Tropical diseases remain a major cause of morbidity and mortality in developing countries.Although combined health efforts brought about significant improvements over the past 20 years,communities in resource-constrai...Tropical diseases remain a major cause of morbidity and mortality in developing countries.Although combined health efforts brought about significant improvements over the past 20 years,communities in resource-constrained settings lack the means of strengthening their environment in directions that would provide less favourable conditions for pathogens.Still,the impact of infectious diseases is declining worldwide along with progress made regarding responses to basic health problems and improving health services delivery to the most vulnerable populations.The London Declaration on Neglected Tropical Diseases(NTDs),initiated by the World Health Organization’s NTD roadmap,set out the path towards control and eventual elimination of several tropical diseases by 2020,providing an impetus for local and regional disease elimination programmes.Tropical diseases are often patchy and erratic,and there are differing priorities in resources-limited and endemic countries at various levels of their public health systems.In order to identify and prioritize strategic research on elimination of tropical diseases,the‘First Forum on Surveillance-Response System Leading to Tropical Diseases Elimination’was convened in Shanghai in June 2012.Current strategies and the NTD roadmap were reviewed,followed by discussions on how to identify and critically examine prevailing challenges and opportunities,including inter-sectoral collaboration and approaches for elimination of several infectious,tropical diseases.A priority research agenda within a‘One Health-One World’frame of global health was developed,including(i)the establishment of a platform for resource-sharing and effective surveillance-response systems for Asia Pacific and Africa with an initial focus on elimination of lymphatic filariasis,malaria and schistosomiasis;(ii)development of new strategies,tools and approaches,such as improved diagnostics and antimalarial therapies;(iii)rigorous validation of surveillance-response systems;and(iv)designing pilot studies to transfer Chinese experiences of successful surveillance-response systems to endemic countries with limited resources.展开更多
Surveillance and response represent the final crucial steps in achieving effective control and particularly elimination of communicable diseases as recognized in the area of neglected tropical diseases(NTDs),applied i...Surveillance and response represent the final crucial steps in achieving effective control and particularly elimination of communicable diseases as recognized in the area of neglected tropical diseases(NTDs),applied in increasing numbers in endemic countries with ongoing control and elimination programmers.More and more national NTD elimination initiatives are scheduled based on the innovative and effective One world-One health perspective to detect pockets of transmission and disease reintroduction.Resource-constrained countries,which carry the heaviest NTD burdens,face various challenges how to strengthen the health system as well as developing effective and novel tools for sureillance and response tailored to local settings.Surillance-response approaches take place in two different stages oralling the basic components of the sureillance response system for NTD elimination.Six different research priorities have been identified:(1)dynamic mapping of transmission,(2)near real-time capture of population dynamics,(3)modelling based on a minimum essential database/dataset,(4)implementation of mobile health(m-health)and sensitive diagnostics,(5)design of effective response packages tailored to different transmission settings and levels,and( 6)validation of approaches and responses packages.展开更多
The peer-reviewed journal Infectious Diseases of Poverty provides a new platform to engage with,and disseminate in an open-access format,science outside traditional disciplinary boundaries.The current piece reviews a ...The peer-reviewed journal Infectious Diseases of Poverty provides a new platform to engage with,and disseminate in an open-access format,science outside traditional disciplinary boundaries.The current piece reviews a thematic series on surveillance-response systems for elimination of tropical diseases.Overall,22 contributions covering a broad array of diseases are featured–i.e.clonorchiasis,dengue,hepatitis,human immunodeficiency virus/acquired immune deficiency syndrome(HIV/AIDS),H7N9 avian influenza,lymphatic filariasis,malaria,Middle East respiratory syndrome(MERS),rabies,schistosomiasis and tuberculosis(TB).There are five scoping reviews,a commentary,a letter to the editor,an opinion piece and an editorial pertaining to the theme“Elimination of tropical disease through surveillance and response”.The remaining 13 articles are original contributions mainly covering(i)drug resistance;(ii)innovation and validation in the field of mathematical modelling;(iii)elimination of infectious diseases;and(iv)social media reports on disease outbreak notifications released by national health authorities.Analysis of the authors’affiliations reveals that scientists from the People’s Republic of China(P.R.China)are prominently represented.Possible explanations include the fact that the 2012 and 2014 international conferences pertaining to surveillance-response mechanisms were both hosted by the National Institute of Parasitic Diseases(NIPD)in Shanghai,coupled with P.R.China’s growing importance with regard to the control of infectious diseases.Within 4 to 22 months of publication,three of the 22 contributions were viewed more than 10000 times each.With sustained efforts focusing on relevant and strategic information towards control and elimination of infectious diseases,Infectious Diseases of Poverty has become a leading journal in the field of surveillance and response systems in infectious diseases and beyond.展开更多
Emerging and re-emerging zoonotic diseases represent a public health challenge of international concern.They include a large group of neglected tropical diseases(NTDs),many of which are of zoonotic nature.Coronavirus ...Emerging and re-emerging zoonotic diseases represent a public health challenge of international concern.They include a large group of neglected tropical diseases(NTDs),many of which are of zoonotic nature.Coronavirus disease 201g(COVID-19),another emerging zoonotic disease,has just increased the stakes exponentially.Most NTDs are subject to the impact of some of the very same human-related activities triggering other emerging and re-emerging diseases,including COVID-19,severe acute respiratory syndrome(SARS),bird flu and swine flu.It is conceivable that COVID-19 will exacerbate the NTDs,as it will divert much needed financial and human resources.There is considerable concern that recent progress achieved with control and elimination efforts will be reverted.Future potential strategies will need to reconsider the determinants of health in NTDs in order to galvanize efforts and come up with a comprehensive,well defined programme that will set the stage for an effective multi-sectorial approach.In this Commentary,we propose areas of potential synergies between the COVID-19 pandemic control efforts other health and non-health sector initiatives and NTD control and elimination programmes.展开更多
Background:Differences in rural and urban settings could account for distinct characteristics in the epidemiology of tuberculosis(TB).We comparatively studied epidemiological features of TB and helminth co-infections ...Background:Differences in rural and urban settings could account for distinct characteristics in the epidemiology of tuberculosis(TB).We comparatively studied epidemiological features of TB and helminth co-infections in adult patients from rural and urban settings of Tanzania.Methods:Adult patients(≥18 years)with microbiologically confirmed pulmonary TB were consecutively enrolled into two cohorts in Dar es Salaam,with~4.4 million inhabitants(urban),and Ifakara in the sparsely populated Kilombero District with~400000 inhabitants(rural).Clinical data were obtained at recruitment.Stool and urine samples were subjected to diagnose helminthiases using Kato-Katz,Baermann,urine filtration,and circulating cathodic antigen tests.Differences between groups were assessed byχ2,Fisher’s exact,and Wilcoxon rank sum tests.Logistic regression models were used to determine associations.Results:Between August 2015 and February 2017,668 patients were enrolled,460(68.9%)at the urban and 208(31.1%)at the rural site.Median patient age was 35 years(interquartile range[IQR]:27-41.5 years),and 454(68%)were males.Patients from the rural setting were older(median age 37 years vs.34 years,P=0.003),had a lower median body mass index(17.5 kg/m2 vs.18.5 kg/m2,P<0.001),a higher proportion of recurrent TB cases(9%vs.1%,P<0.001),and in HIV/TB co-infected patients a lower median CD4 cell counts(147 cells/μl vs.249 cells/μl,P=0.02)compared to those from urban Tanzania.There was no significant difference in frequencies of HIV infection,diabetes mellitus,and haemoglobin concentration levels between the two settings.The overall prevalence of helminth co-infections was 22.9%(95%confidence interval[CI]:20.4-27.0%).The significantly higher prevalence of helminth infections at the urban site(25.7%vs.17.3%,P=0.018)was predominantly driven by Strongyloides stercoralis(17.0%vs.4.8%,P<0.001)and Schistosoma mansoni infection(4.1%vs.16.4%,P<0.001).Recurrent TB was associated with living in a rural setting(adjusted odds ratio[aOR]:3.97,95%CI:1.16-13.67)and increasing age(aOR:1.06,95%CI:1.02-1.10).Conclusions:Clinical characteristics and helminth co-infections pattern differ in TB patients in urban and rural Tanzania.The differences underline the need for setting-specific,tailored public health interventions to improve clinical management of TB and comorbidities.展开更多
基金This research was supported by the National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention and the Swiss Tropical Institute. J. U. is grateful to the Swiss National Science Foundation for a “SNFFoerderungsprofessur” （No. PP00B-102883 ）.
基金The‘First Forum on Surveillance-Response System Leading to Tropical Diseases Elimination’was co-funded by the National Institute of Parasitic Diseases,Chinese Center for Disease Control and Prevention,the Swiss Tropical and Public Health Institute and the World Health OrganizationThe research was partially supported by the National S&T Major Program(grant no.2012ZX10004220)+2 种基金the National S&T Supporting Project(grant no.2007BAC03A02)by supported by China UK Global Health Support Programme(grant no.GHSP-CS-OP1)Xiao-Nong Zhou was funded through a capacity building initiative for Ecohealth Research on Emerging Infectious Disease in Southeast Asia supported by the International Development Research Centre(IDRC),the Canadian International Development Agency(CIDA),and the Australian Agency for International Development(AusAID)in partnership with the Global Health Research Initiative(grant no.105509-00001002-023).
文摘Tropical diseases remain a major cause of morbidity and mortality in developing countries.Although combined health efforts brought about significant improvements over the past 20 years,communities in resource-constrained settings lack the means of strengthening their environment in directions that would provide less favourable conditions for pathogens.Still,the impact of infectious diseases is declining worldwide along with progress made regarding responses to basic health problems and improving health services delivery to the most vulnerable populations.The London Declaration on Neglected Tropical Diseases(NTDs),initiated by the World Health Organization’s NTD roadmap,set out the path towards control and eventual elimination of several tropical diseases by 2020,providing an impetus for local and regional disease elimination programmes.Tropical diseases are often patchy and erratic,and there are differing priorities in resources-limited and endemic countries at various levels of their public health systems.In order to identify and prioritize strategic research on elimination of tropical diseases,the‘First Forum on Surveillance-Response System Leading to Tropical Diseases Elimination’was convened in Shanghai in June 2012.Current strategies and the NTD roadmap were reviewed,followed by discussions on how to identify and critically examine prevailing challenges and opportunities,including inter-sectoral collaboration and approaches for elimination of several infectious,tropical diseases.A priority research agenda within a‘One Health-One World’frame of global health was developed,including(i)the establishment of a platform for resource-sharing and effective surveillance-response systems for Asia Pacific and Africa with an initial focus on elimination of lymphatic filariasis,malaria and schistosomiasis;(ii)development of new strategies,tools and approaches,such as improved diagnostics and antimalarial therapies;(iii)rigorous validation of surveillance-response systems;and(iv)designing pilot studies to transfer Chinese experiences of successful surveillance-response systems to endemic countries with limited resources.
文摘Surveillance and response represent the final crucial steps in achieving effective control and particularly elimination of communicable diseases as recognized in the area of neglected tropical diseases(NTDs),applied in increasing numbers in endemic countries with ongoing control and elimination programmers.More and more national NTD elimination initiatives are scheduled based on the innovative and effective One world-One health perspective to detect pockets of transmission and disease reintroduction.Resource-constrained countries,which carry the heaviest NTD burdens,face various challenges how to strengthen the health system as well as developing effective and novel tools for sureillance and response tailored to local settings.Surillance-response approaches take place in two different stages oralling the basic components of the sureillance response system for NTD elimination.Six different research priorities have been identified:(1)dynamic mapping of transmission,(2)near real-time capture of population dynamics,(3)modelling based on a minimum essential database/dataset,(4)implementation of mobile health(m-health)and sensitive diagnostics,(5)design of effective response packages tailored to different transmission settings and levels,and( 6)validation of approaches and responses packages.
基金supported by the National S&T Major Program(grant no.2012ZX10004220)the fourth round of Three-year Public Health Action Plan of Shanghai(2015-2017,No.GWIV-29).
文摘The peer-reviewed journal Infectious Diseases of Poverty provides a new platform to engage with,and disseminate in an open-access format,science outside traditional disciplinary boundaries.The current piece reviews a thematic series on surveillance-response systems for elimination of tropical diseases.Overall,22 contributions covering a broad array of diseases are featured–i.e.clonorchiasis,dengue,hepatitis,human immunodeficiency virus/acquired immune deficiency syndrome(HIV/AIDS),H7N9 avian influenza,lymphatic filariasis,malaria,Middle East respiratory syndrome(MERS),rabies,schistosomiasis and tuberculosis(TB).There are five scoping reviews,a commentary,a letter to the editor,an opinion piece and an editorial pertaining to the theme“Elimination of tropical disease through surveillance and response”.The remaining 13 articles are original contributions mainly covering(i)drug resistance;(ii)innovation and validation in the field of mathematical modelling;(iii)elimination of infectious diseases;and(iv)social media reports on disease outbreak notifications released by national health authorities.Analysis of the authors’affiliations reveals that scientists from the People’s Republic of China(P.R.China)are prominently represented.Possible explanations include the fact that the 2012 and 2014 international conferences pertaining to surveillance-response mechanisms were both hosted by the National Institute of Parasitic Diseases(NIPD)in Shanghai,coupled with P.R.China’s growing importance with regard to the control of infectious diseases.Within 4 to 22 months of publication,three of the 22 contributions were viewed more than 10000 times each.With sustained efforts focusing on relevant and strategic information towards control and elimination of infectious diseases,Infectious Diseases of Poverty has become a leading journal in the field of surveillance and response systems in infectious diseases and beyond.
文摘Emerging and re-emerging zoonotic diseases represent a public health challenge of international concern.They include a large group of neglected tropical diseases(NTDs),many of which are of zoonotic nature.Coronavirus disease 201g(COVID-19),another emerging zoonotic disease,has just increased the stakes exponentially.Most NTDs are subject to the impact of some of the very same human-related activities triggering other emerging and re-emerging diseases,including COVID-19,severe acute respiratory syndrome(SARS),bird flu and swine flu.It is conceivable that COVID-19 will exacerbate the NTDs,as it will divert much needed financial and human resources.There is considerable concern that recent progress achieved with control and elimination efforts will be reverted.Future potential strategies will need to reconsider the determinants of health in NTDs in order to galvanize efforts and come up with a comprehensive,well defined programme that will set the stage for an effective multi-sectorial approach.In this Commentary,we propose areas of potential synergies between the COVID-19 pandemic control efforts other health and non-health sector initiatives and NTD control and elimination programmes.
基金This work was supported by funding from the Rudolf Geigy Foundation(Basel,Switzerland).
文摘Background:Differences in rural and urban settings could account for distinct characteristics in the epidemiology of tuberculosis(TB).We comparatively studied epidemiological features of TB and helminth co-infections in adult patients from rural and urban settings of Tanzania.Methods:Adult patients(≥18 years)with microbiologically confirmed pulmonary TB were consecutively enrolled into two cohorts in Dar es Salaam,with~4.4 million inhabitants(urban),and Ifakara in the sparsely populated Kilombero District with~400000 inhabitants(rural).Clinical data were obtained at recruitment.Stool and urine samples were subjected to diagnose helminthiases using Kato-Katz,Baermann,urine filtration,and circulating cathodic antigen tests.Differences between groups were assessed byχ2,Fisher’s exact,and Wilcoxon rank sum tests.Logistic regression models were used to determine associations.Results:Between August 2015 and February 2017,668 patients were enrolled,460(68.9%)at the urban and 208(31.1%)at the rural site.Median patient age was 35 years(interquartile range[IQR]:27-41.5 years),and 454(68%)were males.Patients from the rural setting were older(median age 37 years vs.34 years,P=0.003),had a lower median body mass index(17.5 kg/m2 vs.18.5 kg/m2,P<0.001),a higher proportion of recurrent TB cases(9%vs.1%,P<0.001),and in HIV/TB co-infected patients a lower median CD4 cell counts(147 cells/μl vs.249 cells/μl,P=0.02)compared to those from urban Tanzania.There was no significant difference in frequencies of HIV infection,diabetes mellitus,and haemoglobin concentration levels between the two settings.The overall prevalence of helminth co-infections was 22.9%(95%confidence interval[CI]:20.4-27.0%).The significantly higher prevalence of helminth infections at the urban site(25.7%vs.17.3%,P=0.018)was predominantly driven by Strongyloides stercoralis(17.0%vs.4.8%,P<0.001)and Schistosoma mansoni infection(4.1%vs.16.4%,P<0.001).Recurrent TB was associated with living in a rural setting(adjusted odds ratio[aOR]:3.97,95%CI:1.16-13.67)and increasing age(aOR:1.06,95%CI:1.02-1.10).Conclusions:Clinical characteristics and helminth co-infections pattern differ in TB patients in urban and rural Tanzania.The differences underline the need for setting-specific,tailored public health interventions to improve clinical management of TB and comorbidities.
