恰加斯病在美洲的流行病学

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES Lancet Regional Health-Americas Pub Date : 2024-09-01 DOI:10.1016/j.lana.2024.100881
Zulma M. Cucunubá , Sebastián A. Gutiérrez-Romero , Juan-David Ramírez , Natalia Velásquez-Ortiz , Soledad Ceccarelli , Gabriel Parra-Henao , Andrés F. Henao-Martínez , Jorge Rabinovich , María-Gloria Basáñez , Pierre Nouvellet , Fernando Abad-Franch
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引用次数: 0

摘要

南美锥虫病是一种复杂的寄生虫人畜共患病,目前仍威胁着整个美洲的公共健康。通过输血和非本地三带喙昆虫载体控制南美锥虫病传播的举措取得了重大进展;然而,本地载体在整个地区的野生和家养/近家养传播循环中发挥着积极的桥梁作用,每年有数以万计的人受到感染。口腔传播疫情、城市化和垂直传播是新出现的问题,需要创新的战略思维。尽管评估恰加斯病的负担对宣传和持续的公共卫生行动至关重要,但评估恰加斯病的负担仍然十分困难;恰加斯病感染通常无症状,医疗保健服务有限,报告普遍不足,以及可靠测量发病率、流行率和疾病进展所固有的其他方法障碍,都是造成评估困难的原因。寄生虫、病媒和宿主的基因构成是否以及如何影响传播动态和流行病学也尚不清楚。继续开展高质量的研究并制定长期的适应性策略,将病媒控制监测与加强病例检测和患者综合护理相结合,对于有效应对恰加斯病控制所带来的伦理和社会挑战仍然至关重要。该系列的所有论文均可在 https://www.thelancet.com/series/chagasdisease 上查阅。
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The epidemiology of Chagas disease in the Americas

Chagas disease is a complex parasitic zoonosis that still threatens public health across the Americas. Initiatives to control Trypanosoma cruzi transmission via blood transfusion and non-native triatomine-bug vectors have yielded crucial advances; native vectors, however, actively bridge wild and domestic/peri-domestic transmission cycles throughout the region, and tens of thousands of people become infected each year. Oral-transmission outbreaks, urbanisation, and vertical transmission are additional/emerging issues calling for innovative strategic thinking. While critical for advocacy and sustained public health action, assessing Chagas disease burden remains difficult; the often-asymptomatic nature of T. cruzi infection, healthcare access limitations, pervasive underreporting, and other methodological hurdles inherent to reliably measuring incidence, prevalence, and disease progression all contribute to the difficulty. Whether and how parasite, vector, and host genetic makeups affect transmission dynamics and epidemiology is also unclear. Continued high-quality research and long-term, adaptive strategies combining vector control surveillance with enhanced case detection and integral patient care remain critical to effectively address the ethical and societal challenge of Chagas disease control.

This is the first in a Series of five papers about Chagas Disease. All papers in the Series are available at https://www.thelancet.com/series/chagasdisease.

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来源期刊
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期刊介绍: The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.
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