Obstetric Fistula Is a “Neglected Tropical Disease” 英文参考文献.docVIP

Editorial ObstetricFistulaIsa‘‘NeglectedTropicalDisease’’ L.LewisWall1,2 * 1Department of Obstetrics Gynecology, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, United States of America, 2Department of Anthropology,CollegeofArtsandSciences,WashingtonUniversityinSt.Louis,St.Louis,Missouri,UnitedStatesofAmerica The term ‘‘neglected tropical diseases’’ (NTDs) is commonly used to refer to a ‘‘baker’s dozen’’ of infectious conditions prevalent in resource-poor tropical coun- tries. The 13 core diseases in the NTD group include ascariasis, dracunculiasis, hookworm,lymphaticfilariasis,onchocer- ciasis,schistosomiasis,trichuriasis,Chagas disease, human African trypanosomiasis, Buruli ulcer, leprosy, and trachoma [1]. instability, and institutional mismanage- mentthantheyaretoclimaticconditions. The classification of podoconiosis—a de- bilitatingformofelephantiasisthatmimics the classical infection produced by Wuch- ereria bancrofti (but which actually is an urinary tract and the vagina (and some- timesbetweentherectumandthevagina as well) through which urine (or stool) leaks in a continuous and unremitting stream(Figure1). Obstetric fistulas are completely pre- ventable—ifobstructedlaborisdiagnosed early and if appropriate intervention inflammatory geochemical disorder causedbysilicaparticlesabsorbedthrough thefeetofsusceptible,barefootedfarmers who are chronically exposed to volcanic red-claysoils)—asanNTDisevidenceof thistypeofparadigmshift[2,3]. occurs in a timely fashion. This requires thepresenceofaskilledattendantatbirth whocanmakethecorrectdiagnosisanda system of management that functions efficiently to make sure needed interven- tions take place before the awful conse- quences of prolonged obstructed labor develop. Treating obstructed labor cor- rectlyoftenrequiressurgery:performance of a cesarean section that bypasses the obstructioninthepelvisandcreatesanew The World Health Organization has expanded the list to 17 condition