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Towards integrated surveillance-response systems for the prevention of future pandemics

Infectious Diseases of Poverty 2020年第5期9卷 87-92页

作者： jakob Zinsstag Jürg Utzinger Nicole Probst-Hensch Lv Shan Xiao-Nong Zhou Swiss Tropical and Public Health Institute BaselSwitzerland University of Basel BaselSwitzerland National Institute of Parasitic Diseases at the Chinese Center for Disease Control and Prevention&Chinese Center for Tropical Diseases Research WHO Collaborating Center for Tropical DiseasesShanghaiPeople's Republic of China School of Global Health Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of MedicineShanghaiPeople's Republic of China

Most human pathogens originate from non-human hosts and certain pathogens persist in animal reservoirs.The transmission of such pathogens to humans may lead to self-sustaining chains of transmission.These pathogens represent the highest risk for future pandemics.For their prevention,the transmission over the species barrier—although rare—should,by all means,be avoided.In the current COVID-19 pandemic,surprisingly though,most of the current research concentrates on the control by drugs and vaccines,while comparatively little scientific inquiry focuses on future prevention.Already in 2012,the World Bank recommended to engage in a systemic One Health approach for zoonoses control,considering integrated surveillance-response and control of human and animal diseases for primarily economic reasons.First examples,like integrated West Nile virus surveillance in mosquitos,wild birds,horses and humans in Italy show evidence of financial savings from a closer cooperation of human and animal health sectors.Provided a zoonotic origin can be ascertained for the COVID-19 pandemic,integrated wildlife,domestic animal and humans disease surveillance-response may contribute to prevent future outbreaks.In conclusion,the earlier a zoonotic pathogen can be detected in the environment,in wildlife or in domestic animals;and the better human,animal and environmental surveillance communicate with each other to prevent an outbreak,the lower are the cumulative costs.

关键词： Integrated surveillance-response One health Pandemics Transdisciplinarity Zoonoses

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Controlling schistosomiasis with praziquantel:How much longer without a viable alternative?

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Infectious Diseases of Poverty 2017年第1期6卷 654-663页

作者： Robert Bergquist Jürg Utzinger jennifer Keiser Ingerod BrastadSweden Swiss Tropical and Public Health Institute P.O.BoxCH-4002 BaselSwitzerland University of Basel P.O.BoxCH-4003 BaselSwitzerland

The current approach of morbidity control of schistosomiasis,a helminth disease of poverty with considerable public health and socioeconomic impact,is based on preventive chemotherapy with praziquantel.There is a pressing need for new drugs against this disease whose control entirely depends on this single drug that has been widely used over the past 40 years.We argue that a broader anthelminthic approach supplementing praziquantel with new antischistosomals targeting different parasite development stages would not only increase efficacy but also reduce the risk for drug resistance.Repositioning drugs already approved for other diseases provides a shortcut to clinical trials,as it is expected that such drugs rapidly pass the regulatory authorities.The antischistosomal properties of antimalarial drugs(e.g.,semisynthetic artemisinins,synthetic trioxolanes,trioxaquines and mefloquine)and of drugs being developed or registered for other purposes(e.g.,moxidectin and miltefosin),administered alone or in combination with praziquantel,have been tested in the laboratory and clinical trials.Another avenue to follow is the continued search for new antischistosomal properties in plants.Here,we summarise recent progress made in schistosomiasis chemotherapy,placing particular emphasis on repositioning of existing drugs against schistosomiasis.

关键词： Chemotherapy Drug repositioning Elimination Morbidity control Praziquantel Schistosomiasis

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Strategies supporting the prevention and control of neglected tropical diseases during and beyond the COVID-19 pandemic

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Infectious Diseases of Poverty 2020年第4期9卷 135-141页

作者： john P.Ehrenberg Xiao-Nong Zhou Gilberto Fontes Eliana M.M.Rocha Marcel Tanner Jürg Utzinger Avenida Cedro 9 #303CholulMeridaYucatanMexico Formerly World Health Organization Regional Office for the Western PacificManilaThe Philippines National Institute of Parasitic Diseases at the Chinese Center for Disease Control and Prevention&Chinese Center for Tropical Diseases Research ShanghaiPeople's Republic of China School of Global Health Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of MedicineShanghaiPeople's Republic of China Laboratory of Parasitology Central-West CampusFederal University of S(a)o Jo(a)o del ReiDivinopolisMinas GeraisBrazil Swiss Tropical and Public Health Institute BaselSwitzerland University of Basel BaselSwitzerland

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.

关键词： COVID-19 Emerging and re-emerging diseases Multi-sectorial approaches Neglected tropical diseases Zoonotic diseases

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A decade of innovation to deepen the understanding of infectious diseases of poverty and foster their control and elimination

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Infectious Diseases of Poverty 2022年第6期11卷 1-4页

作者： Dirk Engels Sheng‑lan Tang Colin DButler Ayoade MjOduola Tania Cde Araujo‑jorge George FGao Jürg Utzinger Xiao‑Nong Zhou World Health Organization(Retired) GenevaSwitzerland Duke University DurhamUSA Australia National University CanberraAustralia University of Ibadan Research Foundation University of IbadanIbadanNigeria Institute Oswaldo Cruz Oswaldo Cruz FoundationRio de JaneiroBrazil Chinese Acad‑emy of Sciences BeijingPeople’s Republic of China Swiss Tropical and Public Health Institute AllschwilSwitzerland University of Basel BaselSwitzerland National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention Chinese Center for Tropical Diseases ResearchShanghaiPeo‑ple’s Republic of China One Health Center Shanghai Jiao Tong University The University of EdinburghShanghaiPeople’s Republic of China

Exactly 10 years ago,on 25 October 2012,a group of scientists,policy-makers,and practitioners undertook an ambitious project to launch a new open-access journal,named Infectious Diseases of Poverty[1].The idea had originated from a think-tank put forth by the Special Programme for Research and Training in Tropical Diseases(TDR),an organisation co-sponsored by the United Nations Children’s Fund(UNICEF),the United Nations Development Programme(UNDP),the World Bank,and the World Health Organization(WHO).Indeed,this think-tank published a comprehensive Global Report for Research on Infectious Diseases of Poverty[2]that guided the scope and remit of Infectious Diseases of Poverty.

关键词： UNICEF elimination originated

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The economic impact of schistosomiasis

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Infectious Diseases of Poverty 2021年第6期10卷 106-106页

作者： Daniele Rinaldo javier Perez‑Saez Penelope Vounatsou Jürg Utzinger jean-Louis Arcand Department of Economics and Land EnvironmentEconomics and Policy Institute(LEEP)University of ExeterExeterEngland 不详

Background:The economic impact of schistosomiasis and the underlying tradeofs between water resources devel‑opment and public health concerns have yet to be quantifed.Schistosomiasis exerts large health,social and fnan‑cial burdens on infected individuals and households.While irrigation schemes are one of the most important policy responses designed to reduce poverty,particularly in sub-Saharan Africa,they facilitate the propagation of schistoso‑miasis and other diseases.Methods:We estimate the economic impact of schistosomiasis in Burkina Faso via its efect on agricultural produc‑tion.We create an original dataset that combines detailed household and agricultural surveys with high-resolution geo-statistical disease maps.We develop new methods that use the densities of the intermediate host snails of schis‑tosomiasis as instrumental variables together with panel,spatial and machine learning techniques.Results:We estimate that the elimination of schistosomiasis in Burkina Faso would increase average crop yields by around 7%,rising to 32%for high infection clusters.Keeping schistosomiasis unchecked,in turn,would correspond to a loss of gross domestic product of approximately 0.8%.We identify the disease burden as a shock to the agricultural productivity of farmers.The poorest households engaged in subsistence agriculture bear a far heavier disease burden than their wealthier counterparts,experiencing an average yield loss due to schistosomiasis of between 32 and 45%.We show that the returns to water resources development are substantially reduced once its health efects are taken into account:villages in proximity of large-scale dams sufer an average yield loss of around 20%,and this burden decreases as distance between dams and villages increases.Conclusions:This study provides a rigorous estimation of how schistosomiasis afects agricultural production and how it is both a driver and a consequence of poverty.It further quantifes the tradeof between the economics of water infrastructures and their impact on public h

关键词： Schistosomiasis Neglected Tropical Diseases Sub-Saharan Africa Agriculture Water Resources Development Poverty

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Environmental determinants of access to shared sanitation in informal settlements:a cross-sectional study in Abidjan and Nairobi

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Infectious Diseases of Poverty 2023年第2期12卷 132-132页

作者： Vitor Pessoa Colombo jérôme Chenal Fred Orina Hellen Meme jeanne d’Arc Amoin Koffi Brama Koné Jürg Utzinger École Polytechnique Fédérale de Lausanne Lausanne Switzerland Université Mohammed VI Polytechnique Ben Guerir Morocco Kenya Medical Research Institute Nairobi Kenya Centre Suisse de Recherches Scientifiques en Côte d’Ivoire Abidjan Côte d’Ivoire Université Péléforo Gon Coulibaly Korhogo Côte d’Ivoire Swiss Tropical and Public Health Institute Allschwil Switzerland University of Basel Basel Switzerland

Background Universal access to basic sanitation remains a global challenge,particularly in low-and middle-income countries.Efforts are underway to improve access to sanitation in informal settlements,often through shared facilities.However,access to these facilities and their potential health gains—notably,the prevention of diarrheal diseases—may be hampered by contextual aspects related to the physical environment.This study explored associations between the built environment and perceived safety to access toilets,and associations between the latter and diarrheal infections.Methods A cross-sectional study was carried out between july 2021 and February 2022,including 1714 households in two informal settlements in Abidjan(Côte d’Ivoire)and two in Nairobi(Kenya).We employed adjusted odds ratios(aORs)obtained from multiple logistic regressions(MLRs)to test whether the location of the most frequently used toilet was associated with a perceived lack of safety to use the facility at any time,and whether this perceived insecurity was associated with a higher risk of diarrhea.The MLRs included several exposure and control variables,being stratified by city and age groups.We employed bivariate logistic regressions to test whether the perceived insecurity was associated with settlement morphology indicators derived from the built environment.Results Using a toilet outside the premises was associated with a perceived insecurity both in Abidjan[aOR=3.14,95%confidence interval(CI):1.13–8.70]and in Nairobi(aOR=57.97,95%CI:35.93–93.53).Perceived insecurity to access toilets was associated with diarrheal infections in the general population(aOR=1.90,95%CI:1.29–2.79 in Abidjan,aOR=1.69,95%CI:1.22–2.34 in Nairobi),but not in children below the age of 5 years.Several settlement morphology features were associated with perceived insecurity,namely,buildings’compactness,the proportion of occupied land,and angular deviation between neighboring structures.Conclusions Toilet location was a critical determinant of perceived security,and h

关键词： Diarrhea Informal settlements Safety Sanitation Urban morphology Abidjan Africa Côte d’Ivoire Kenya Nairobi

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Experience and lessons from health impact assessment guiding prevention and control of HIV/AIDS in a copper mine project,northwestern Zambia

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Infectious Diseases of Poverty 2017年第1期6卷 1023-1033页

作者： Astrid M.Knoblauch Mark j.Divall Milka Owuor Kennedy Nduna Harrison Ng’uni Gertrude Musunka Anna Pascall Jürg Utzinger Mirko S.Winkler Swiss Tropical and Public Health Institute P.O.BoxCH-4002 BaselSwitzerland University of Basel P.O.BoxCH-4003 BaselSwitzerland SHAPE Consulting Ltd. GY12 St Peter PortChannel IslandsGuernseyUK Solwezi District Health Management Team 40100 SolweziZambia First Quantum Minerals Limited 10100 LusakaZambia

Background:To avoid or mitigate potential project-related adverse health effects,the Trident copper project in Kalumbila,northwestern Zambia,commissioned a health impact assessment.HIV was identified a priority health issue based on the local vulnerability to HIV transmission and experience from other mining projects in Africa.Hence,an HIV/AIDS management plan was developed,including community and workplace interventions,with HIV testing and counselling(HTC)being one of the key components.We present trends in HTC data over a 4-year period.Methods:In 13 communities affected by the Trident project,HTC was implemented from 2012 onwards,using rapid diagnostic tests,accompanied by pre-and post-test counselling through trained personnel.In addition,HTC was initiated in the project workforce in 2013,coinciding with the launch of the mine development.HTC uptake and HIV positivity rates were assessed in the study population and linked to demographic factors using regression analysis.Results:In total,11,638 community members and 5564 workers have taken up HTC with an increase over time.The HIV positivity rate in the community was 3.0%in 2012 and 3.4%in 2015,while positivity rate in the workforce was 5.2%in 2013 and 4.3%in 2015.Females showed a significantly higher odds of having a positive test result than males(odds ratio(OR)=1.96,95%confidence interval(CI):1.55-2.50 among women in the community and OR=2.90,95%CI:1.74-4.84 among women in the workforce).HTC users in the 35-49 years age group were most affected by HIV,with an average positivity rate of 6.6%in the community sample and 7.9%in the workforce sample.These study groups had 4.50 and 4.95 higher odds of being positive,respectively,compared to their younger counterparts(15-24 years).Conclusions:While HTC uptake increased five-fold in the community and almost three-fold in the workplace,the HIV positivity rates were insignificantly higher in 2015 compared to 2012.Our data can be used alongside other surveillance data to track HIV transmission in this specific context

关键词： Community health management Health impact assessment HIV Mining Occupational health Sexually transmitted infections Zambia

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蒿甲醚对感染小鼠体内埃及血吸虫超微结构的影响

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中国寄生虫学与寄生虫病杂志 2006年第5期24卷 321-328页

作者：肖树华 Jürg Utzinger 沈炳贵 Marcel TANNER jacques CHOLLET 中国疾病预防控制中心寄生虫病预防控制所上海200025 Swiss Tropical InstituteP.O.BoxCH-4002 BaselSwitzerland

目的观察蒿甲醚对小鼠体内埃及血吸虫成虫超微结构的损害。方法8只小鼠于感染埃及血吸虫尾蚴后81d用单剂蒿甲醚400mg/kg口服治疗。治后24h、3d、7d和14d各剖杀2只小鼠,用灌注法收集血吸虫,并按常规方法固定和处置虫体,作透射电镜观察。... 详细信息

目的观察蒿甲醚对小鼠体内埃及血吸虫成虫超微结构的损害。方法8只小鼠于感染埃及血吸虫尾蚴后81d用单剂蒿甲醚400mg/kg口服治疗。治后24h、3d、7d和14d各剖杀2只小鼠,用灌注法收集血吸虫,并按常规方法固定和处置虫体,作透射电镜观察。从另2只未治疗的感染小鼠体内取虫作对照。结果蒿甲醚对血吸虫皮层超微结构的损害主要是皮层基质的肿胀、溶解和空泡变化,基底膜消失和部份受损皮层破裂;在感觉器和皮层结节中,常见其内部结构广泛溶解。在肌层、实质组织、合体细胞和肠管上皮细胞中,查见局灶性或广泛的溶解、粗面内质网减少及线粒体空泡变化和变性。雌虫卵黄细胞的严重变化是空泡变化、粗面内质网减少、卵黄球融合以及受损卵黄细胞破溃等。上述雌、雄虫变化于感染小鼠用蒿甲醚治疗后24h即可见到,并逐渐加重,3～7d后最重。治后14d,部分雌、雄虫仍示有超微结构的损害,但同时亦观察到受损虫组织的恢复。结论蒿甲醚对埃及血吸虫成虫的皮层和皮层下组织具有广泛和严重的超微结构损害。

关键词：蒿甲醚血吸虫病埃及血吸虫亚显微结构透射电镜术

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蒿甲醚对感染小鼠体内埃及血吸虫皮层的损害(英文)

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中国寄生虫学与寄生虫病杂志 2006年第6期24卷 425-432页

作者：肖树华 Marcel TANNER 沈炳贵 Jürg Utzinger jacques CHOLLET 中国疾病预防控制中心寄生虫病预防控制所世界卫生组织血吸虫病疟疾和丝虫病合作中心上海200025 Swiss Tropical Institute P.O. Box CH-4002 Basel Switzerland

目的评价蒿甲醚对小鼠体内埃及血吸虫皮层的损害作用。方法8只小鼠于感染埃及血吸虫尾蚴后81d,用单剂蒿甲醚400mg/kg口服治疗。治疗后1、3、7和14d各剖杀2只小鼠,用灌注法收集血吸虫,并按常规方法固定和处置虫体,作扫描电镜观察。从另2... 详细信息

目的评价蒿甲醚对小鼠体内埃及血吸虫皮层的损害作用。方法8只小鼠于感染埃及血吸虫尾蚴后81d,用单剂蒿甲醚400mg/kg口服治疗。治疗后1、3、7和14d各剖杀2只小鼠,用灌注法收集血吸虫,并按常规方法固定和处置虫体,作扫描电镜观察。从另2只未作治疗的感染小鼠取虫作对照。结果用蒿甲醚治疗后24h,雄虫的皮层结节肿大、破溃或从皮层上剥落;在雄虫和雌虫的体表可查见有局灶性或广泛的皮层肿胀、融合、空泡变化、糜烂和剥落,以及感觉结构的破坏。治疗后3d,雌、雄虫的皮层损害加重,最严重的损害为口吸盘肿胀和破溃,并查见皮层褶嵴有广泛和严重的肿胀、糜烂和剥落,以及雌虫盘状感觉结构的破坏。治疗后7至14d,有些虫仍示有中或重度皮层损害,而有些仍存活的虫则示其大部分皮层已有明显恢复。结论蒿甲醚对埃及血吸虫的皮层具有广泛和严重的损害作用。

关键词：蒿甲醚血吸虫病埃及血吸虫扫描电镜术

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Prevalence and risk factors of undernutrition among schoolchildren in the Plateau Central and Centre-Ouest regions of Burkina Faso

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Infectious Diseases of Poverty 2017年第1期6卷 140-153页

作者： Severine Erismann Astrid M.Knoblauch Serge Diagbouga Peter Odermatt jana Gerold Akina Shrestha Grissoum Tarnagda Boubacar Savadogo Christian Schindler Jürg Utzinger Gueladio Cisse Swiss Tropical and Public Health Institute P.O.BoxCH-4002 BaselSwitzerland University of Basel P.O.BoxCH-4003 BaselSwitzerland Institut de Recherches en Sciences de la Sante P.O.Box 7192Ouagadougou 03Burkina Faso Kathmandu University P.O.Box 625045200 DhulikhelNepa

Background:Multiple factors determine children’s nutritional status,including energy and nutrient intake,recurrent infectious diseases,access(or lack thereof)to clean water and improved sanitation,and hygiene practices,among others.The“Vegetables go to School:improving nutrition through agricultural diversification”(VgtS)project implements an integrated school garden programme in five countries,including Burkina Faso.The aim of this study was to determine the prevalence of undernutrition and its risk factors among schoolchildren in Burkina Faso before the start of the project.Methods:In February 2015,a cross-sectional survey was carried out among 455 randomly selected children,aged 8-14 years,in eight schools in the Plateau Central and Centre-Ouest regions of Burkina Faso.Nutritional status was determined by anthropometric assessment.Helminth and intestinal protozoa infections were assessed using the Kato-Katz and a formalin-ether concentration method.A urine filtration technique was used to identify Schistosoma haematobium eggs.Prevalence of anaemia was determined by measuring haemoglobin levels in finger-prick blood samples.Questionnaires were administered to children to determine their knowledge of nutrition and health and their related attitudes and practices(KAP).Questionnaires were also administered to the children’s caregivers to identify basic household socio-demographic and economic characteristics,and water,sanitation and hygiene(WASH)conditions.To determine the factors associated with schoolchildren’s nutritional status,mixed logistic regression models were used.Differences and associations were considered statistically significant if P-values were below 0.05.Results:Complete datasets were available for 385 children.The prevalence of undernutrition,stunting and thinness were 35.1%,29.4%and 11.2%,respectively.The multivariable analysis revealed that undernutrition was associated with older age(i.e.12-14 years compared tojusted odds ratio(aOR)=3.45,95%confidence interval(CI)2.12-5.62,P<0.001)

关键词： Anaemia Burkina Faso Intestinal parasitic infections School garden Undernutrition Water sanitation and hygiene(WASH)

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