背景:传统医学(TM)干预措施是针对新兴和地方性人畜共患疾病的传统医学干预措施的合理治疗替代方案,特别是在可能缺乏资源和基础设施的中低收入国家。尽管TM干预的使用越来越受欢迎,它们的临床安全性和有效性在许多国家的传统医疗保健中仍然存在争议。
方法:我们对同行评审的文献进行了范围审查,该文献综合并绘制了TM干预措施在印度次大陆治疗和预防人畜共患病的证据。该地区,生物多样性和新出现的感染的全球热点,其特征在于TM使用的高流行率。基于科学文献(主要是案例研究,n=l06项研究),我们的评论(1)绘制了文献的范围,(2)综合了TM干预对人畜共患病的应用证据,(3)批判性地反映TM的状况,并确定未来研究重点的领域。
结果:证据综合证实了TM干预对次大陆人畜共患病的广泛使用,大部分研究来自印度(n=99研究,93.4%),其次是巴基斯坦(n=3项研究,2.8%),孟加拉国(n=2项研究,1.9%),和斯里兰卡(n=1,0.9%)。大多数综述的研究报告了植物物种的民族药用,主要用于治疗登革热(n=20项研究),结核病(n=18项研究),大肠杆菌感染(n=16项研究),淋巴丝虫病和霍乱(n=9个)。然而,关于这些报告的TM干预措施的安全性和有效性的证据是有限的,这表明这些数据很少在同行评审的文献中收集和/或共享。
结论:因此,这篇综述强调,虽然TM已经被使用,并且可以提供更广泛的干预措施来对抗新兴和地方性人畜共患病和外寄生虫,迫切需要对这些干预措施的安全性和有效性进行严格的临床试验和验证.
BACKGROUND: Traditional medicine (TM) interventions are plausible therapeutic alternatives to conventional medical interventions against emerging and endemic zoonotic diseases, particularly in low-and middle-income countries that may lack resources and infrastructure. Despite the growing popularity in the usage of TM interventions, their clinical safety and effectiveness are still contested within conventional healthcare in many countries.
METHODS: We conducted a scoping review of the peer-reviewed literature that synthesises and maps the evidence on TM interventions for the treatment and prevention of zoonoses on the Indian subcontinent. The region, a global hotspot of biodiversity and emerging infections, is characterised by high prevalence of TM use. Based on the scientific literature (mostly case study research, n=l06 studies), our review (1) maps the scope of the literature, (2) synthesises the evidence on the application of TM interventions for zoonoses, and (3) critically reflects on the state of TM and identifies areas for future research focus.
RESULTS: The evidence synthesis confirmed widespread usage of TM interventions for zoonoses on the subcontinent, with the majority of research reported from India (n=99 studies, 93.4%), followed by Pakistan (n=3 studies, 2.8%), Bangladesh (n=2 studies, 1.9%), and Sri Lanka (n=1, 0.9%). Most of the reviewed studies reported on ethno-medicinal uses of plant species, primarily for treating dengue (n=20 studies), tuberculosis (n=18 studies), Escherichia coli infection (n=16 studies), lymphatic filariasis and cholera (n=9 apiece). However, the evidence on the safety and effectiveness of these reported TM interventions is limited, indicating that these data are rarely collected and/or shared within the peer-reviewed literature.
CONCLUSIONS: This review thus highlights that, whilst TMs are already being used and could offer more widely accessible interventions against emerging and endemic zoonoses and ectoparasites, there is an urgent need for rigorous clinical testing and validation of the safety and effectiveness of these interventions.