PDF(Pubmed)
Abstract：
Hookworm disease is a major global public health concern, annually affecting 500-700 million of the world\'s poorest people. The World Health Organization is targeting the elimination of hookworm as a public health problem by 2030 using a strategy of mass drug administration (MDA) to at-risk human populations. However, in Southeast Asia and the Pacific the zoonotic hookworm species, Ancylostoma ceylanicum, is endemic in dogs and commonly infects people. This presents a potential impediment to the effectiveness of MDA that targets only humans. Here, we develop a novel multi-host (dog and human) transmission model of A. ceylanicum and compare the effectiveness of human-only and \"One Health\" (human plus dog) MDA strategies under a range of eco-epidemiological assumptions. We show that One Health interventions-targeting both dogs and humans-could suppress prevalence in humans to ≤ 1% by the end of 2030, even with only modest coverage (25-50%) of the animal reservoir. With increasing coverage, One Health interventions may even interrupt transmission. We discuss key unresolved questions on the eco-epidemiology of A. ceylanicum, the challenges of delivering MDA to animal reservoirs, and the growing importance of One Health interventions to human public health.
摘要：
钩虫病是全球主要的公共卫生问题,每年影响5-7亿世界上最贫穷的人。世界卫生组织的目标是到2030年消除钩虫作为一个公共卫生问题，采用大规模药物管理（MDA）的战略，以应对高危人群。然而,在东南亚和太平洋地区的人畜共患钩虫物种，ceylanicum囊肿,是狗特有的，通常会感染人。这对仅针对人类的MDA的有效性提出了潜在障碍。这里,我们开发了一种新型的头孢霉素多宿主（狗和人）传播模型，并在一系列生态流行病学假设下比较了仅人和“一种健康”（人加狗）MDA策略的有效性。我们表明，针对狗和人类的一种健康干预措施可以在2030年底之前将人类的患病率抑制到≤1％，即使只有适度的动物水库覆盖率（25-50％）。随着覆盖面的扩大,一种健康干预措施甚至可能中断传播。我们讨论了关于塞氏芽孢杆菌生态流行病学的关键问题，向动物水库输送MDA的挑战，以及OneHealth干预措施对人类公共卫生的重要性日益增加。
