neglected tropical diseases

被忽视的热带病
  • 文章类型: Systematic Review
    被忽视的热带病(NTDs)是一组影响世界上低收入和中等收入国家最贫困人口的疾病。NTD与负面行为体验相关,包括歧视,排斥和污名化,使那些受影响的人容易出现心理健康问题。因此,研究人员对阐明与NTD相关的心理健康负担表现出了深刻的兴趣。为了解决与流行有关的新兴文献中的相关问题,NTD心理健康问题的评估和相关性,采用系统综述方法.在PRISMA准则的基础上,对电子数据库进行了搜索,筛选并符合预定纳入和排除标准的文章的个别期刊和参考书目。来自非洲的16篇文章,亚洲和南美国家被列入审查。抑郁症是最广泛调查的心理健康问题,接着是压力和焦虑,患病率估计为7-54%,8-43%和19-53%,分别。PHQ-9和GAD-7和自我报告问卷是最广泛使用的心理健康筛查工具。心理健康问题的主要关联是较低的教育和经济地位以及女性性别。我们建议多部门和多层次的心理健康及相关干预措施,以解决NTD中日益增长的心理健康负担。
    Neglected tropical diseases (NTDs) are a group of disease conditions that affect the world\'s poorest people in low- and middle-income countries. NTDs are associated with negative behavioural experiences, including discrimination, rejection and stigmatization, that predisposes those affected to mental health problems. Consequently, researchers have shown profound interest in elucidating the mental health burden associated with NTDs. To address pertinent issues in the burgeoning literature relating to the prevalence, assessment and correlates of mental health problems in NTDs, a systematic review methodology was used. Underpinned by the PRISMA guidelines, a search was conducted of electronic databases, individual journals and bibliographies for articles that were screened and subjected to predetermined inclusion and exclusion criteria. Sixteen articles from African, Asian and South American countries were included in the review. Depression was the most widely investigated mental health issue, followed by stress and anxiety, with prevalence estimates of 7-54%, 8-43% and 19-53%, respectively. The PHQ-9 and GAD-7 and Self-Reporting Questionnaire were the most widely administered mental health screening tools. The major correlates of mental health problems are lower education and economic status and female gender. We recommend multisectoral and multilayered mental health and related interventions to address the increasing burden of mental health in NTDs.
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  • 文章类型: Journal Article
    目标:绝大多数蠕虫病仍然被忽视的热带病(NTDs),导致严重的发病率。抗寄生虫药物的广泛和周期性分布,仍然是控制这些疾病的基石。在西班牙,大多数蠕虫病病例是进口的,怀疑和诊断变得越来越重要。我们的主要目标是在我们的设施内呈现蠕虫病诊断的流行病学景观,同时还详细说明了受影响人口的人口特征。
    方法:从2007年1月1日至2020年12月31日,在SeveritarioOchoa医院(HUSO)进行了一项回顾性研究,包括在此期间所有确诊的蠕虫病病例。综合流行病学,临床,收集所有确诊患者的微生物学数据.研究人群包括在HUSO接受治疗的患者,以及在Leganés和Fuenlabrada初级保健单位接受治疗的人。随后,进行了描述性和比较性统计,比较西班牙和外国患者。
    结果:在此期间,共有952名患者被诊断为某种形式的蠕虫病。其中,495是西班牙语,457是外国人。确定的蠕虫总数,包括患有多种感染的患者,是1,010。在年龄分布方面,非洲人和美国人之间存在显着差异,在0-15岁的非洲人和31-60岁的美国人中,患病率较高。蠕虫的分布有变化,与S.stercoralis显著影响美国人。对于西班牙患者来说,Trichuristrichilura和S.stercoralis的存在与嗜酸性粒细胞增多显著相关,而在外国患者中,它与Trichuristrichiura有关,蛔虫等等。关于症状,在西班牙人中皮肤表现更频繁,而消化在外国人中更为常见。
    结论:这项研究提供了在马德里医院观察到的蠕虫感染的重要流行病学见解。尽管蠕虫感染的患病率一直在下降,仍然需要筛查和诊断外国患者。
    OBJECTIVE: Vast majority of helminth diseases remain neglected tropical diseases (NTDs), causing significant morbidity. The widespread and periodic distribution of antiparasitic drugs, remains the cornerstone for controlling these diseases. In Spain, most helminthiasis cases are imported, and suspicion and diagnosis have become increasingly important. Our primary objective is to present the epidemiological landscape of helminthiasis diagnoses within our facility, while also detailing the demographic characteristics of the affected population.
    METHODS: A retrospective study was conducted at the Hospital Universitario Severo Ochoa (HUSO) from January 1, 2007, to December 31, 2020, encompassing all diagnosed cases of helminthiasis during this period. Comprehensive epidemiological, clinical, and microbiological data were gathered for all diagnosed patients. The study population comprised patients receiving treatment at the HUSO, as well as those receiving treatment at the Leganés and Fuenlabrada Primary Care Units. Subsequently, descriptive and comparative statistics were performed, comparing Spanish and foreign patients.
    RESULTS: During this period, a total of 952 patients were diagnosed with some form of helminthiasis. Among them, 495 were Spanish, and 457 were foreign. The total number of helminths identified, including patients with multiple infections, was 1,010. Significant differences were observed between Africans and Americans in terms of age distribution, with a higher prevalence among Africans in the 0-15 age range and among Americans in the 31-60 age range. Variations were noted in the distribution of helminths, with S. stercoralis significantly affecting Americans. For Spanish patients, the presence of Trichuris trichiura and S. stercoralis was significantly associated with eosinophilia, whereas among foreign patients, it was associated with Trichuris trichiura, Ascaris lumbricoides among others. Regarding symptoms, skin manifestations were more frequent among Spanish, while digestive were more common among foreigners.
    CONCLUSIONS: This study offers crucial epidemiological insights into helminth infections observed over time in a Madrid hospital. Although the prevalence of helminth infections has been decreasing, there is still a need for screening and diagnosing foreign patients.
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  • 文章类型: Journal Article
    被忽视的热带病(NTD)包括一组主要在热带地区发现的疾病,它们的起源可以追溯到2000年被纳入联合国千年发展目标。该倡议旨在提高认识和全球资金,以防治这些疾病,在卫生条件有限的地区茁壮成长,healthcare,和教育。NTDs是由各种病原体引起的,如细菌,真菌,寄生虫,和病毒,并影响资源贫乏社区的20多亿人,导致可预防的死亡和毁灭性后果。虽然肌肉骨骼系统只是偶尔受到影响,由此产生的慢性残疾阻止个人工作,在世界这个地区构成了巨大的社会经济负担。一些NTD表现出明显的成像特征,放射科医生需要意识到这些特征,以便于早期治疗。在这次审查中,我们深入研究肌肉骨骼NTDs,专注于临床特征和影像学表现,鉴别诊断,和临床管理。
    Neglected tropical diseases (NTDs) encompass a group of diseases predominantly found in tropical regions, with origins dating back to their inclusion in the United Nations Millennium Development Goals in 2000. This initiative aimed to raise awareness and global funding to combat these diseases, which thrive in areas with limited sanitation, healthcare, and education. NTDs are caused by various pathogens such as bacteria, fungi, parasites, and viruses and affect over two billion individuals in resource-poor communities, leading to preventable deaths and devastating consequences. While the musculoskeletal system is only occasionally affected, the resulting chronic disabilities prevent individuals from working, posing a significant socioeconomic burden in this region of the world. Some NTDs exhibit distinct imaging features, and radiologists need to be aware of these characteristics to facilitate early treatment. In this review, we delve into musculoskeletal NTDs, focusing on clinical features and imaging findings, differential diagnosis, and clinical management.
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  • 文章类型: Systematic Review
    背景:NTDs历来比同一地区的其他疾病受到的关注少。尽管消除NTD取得了进展,但最近的差距分析显示出明显的缺点。进行了系统的范围审查,以了解NTD控制,消除,以及过去30年来世卫组织非洲区域的根除努力。
    方法:来自PubMed的同行评审出版物,WebofScience,和与NTD控制相关的Cochrane数据库,消除,对世卫组织非洲区域1990年至2022年的根除情况进行了审查。纳入的文章根据NTD进行分类;研究地点,type,和时期;和主题领域。世卫组织的技术和指导文件,UN,合作伙伴,和学术/研究机构进行了审查。记录了针对特定国家的多年NTD总计划。
    结果:480篇同行评审文章,六个Cochrane评论,其中包括134份技术报告。MDA和非干预/调查相关研究是共同的主题。淋巴丝虫病,沙眼,血吸虫病,盘尾丝虫病是研究最频繁的NTDs。坦桑尼亚,埃塞俄比亚,尼日利亚是代表最多的国家;多国研究有限。
    结论:这篇综述突出了NTD控制方面取得的进展,消除,世卫组织非洲区域的根除努力,并可以为国家/区域战略提供信息。疾病和地理差异很明显,保证在某些国家的重点和研究。NTD控制程序的标准化方法需要持续进展。
    背景:本研究没有资金来源。
    OBJECTIVE: NTDs historically receive less attention than other diseases in the same regions. Recent gap analyses revealed notable shortcomings despite NTD elimination progress. This systematic scoping review was conducted to understand NTD control, elimination, and eradication efforts in the WHO African region over the last 30 years.
    METHODS: Peer-reviewed publications from PubMed, Web of Science, and Cochrane databases related to NTD control, elimination, and eradication in the WHO African Region from 1990 to 2022 were reviewed. Included articles were categorized based on NTD; study location, type, and period; and topic areas. Technical and guidance documents from WHO, UN, partner, and academic/research institutions were reviewed. Country-specific multi-year NTD master plans were documented.
    RESULTS: Four hundred eighty peer-reviewed articles, six Cochrane reviews, and 134 technical reports were included. MDA and non-interventional/survey-related studies were common topics. Lymphatic filariasis, trachoma, schistosomiasis, and onchocerciasis were the most frequently studied NTDs. Tanzania, Ethiopia, and Nigeria were the most represented countries; multi-country studies were limited.
    CONCLUSIONS: The review highlights progress made in NTD control, elimination, and eradication efforts in the WHO African Region and can inform national/regional strategies. Disease and geographical disparities were evident, warranting focus and research in certain countries. A standardized approach to NTD control programs is needed for sustained progress.
    BACKGROUND: There was no funding source for this study.
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  • 文章类型: Case Reports
    皮肤幼虫偏头痛(CLM)是由钩虫寄生幼虫的入侵和迁移引起的皮炎,主要影响热带和亚热带地区。本报告介绍了一名尼泊尔儿童的CLM病例,并概述了有关这种情况的文献。
    一个来自尼泊尔农村地区的4岁男孩左脚出现瘙痒性皮肤损伤,最初误诊为真菌感染。病变逐渐扩大,形成浆液性红斑,变得强烈瘙痒。病人的家庭社会经济状况很差,这个孩子经常赤脚走在一个有许多家犬和流浪狗的地方。临床确诊,口服阿苯达唑和抗组胺药治疗可完全缓解症状。
    CLM是一种被忽视的人畜共患疾病,由于漏报和误诊,发展中国家的负担被低估了。Ancylostomaspp的幼虫。是常见的罪魁祸首,当它们通过皮肤迁移时引起局部炎症反应。诊断主要是临床和常规检查通常没有异常。并发症可能包括继发细菌感染,过敏,和罕见的内脏器官迁移。治疗选择包括阿苯达唑或伊维菌素,强调卫生的预防措施,鞋类使用,和宠物驱虫。
    CLM是一种被忽视的疾病,主要影响热带地区的边缘化社区。提高医疗保健提供者的认识,进行观察性研究,并制定治疗指南,尤其是对儿童来说,是解决这一公共卫生问题的重要步骤。预防性努力,例如促进卫生和鞋类使用,应鼓励降低CLM发生率。
    UNASSIGNED: Cutaneous larva migrans (CLM) is a dermatitis caused by the invasion and migration of parasitic larvae of hookworms, primarily affecting tropical and subtropical regions. This report presents a case of CLM in a Nepali child and provides an overview of the literature on this condition.
    UNASSIGNED: A 4-year-old boy from a rural area in Nepal presented with a pruritic skin lesion on his left foot, initially misdiagnosed as fungal infection. The lesion gradually expanded, forming a serpiginous erythema, and became intensely pruritic. The patient\'s family had poor socioeconomic conditions, and the child frequently walked barefoot in an area with many domestic and stray dogs. Diagnosis was confirmed clinically, and treatment with oral albendazole and antihistamines resulted in complete resolution of symptoms.
    UNASSIGNED: CLM is a neglected zoonotic disease, with an underestimated burden in developing countries due to underreporting and misdiagnosis. The larvae of Ancylostoma spp. are common culprits, causing a localized inflammatory reaction as they migrate through the skin. Diagnosis is mainly clinical and routine investigations usually reveal no abnormality. Complications may include secondary bacterial infections, allergies, and rare migration to internal organs. Treatment options include albendazole or ivermectin, with preventive measures emphasizing hygiene, footwear use, and pet deworming.
    UNASSIGNED: CLM is a neglected disease that primarily affects marginalized communities in tropical regions. Raising awareness among healthcare providers, conducting observational studies, and developing treatment guidelines, especially for children, are essential steps to address this public health concern. Preventive efforts, such as promoting hygiene and footwear use, should be encouraged to reduce CLM incidence.
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  • 文章类型: Journal Article
    利什曼病是一种被忽视的热带病,已经影响到全球超过3.5亿人,可以表现为三种不同的形式:皮肤,粘膜皮肤,或者内脏。此外,目前的治疗方案存在影响疗效和患者依从性的缺点.面对这一全球健康问题,已经探索了治疗利什曼病的新方法。姜黄素,从姜黄根茎中获得的多酚,对不同种类的利什曼原虫具有杀利什曼活性。虽然其作用机制尚未完全阐明,其潜在的利什曼杀菌力可能与其抗氧化和抗炎特性有关。然而,它具有损害其临床使用的局限性。相反,纳米技术已被用作解决与药物相关的生物制药挑战的工具,如姜黄素。从药物输送的角度来看,纳米载体(1-1000nm)可以提高稳定性,增加溶解度,促进细胞内传递,增加生物活性。因此,这篇综述对用于治疗利什曼病的姜黄素纳米载体进行了深入的研究.
    Leishmaniasis is a neglected tropical disease that has affected more than 350 million people worldwide and can manifest itself in three different forms: cutaneous, mucocutaneous, or visceral. Furthermore, the current treatment options have drawbacks which compromise efficacy and patient compliance. To face this global health concern, new alternatives for the treatment of leishmaniasis have been explored. Curcumin, a polyphenol obtained from the rhizome of turmeric, exhibits leishmanicidal activity against different species of Leishmania spp. Although its mechanism of action has not yet been fully elucidated, its leishmanicidal potential may be associated with its antioxidant and anti-inflammatory properties. However, it has limitations that compromise its clinical use. Conversely, nanotechnology has been used as a tool for solving biopharmaceutical challenges associated with drugs, such as curcumin. From a drug delivery standpoint, nanocarriers (1-1000 nm) can improve stability, increase solubility, promote intracellular delivery, and increase biological activity. Thus, this review offers a deep look into curcumin-loaded nanocarriers intended for the treatment of leishmaniasis.
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  • 文章类型: Journal Article
    布鲁里溃疡(BU),被忽视的热带病(NTD),是由溃疡分枝杆菌引起的皮肤和皮下组织感染。这种疾病在许多南美都有记载,亚洲人,和西太平洋国家,遍布非洲大部分地区,尤其是在西非和中非。在医疗匮乏的农村地区,BU是一种毁灭性的疾病,可以使患者永久残疾并受到社会污名化。人们认为溃疡分枝杆菌会产生一种真菌内酯毒素,这导致患病组织的坏死,并且可能与BU的病因有关。最初,患者可能会注意到皮肤上的无痛结节或斑块;随着疾病的进展,然而,它可能会扩散到身体的其他部位,包括肌肉和骨骼。临床体征,微生物培养,和患病组织的组织学分析都有助于BU的诊断。虽然抗生素治疗和手术切除感染组织对于BU管理是必要的,在传统医学获得有限的地区,植物衍生医学可能是一种替代方法。在这里,我们回顾了地理分布,社会经济,危险因素,诊断,病原体的生物学和生态学。复杂的环境,社会经济,并讨论了影响BU的遗传因素。Further,我们的评论重点介绍了未来需要的研究领域,以制定通过使用非洲本土植物来管理疾病的策略.
    Buruli ulcer (BU), a neglected tropical disease (NTD), is an infection of the skin and subcutaneous tissue caused by Mycobacterium ulcerans. The disease has been documented in many South American, Asian, and Western Pacific countries and is widespread throughout much of Africa, especially in West and Central Africa. In rural areas with scarce medical care, BU is a devastating disease that can leave patients permanently disabled and socially stigmatized. Mycobacterium ulcerans is thought to produce a mycolactone toxin, which results in necrosis of the afflicted tissue and may be involved in the etiology of BU. Initially, patients may notice a painless nodule or plaque on their skin; as the disease progresses, however, it may spread to other parts of the body, including the muscles and bones. Clinical signs, microbial culture, and histological analysis of afflicted tissue all contribute to a diagnosis of BU. Though antibiotic treatment and surgical removal of infected tissue are necessary for BU management, plant-derived medicine could be an alternative in areas with limited access to conventional medicine. Herein we reviewed the geographical distribution, socioeconomic, risk factors, diagnosis, biology and ecology of the pathogen. Complex environmental, socioeconomic, and genetic factors that influence BU are discussed. Further, our review highlights future research areas needed to develop strategies to manage the disease through the use of indigenous African plants.
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  • 文章类型: Journal Article
    钩端螺旋体病是一种具有全球重要性的人畜共患疾病,具有显著的发病率和死亡率。然而,这种疾病经常被忽视和诊断不足,导致疾病的真实规模和严重程度的不确定性。一种被忽视的热带病,钩端螺旋体病不成比例地影响最容易受到人畜共患疾病爆发的不利社会经济社区,由于接触传染性动物和受污染的土壤和水域。随着越来越多的证据表明钩端螺旋体能够存活,坚持,在环境中繁殖,本文回顾了目前对环境中病原体的理解,并强调了对未来研究最重要的未知因素。通过对文献进行系统的布尔回顾,我们的研究发现,钩端螺旋体患病率的详细现场研究,生存,目前的文献中缺乏在自然水域和土壤中的传播。这篇综述确定了强烈需要评估物理特征和生物地球化学过程,以支持钩端螺旋体在环境中的长期生存能力,然后对当前野生动植物和牲畜中相同钩端螺旋体菌株的传播和移动进行流行病学评估,这是第一步。提高我们对钩端螺旋体病传播周期的环境阶段的理解。
    Leptospirosis is a zoonotic disease of global importance with significant morbidity and mortality. However, the disease is frequently overlooked and underdiagnosed, leading to uncertainty of the true scale and severity of the disease. A neglected tropical disease, leptospirosis disproportionately impacts disadvantaged socioeconomic communities most vulnerable to outbreaks of zoonotic disease, due to contact with infectious animals and contaminated soils and waters. With growing evidence that Leptospira survives, persists, and reproduces in the environment, this paper reviews the current understanding of the pathogen in the environment and highlights the unknowns that are most important for future study. Through a systematic Boolean review of the literature, our study finds that detailed field-based study of Leptospira prevalence, survival, and transmission in natural waters and soils is lacking from the current literature. This review identified a strong need for assessment of physical characteristics and biogeochemical processes that support long-term viability of Leptospira in the environment followed by epidemiological assessment of the transmission and movement of the same strains of Leptospira in the present wildlife and livestock as the first steps in improving our understanding of the environmental stage of the leptospirosis transmission cycle.
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  • 文章类型: Systematic Review
    背景:全球超过17亿人受到被忽视的热带病(NTDs)的影响。受NTD影响的人口中有40%生活在非洲最贫穷的人,最脆弱的,很难到达地理区域。NTD造成了巨大的社会和经济负担,加剧了边缘化和污名化。世界卫生组织目前的NTD路线图旨在防止,control,消除,或根除20种热带病。埃塞俄比亚经历了这些疾病的沉重负担,但是目前对诊断的访问,医学,和/或护理很少被探索以告知该国的NTD战略计划。范围界定审查的总体目的是绘制和描述NTD的负担和获得诊断方面的挑战,医学,和/或在埃塞俄比亚的护理。
    方法:在PubMed,科克伦图书馆,和谷歌学者从2000年1月到2022年5月,没有语言或学习设计的限制。遵循系统审查和Meta分析扩展的首选报告项目,用于筛选研究。对关键发现进行了定性提取和叙述。
    结果:搜索结果为4532篇文章,其中105项符合纳入标准,并被纳入范围审查的三个主题:NTD的负担,访问诊断,药物和/或护理,和关键障碍。尽管埃塞俄比亚在预防和控制NTD方面取得了进展,负担仍然很高,以及获得诊断的进展,药物/药物,和/或护理非常缓慢。贫穷,生活质量差,NTD计划的资金不足使该国消除NTD计划的进程减速。
    结论:范围审查确定了大量关于埃塞俄比亚NTDs负担和诊断策略的研究,治疗,和/或护理;然而,关于新诊断技术和药物在该国的适用性和潜在益处的证据很少。定期审查和分析此类国家一级的证据对于为国家NTD路线图和地方实施战略提供信息非常重要。
    More than 1.7 billion people are affected by neglected tropical diseases (NTDs) worldwide. Forty percent of the NTD-affected people live in Africa with the poorest, most vulnerable, and hard to reach geographical areas. The NTDs cause significant social and economic burden and deepen marginalization and stigmatization. The World Health Organization\'s current roadmap for NTD aims to prevent, control, eliminate, or eradicate 20 tropical diseases. Ethiopia experiences a high burden of these diseases, but current access to diagnostics, medicine, and/or care has been little explored to inform the country\'s NTD strategic plan. The overall purpose of the scoping review was to map and characterize the burden of NTDs and challenges in access to diagnostics, medicine, and/or care in Ethiopia.
    A systematic search of evidence was conducted in PubMed, Cochrane Library, and Google Scholar from January 2000 until May 2022, without restrictions of language or study design. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review was followed for screening of studies. Key findings were extracted and narrated qualitatively.
    The search resulted in 4532 articles, of which 105 met the inclusion criteria and were included in the scoping review under three themes: burden of NTDs, access to diagnostics, medicine and/or care, and key barriers. Although gains have been made in the prevention and control of NTDs in Ethiopia, the burden remains high, and progress in access to diagnostics, medicine/drugs, and/or care is very slow. Poverty, poor quality of life, and underfunding of NTD programs decelerate the process of NTD elimination program in the country.
    The scoping review identified a considerable number of studies on the burden of NTDs in Ethiopia and strategies for diagnosis, treatment, and/or care; however, there is a paucity of evidence on the suitability and potential benefits of novel diagnostic technologies and medicines in the country. A regular review and analysis of such country-level evidence is important to inform the country NTDs roadmap and local implementation strategies.
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  • 文章类型: Systematic Review
    背景:目前,泌尿生殖道血吸虫病(UGS)并发症的诊断或治疗尚无标准化指南.这篇系统的文献综述旨在研究有关诊断方法和这种情况的临床管理的最新技术。
    方法:在MEDLINE数据库中对1990年1月至2021年1月之间发表的文献进行了系统回顾,关于UGS并发症的诊断手段或治疗选择的文章的范围检查,即阻塞性尿路病,膀胱癌,流产,异位妊娠,不孕症,肾衰竭,尿石症和侵入性手术的需要。然后根据纳入标准从被认为合格的文章中提取相关数据。
    结果:总计,通过研究查询确定了3052篇文章,其中纳入标题/摘要筛选和全文评估后符合纳入标准的167篇文章,在诊断和治疗方面都有35%,51%的诊断和14%的治疗。超声是诊断UGS并发症的最常用工具,表现良好。关于肾积水的管理,大多数现有证据来自基于社区的研究,在这些研究中,吡喹酮的普遍治疗导致梗阻性尿道病患病率降低.关于外科手术的研究,激光内切开术后支架置入术主要应用于成人患者,导致60%的粗治愈率(71例患者中有43例).在严重肾积水的情况下,由输尿管重新植入组成的手术显示出优异的效果,粗治愈率为98%(160例治疗中的157例治愈患者)。关于膀胱癌,有93例明确诊断为UGS相关膀胱的患者的数据可根据疾病分期报告可变且有时联合的方法.关于堕胎诊断和管理的现有数据,异位妊娠,不孕症,肾衰竭,还介绍了由于UGS而引起的尿石症和侵入性手术的需求。
    结论:该综述提供了目前可用于复杂UGS的诊断和治疗方案的全貌。这些结果对于指导临床医生正确管理和追踪未来研究的方向都是有用的。
    BACKGROUND: Currently, there are no standardized guidelines for the diagnosis or management of the complications of urogenital schistosomiasis (UGS). This systematic review of the literature aims to investigate the state of the art in reference to diagnostic approaches and the clinical management of this condition.
    METHODS: A systematic review of literature published between January 1990 and January 2021 was conducted in the MEDLINE database, scoping for articles regarding diagnostic means or therapeutic options for the complications of UGS, namely obstructive uropathy, bladder cancer, abortion, ectopic pregnancy, infertility, kidney failure, urolithiasis and the need for invasive procedures. Relevant data were then extracted from the articles deemed eligible according to the inclusion criteria.
    RESULTS: In total, 3052 articles were identified by the research query, of which 167 articles fulfilling inclusion criteria after title/abstract screening and full-text evaluation were included, 35% on both diagnostic and therapeutic aspects, and 51% on diagnosis and 14% on therapy. Ultrasound was the most frequently tool employed for the diagnosis of UGS complications showing a good performance. Concerning the management of hydronephrosis, the majority of available evidences came from community-based studies where universal treatment with praziquantel was used leading to decrease of prevalence of obstructive uropathy. Concerning studies on surgical procedures, laser endoureterotomy followed by stenting was mostly employed in adult patients leading to a crude cure rate of 60% (43 of 71 patients). In the case of severe hydronephrosis, surgery consisting of ureteral re-implantation showed excellent results with a crude cure rate of 98% (157 cured patients of 160 treated). Concerning bladder cancer, data on 93 patients with a clear diagnosis of UGS-related bladder were available reporting a variable and sometime combined approach based on disease stage. Available data on diagnosis and management of abortion, ectopic pregnancy, infertility, kidney failure, urolithiasis and the need for invasive procedures due to UGS are also presented.
    CONCLUSIONS: The review produced a complete picture of the diagnostic and therapeutic options currently available for complicated UGS. These results can be useful both for guiding clinicians towards correct management and for tracing the direction of future research.
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