis of publications, keyword cluster analysis, annual trending topic analysis, and co-authorship analysis were conducted using R software, VOSViewer, and Pajek.

Results

The results indicated that the percentage of AMR-OH articles among all AMR articles increased from 5.21% in 1990 to 20.01% in 2023. Key topics in the current AMR-OH articles included the mechanism of AMR, AMR epidemiology, and public health control strategies. Epidemiological research initially focused on human and animal health and then shifted to environmental factors in the third period. Research at the molecular level focused on the mechanisms of AMR transmission in various domains, along with the dynamics and diversity of antibiotic resistance genes (ARGs). The co-authorship analysis suggested a significant increase in cooperation among low- and middle-income countries in the third period.

Conclusion

The scope of epidemiological research on AMR has expanded by including human, animal, and environmental areas. Moreover, genetic and molecular level research represents the forefront of this field, offering innovative tools to combat AMR in the future. This study suggests further research to translate existing findings into practical implementation of the One Health strategy, and to support globally consistent action in combating AMR.

背景抗菌素耐药性(AMR)是一种全球性的公共卫生威胁,需要通过 "一体健康 "干预措施采取行动。本研究旨在追溯有关 AMR 的 "一体健康 "研究的历史发展,为未来的研究和行动提供证据支持。方法对从科学网核心数据库(WoSCC)检索到的抗菌素耐药性领域的 "一体健康 "文章(AMR-OH 文章)进行文献计量分析。AMR-OH 文章是指同时涉及人类健康和至少一个其他领域(包括动物、环境或植物)的 AMR 领域文章。根据全球抗击 AMR 行动的发展情况,确定了三个研究时期。结果表明,AMR-OH 文章在所有 AMR 文章中所占比例从 1990 年的 5.21% 增加到 2023 年的 20.01%。当前 AMR-OH 文章的主要话题包括 AMR 的机制、AMR 流行病学和公共卫生控制策略。流行病学研究最初侧重于人类和动物健康,然后在第三个时期转向环境因素。分子层面的研究侧重于 AMR 在各个领域的传播机制,以及抗生素耐药基因 (ARG) 的动态和多样性。共同作者分析表明,第三阶段中低收入国家之间的合作显著增加。此外,基因和分子水平的研究代表了这一领域的前沿,为未来抗击 AMR 提供了创新工具。本研究建议进一步开展研究,将现有研究成果转化为 "一个健康 "战略的实际实施,并支持全球采取一致行动抗击 AMR。
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引用次数: 0
Global, regional, and national burden of upper respiratory infections, 1990–2021: Findings from the Global Burden of Disease study 2021 1990-2021 年全球、地区和国家上呼吸道感染负担:2021 年全球疾病负担研究结果
Pub Date : 2024-01-01 DOI: 10.1016/j.soh.2024.100084
Shun-Xian Zhang , Yu-Juan Liu , En-Li Tan , Guo-Bing Yang , Yu Wang , Xiao-Jie Hu , Ming-Zi Li , Lei Duan , Shan Lv , Li-Guang Tian , Mu-Xin Chen , Fan-Na Wei , Qin Liu , Yan Lu , Shi-Zhu Li , Pin Yang , Jin-Xin Zheng

Background

Upper respiratory infections (URIs) are common infectious diseases worldwide. Accurate and timely assessment of the disease burden of URIs is crucial for governments to develop comprehensive prevention and control strategies, and to allocate and utilize healthcare resources more efficiently.

Methods

For URIs in Global Burden of Disease (GBD) 2021 database, age-standardized incidence rates (ASIR), age-standardized prevalence rates (ASPR), age-standardized mortality rates (ASMR), disability-adjusted life-years (DALYs), and case numbers for incidence, prevalence, deaths, and DALYs across the globe, five socio-demographic index (SDI) regions, 21 geographical regions, and 204 countries and territories were provided and analyzed. Trends from 1990 to 2021 were described using the average annual percentage change (AAPC), and future URIs burden was projected with a Bayesian age-period-cohort (BAPC) model.

Results

From 1990 to 2021, there was a significant decline in global ASIR (APCC = −289.86, 95% confidence interval [CI]: −298.59 to −281.12), ASPR (AAPC = −4.04, 95% CI: −4.16 to −3.92), ASMR (AAPC = −0.02, 95 % CI: −0.02 to −0.03) and age-standardized DALY rate (AAPC = −0.75, 95% CI: −0.76 to −0.74). The ASIR, ASPR, ASMR, and age-standardized DALY rate were high in elderly for both males and females, and both genders. Similarly, the number of incident cases, prevalence cases, deaths, and DALY cases for URIs was highest in children under five years. The ASMR and age-standardized DALY rate exhibited a negative correlation with SDI across 204 countries and territories in 2021. The ASIR and ASPR for URIs will show an upward trend from 2022 to 2050, while ASMR and age-standardized DALY rate are expected to decline. Low birth weight for gestation remains the leading contributor to deaths related to URIs.

Conclusion

Despite the global decline in URIs burden, significant challenges remain among the elderly population. These findings support the optimization and implementation of public health policies, including targeted vaccination and integrated One Health approaches to reduce the burden in high-risk populations.
背景上呼吸道感染(URI)是全球常见的传染病。准确、及时地评估尿毒症的疾病负担对各国政府制定综合防控策略、更有效地分配和利用医疗资源至关重要。方法对于全球疾病负担(GBD)2021数据库中的尿毒症,提供并分析了全球5个社会人口指数(SDI)地区、21个地理区域以及204个国家和地区的年龄标准化发病率(ASIR)、年龄标准化流行率(ASPR)、年龄标准化死亡率(ASMR)、残疾调整生命年(DALYs)以及发病、流行、死亡和残疾调整生命年的病例数。结果从 1990 年到 2021 年,全球 ASIR 显著下降(APCC = -289.86,95% 置信区间 [CAPC])。86,95% 置信区间[CI]:-298.59 至 -281.12)、ASPR(AAPC = -4.04,95% CI:-4.16 至 -3.92)、ASMR(AAPC = -0.02,95% CI:-0.02 至 -0.03)和年龄标准化残疾调整寿命年率(AAPC = -0.75,95% CI:-0.76 至 -0.74)均有显著下降。老年男性和女性的 ASIR、ASPR、ASMR 和年龄标准化 DALY 率均较高。同样,五岁以下儿童的尿毒症发病人数、患病人数、死亡人数和残疾调整寿命年数也最高。2021 年,204 个国家和地区的 ASMR 和年龄标准化 DALY 率与 SDI 呈负相关。从 2022 年到 2050 年,尿毒症的 ASIR 和 ASPR 将呈上升趋势,而 ASMR 和年龄标准化残疾调整寿命年率预计将下降。尽管全球尿毒症负担有所下降,但老年人口仍面临巨大挑战。这些研究结果支持优化和实施公共卫生政策,包括有针对性的疫苗接种和 "一体健康 "综合方法,以减轻高危人群的负担。
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Science in One Health
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