量化被忽视者:人类弓形虫病全球负担和经济影响的初步估计

Alistair Antonopoulos , Alessio Giannelli , Eric R. Morgan , Johannes Charlier
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摘要

弓形虫病是一种人畜共患的寄生虫病,由伴侣动物(狗和猫)体内的弓形虫属蛔虫线虫引起,影响着高收入和中低收入国家的人们。弓形虫病可表现为几种不同的综合征。最常见的通常被称为普通弓形虫病,是一种自限性轻微发热性疾病。眼幼虫移行症和内脏幼虫移行症是严重的疾病表现,分别影响眼睛和其他内脏器官,但据报道很少发生。绝大多数无症状病例被认为是由普通弓形虫病引起的,该病也与儿童的认知障碍有关。迄今为止,很少有研究试图量化弓形虫病对人类健康造成的负担。在本研究中,我们采用残疾调整生命年(DALY)方法进行了初步估算。我们估计,在 28 个选定的国家中,由于常见的弓形虫病,每年共损失 23,084 个残疾调整生命年。根据 19% 的全球平均血清流行率推算,我们估计所有国家每年因弓形虫病造成的残疾调整生命年损失为 91,714 人,其中 40,912 人的损失可归因于病情较轻的弓形虫病(即普通弓形虫病),50,731 人的损失可归因于儿童认知障碍。临床诊断和报告的眼部和内脏幼虫蚴病只占估计的总健康负担的一小部分。我们还发现,在全国范围内,猫或狗的感染率与人类血清阳性反应率之间存在正相关,但估计的土壤污染与人类血清阳性反应率之间没有相关性。最后,根据医疗费用和收入损失估算,毒鼠病对部分国家的潜在经济影响为每年 25 亿美元。这些初步估算可以呼吁人们采取行动,进一步开展研究并采取循证措施来应对弓形虫病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Quantifying the neglected: Initial estimation of the global burden and economic impact of human toxocariasis

Toxocariasis is a parasitic zoonotic infection caused by Toxocara spp., ascarid nematodes of companion animals (dogs and cats) affecting people in both high-income and low/middle-income countries. Toxocariasis can manifest as several distinct syndromes. The most frequent, often termed common toxocariasis, is a self-limiting and mild febrile illness. Ocular and visceral larva migrans are severe disease manifestations affecting the eye and other internal organs, respectively, but their reported occurrence is rare. The vast majority of symptomatic cases are thought due to common toxocariasis, which has also been associated with cognitive impairment in children. Few studies to date have sought to quantity the health burden of toxocariasis in humans. In this study we provide a preliminary estimation using the Disability-Adjusted Life Year (DALY) approach. We estimate a total of 23,084 DALYs are lost annually in 28 selected countries due to common toxocariasis. Extrapolating based on a global average seroprevalence rate of 19%, we estimate 91,714 DALYs per year are lost across all countries due to toxocariasis, of which 40,912 are attributable to less severe forms, i.e. common toxocariasis, and 50,731 to cognitive impairment in children. Clinically diagnosed and reported ocular and visceral larva migrans represent a small proportion of estimated total health burden. We also found a positive correlation at national level between prevalence in cats or dogs and seroprevalence in humans, but no correlation between estimated soil contamination and seroprevalence in humans. Finally, we estimate the potential economic impact of toxocariasis in selected countries at 2.5 billion USD per annum, from costs of medical treatment and lost income. These preliminary estimates should serve as a call to action for further research and evidence-based measures to tackle toxocariasis.

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