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Elimination of tropical disease through surveillance and response

Infectious Diseases of Poverty 2013年第1期2卷 1-5页

作者： Xiao-Nong Zhou RobertBergquist marcel tanner National Insttute of Parasitic Diseases Chinese Center for Disease Control and PreventionShanghai 200025People's Republic of China WHO Collaborating Centre for Malaria Schistosomiasis and FilarlasisKey Laboratory of Parasite and Vector BlologyMinistry of HealthShanghal 200025People's Republic of China Ingerod 407BrastadSweden Department of Epidemiology and Public Health Swiss Tropical and Public Health InstituteP.O.BoxBasel CH4002 Swizerand University of Basel P.O.BoxBasel CH4003Switzerland

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.

关键词： elimination tropical neglected

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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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Does the use of double hormone replacement therapy for trauma patient organ donors improve organ recovery for transplant

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World Journal of Transplantation 2024年第2期14卷 119-125页

作者： Eden M Gallegos tanner Reed Paige Deville Blake Platt Claudia Leonardi Lillian Bellfi Jessica Dufrene Saad Chaudhary John Hunt Lance Stuke Patrick Greiffenstein Jonathan Schoen Alan Marr Anil Paramesh Alison A Smith Department of Physiology Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70124United States Department of Medicine Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70112United States Department of Surgery Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70112United States Department of Trauma Surgery Tacoma General HospitalTacoma 98405United States Department of Public Health Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70112United States Department of Donation Services Louisiana Organ Procurement AgencyCovingtonLA 70433United States Department of Surgery Tulane Transplant InstituteTulane University School of MedicineNew OrleansLA 70112United States

BACKGROUND With an ongoing demand for transplantable organs,optimization of donor management protocols,specifically in trauma populations,is important for obta-ining a high yield of viable organs per patient.Endocrine management of brain-dead potential organ donors(BPODs)is controversial,leading to heterogeneous clinical management approaches.Previous studies have shown that when levo-thyroxine was combined with other treatments,including steroids,vasopressin,and insulin,BPODs had better organ recovery and survival outcomes were increased for transplant recipients.AIM To determine if levothyroxine use in combination with steroids in BPODs increased the number of organs donated in trauma patients.METHODS A retrospective review of adult BPODs from a single level 1 trauma center over ten years was performed.Exclusion criteria included patients who were not solid organ donors,patients who were not declared brain dead(donation after circulatory death),and patients who did not receive steroids in their hospital course.Levothyroxine and steroid administration,the number of organs donated,the types of organs donated,and demographic information were recorded.Univariate analyses were performed with P0.05).In the ST/LT group,68.1%(n=47)donated a high yield(3-5)of organ types per donor compared to 42.1%(n=8)in the ST group(P=0.038).There was no difference in the total number of organ types donated between the groups(P=0.068).CONCLUSION This study suggests that combining levothyroxine and steroid administration increases high-yield organ donation per donor in BPODs in the trauma patient population.Limitations to this study include the retrospective design and the relatively smal

关键词： Organ donation Trauma Brain death Levothyroxine Hormone replacement therapy Steroids Organ donor Retrospective

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Surveillance-response systems: the key to elimination of tropical diseases

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Infectious Diseases of Poverty 2014年第1期3卷 157-166,156页

作者： Ernest Tambo Lin Ai Xia Zhou Jun-Hu Chen Wei Hu Robert Bergquist Jia-Gang Guo Jürg Utzinger marcel tanner Xiao-Nong Zhou National Institute of Parasitic Diseases Chinese Center for Disease Control and PreventionShanghai 200025People’s Republic of China Biochemistry Department Center for Sustainable Malaria ControlFaculty of Natural&Agricultural SciencesUniversity of PretoriaHatfield 0028South Africa WHO Collaborating Centre for Malaria Schistosomiasis and FilariasisKey Laboratory of Parasite and Vector BiologyMinistry of HealthShanghai 200025People’s Republic of China Sochow University Suzhou 215123People’s Republic of China School of Life Science Fudan UniversityShanghai 200433People’s Republic of China Ingerod 407 BrastadSweden Department of Control of Neglected Tropical Diseases World Health OrganizationAvenue Appia 20CH-1211 GenevaSwitzerland Department of Epidemiology and Public Health Swiss Tropical and Public Health InstituteP.O.BoxCH-4002 BaselSwitzerland University of Basel P.O.BoxCH-4003 BaselSwitzerland

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

关键词： Tropical diseases Control Elimination Surveillance-response system Global health China

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蒿甲醚对曼氏血吸虫的作用 :剂量与效应的关系和虫的形态学和组织病理学的变化(英文)

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中国寄生虫学与寄生虫病杂志 2004年第3期22卷 148-153,i002页

作者：肖树华郭俭 Jacques Chollet 吴嘉彤 marcel tanner Jurg Utzinger 中国疾病控制预防中心寄生虫病控制预防所 Swiss Tropical Institute PO Box CH-4002 Basel Switzerland Swiss Tropical Institute PO Box CH-4002 Basel SwitzerlandOffice of Population Research Princeton University Princeton NJ08544 USA

目的　应用感染曼氏血吸虫 (利比里亚株 )的小鼠观察蒿甲醚单剂量与效应的关系 ,虫体肝移及蒿甲醚所引起的虫的形态学和组织病理学变化。　方法　感染 2 1d童虫的小鼠一次口服蒿甲醚 12 .5mg/kg至 60 0mg/kg不同剂量 ,治后 2 8d剖检观... 详细信息

目的　应用感染曼氏血吸虫 (利比里亚株 )的小鼠观察蒿甲醚单剂量与效应的关系 ,虫体肝移及蒿甲醚所引起的虫的形态学和组织病理学变化。　方法　感染 2 1d童虫的小鼠一次口服蒿甲醚 12 .5mg/kg至 60 0mg/kg不同剂量 ,治后 2 8d剖检观察各组虫数。感染 46d或 70d成虫的小鼠一次口服蒿甲醚 40 0mg/kg后 8～ 14d ,观察虫体肝移及其形态和组织病理学变化。　结果　蒿甲醚对 2 1d童虫的最低有效剂量为 2 0 0mg/kg ,减虫率为 81%。用蒿甲醚治疗后 8h成虫开始肝移 ,3～ 7d全部肝移 ,14d有 3 1%的虫返回肠系膜静脉。成虫虫体萎缩 ,咽部扩大 ,肠管膨胀及其色素减少。雌虫局部体表受损 ,白细胞附着 ,卵巢及卵黄腺变性退化 ,以及雄虫睾丸萎缩等。在肝内的虫体被嗜酸粒细胞为主的炎细胞包围和浸润。　结论　蒿甲醚对小鼠曼氏血吸虫 2 1d童虫的最低有效剂量为 2 0 0mg/kg ,可引起曼氏血吸虫成虫萎缩、退化或死亡。在肝内受损的虫体主要是被嗜酸粒细胞包围和侵袭所致。

关键词：蒿甲醚曼氏血吸虫剂量形态学组织病理学嗜酸粒细胞

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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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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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Distinct clinical characteristics and helminth co-infections in adult tuberculosis patients from urban compared to rural Tanzania

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Infectious Diseases of Poverty 2018年第1期7卷 243-254页

作者： George Sikalengo Jerry Hella Francis Mhimbira Liliana K.Rutaihwa Farida Bani Robert Ndege Mohamed Sasamalo Lujeko Kamwela Khadija Said Grace Mhalu Yeromin Mlacha Christoph Hatz Stefanie Knopp Sebastien Gagneux Klaus Reither Jurg Utzinger marcel tanner Emilio Letang Maja Weisser Lukas Fenner Ifakara Health Institute Dar es SalaamTanzania Swiss Tropical and Public Health Institute BaselSwitzerland' University of Basel BaselSwitzerland Institute of Social and Preventive Medicine University of BernBernSwitzerland

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 incr

关键词： Co-infection Helminth infection Recurrent tuberculosis Schistosomiasis Tanzania Tubercu

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蒿甲醚和青蒿琥酯对感染曼氏血吸虫小鼠治疗作用的初步研究

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中国血吸虫病防治杂志 2005年第5期17卷 362-364页

作者：涂祖武 Juerg Utzinger Jacques Chollet 肖树华 marcel tanner 湖北省疾病预防控制中心血吸虫病防治研究所武汉430079 瑞士热带病研究所中国疾病预防控制中心寄生虫病预防控制所

目的了解蒿甲醚和青蒿琥酯对小鼠曼氏血吸虫作用的效果。方法将小鼠随机分成12个实验组及1个对照组,以皮下注射的方法,每鼠接种约80条尾蚴,接种尾蚴46d后,分别以蒿甲醚或青蒿琥酯灌胃治疗,第1天,分别以400、300、200mg/kg的剂量1次灌胃;... 详细信息

目的了解蒿甲醚和青蒿琥酯对小鼠曼氏血吸虫作用的效果。方法将小鼠随机分成12个实验组及1个对照组,以皮下注射的方法,每鼠接种约80条尾蚴,接种尾蚴46d后,分别以蒿甲醚或青蒿琥酯灌胃治疗,第1天,分别以400、300、200mg/kg的剂量1次灌胃;第2～7天,则每天分别按以上剂量的半量灌胃,7d灌胃的总剂量分别为1600、1200、800mg/kg。总量1剂组,在第7天,分别按1600、1200、800mg/kg剂量1次灌胃。另设感染阳性对照组,不加治疗。结果蒿甲醚7日疗法1600、1200、800mg/kg剂量组减虫率分别为53.0%、49.0%和53.0%,减雌率为78.0%～82.0%,总量1剂组效果与7日疗法基本相同。青蒿琥酯7日疗法相应剂量减虫率分别为16.0%、37.0%和49.0%。结论蒿甲醚和青蒿琥酯对小鼠曼氏血吸虫具有一定的杀虫效果,蒿甲醚在疗效和毒性方面稍佳。

关键词：曼氏血吸虫蒿甲醚青蒿琥酯

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三苯双脒、青蒿琥酯、蒿甲醚和吡喹酮单剂、多剂或联合用药治疗大鼠华支睾吸虫感染的实验研究

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中国寄生虫学与寄生虫病杂志 2008年第5期26卷 321-326页

作者：肖树华薛剑 marcel tanner 张永年 Jennifer KEISER Jug UTZINGER 强慧琴刘晓云中国疾病预防控制中心寄生虫病预防控制所卫生部寄生虫病原与媒介生物学重点实验室世界卫生组织疟疾、血吸虫病和丝虫病合作中心上海200025 瑞士热带病研究所公共卫生和流行病学系巴塞尔CH-4002 瑞士热带病研究所医学寄生虫学和感染生物学系瑞士巴塞尔CH-4002 利物浦热带病医学院利物浦L3 5QA

目的观察三苯双脒、青蒿琥酯、蒿甲醚、或吡喹酮单剂、多剂给药,及其伍用治疗感染华支睾吸虫大鼠的疗效。方法147只SD大鼠各感染50个华支睾吸虫囊蚴,于感染后42～44d分组治疗。各药物采用灌胃给药。①60只感染大鼠随机分为11组(每组4～5... 详细信息

目的观察三苯双脒、青蒿琥酯、蒿甲醚、或吡喹酮单剂、多剂给药,及其伍用治疗感染华支睾吸虫大鼠的疗效。方法147只SD大鼠各感染50个华支睾吸虫囊蚴,于感染后42～44d分组治疗。各药物采用灌胃给药。①60只感染大鼠随机分为11组(每组4～5只),分别为三苯双脒150mg/kg(顿服)、75mg/(kg·d)×2d、50mg/(kg·d)×3d和25mg/kg(tid)×2d组;吡喹酮150mg/kg(顿服)、75mg/(kg·d)×2d和25mg/kg(tid)×2d;青蒿琥酯或蒿甲醚75mg/kg(顿服)和37.5mg/(kg·d)×2d组。②另87只感染大鼠随机分为15组(每组4～6只),用青蒿琥酯或蒿甲醚(30mg/kg)分别与吡喹酮(150mg/kg)、三苯双脒(50mg/kg和75mg/kg)伍用组;三苯双脒(50mg/kg)与吡喹酮(150mg/kg)伍用组;三苯双脒(75mg/kg)与吡喹酮(187.5mg/kg)伍用组,及各药的单用组。并设同批感染未治疗对照组。受治鼠于治疗后2周剖杀,收集胆管和肝组织内的残留华支睾吸虫,计算各组的平均虫数和减虫率,用非参数统计方法(Mann-Whitney秩和检验)对相应组间的平均虫数进行分析。结果感染华支睾吸虫的大鼠口服单剂三苯双脒或吡喹酮(150mg/kg)的减虫率分别为57.2%和63.8%。三苯双脒各小剂量多次给药组的减虫率稍高,达77.1%～79.4%,而吡喹酮小剂量多次给药组的减虫率则为50.6%～54.2%。但两种药物各组间的平均虫数的差异无统计学意义。青蒿琥酯和蒿甲醚各单剂给药组与小剂量多次给药组的减虫率均较高,分别为90.4%～98.5%和100%。三苯双脒小剂量(50或75mg/kg)与吡喹酮(150mg/kg或187.5mg/kg)伍用治疗,减虫率为74.9%～100%,高于其各单药组的减虫率(26.9%～79.6%)。青蒿琥酯或蒿甲醚小剂量(30mg/kg)与吡喹酮(150mg/kg)或三苯双脒(50或75mg/kg)伍用治疗,减虫率为74.9%～97.9%,亦高于其各药组的减虫率(24.8%～79.6%)。结论青蒿琥酯、蒿甲醚、吡喹酮和三苯双脒均为有效的抗华支睾吸虫药物,各药物小剂量伍用具有增效作用。

关键词：三苯双脒青蒿琥酯蒿甲醚吡喹酮大鼠华支睾吸虫联合治疗

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