Schistosomiasis Japonica The DALYs Recaptured 英文参考文献.docVIP

ExpertCommentary SchistosomiasisJaponica:TheDALYsRecaptured CharlesH.King* CenterforGlobalHealthandDiseases,CaseWesternReserveUniversitySchoolofMedicine,Cleveland,Ohio,UnitedStatesofAmerica TheChallengeofEstimatingDisabilitydueto Schistosomiasis devalued the importance of preventing schistosome infection. Accordingly,inhealthpolicymaking,schistosomiasiswasrelegated to be one of the most ‘‘neglected’’ among the neglected tropical diseases(NTDs)[4,12]. Schistosomaparasitesaredisease-producingtrematodes,or‘‘blood flukes’’,thatinfectanestimated207millionpeopleworldwide[1]. Althoughschistosomesarecommoninthedevelopingworld,their roleinhumandiseaseanddisabilityisnotwidelyappreciated,even by tropical medicine and health policy specialists [2]. A disability analysisreportedbyFinkelsteinandcolleaguesinthiseditionofPLoS NeglectedTropicalDiseases[3]ispartofanewresearchmovementthat aimstocorrectthisproblem. Inreality,theday-to-dayexperienceofschistosomiasisinvolves anumberofunder-acknowledged,insidious,sub-clinicalmorbid- itiesthataffectpatientsonadailybasis.Manycurrentstudiesare nowfocusingontheseaspectsofdisease,includingperformance- related impacts such as chronic anemia, malnutrition, cognitive impairment, and physical endurance. However, to dispute the GBD program’s previous underassessments, we need further, evidence-based assessments that will provide more valid overall disability weights that can be used to add up the lifetime health burdenofhavingan‘‘average’’infectionwithschistosomiasis[4]. Bywayofbackground,itshouldberecognizedthatanyinfection withthemajorspeciesthataffecthumans,i.e.,Schistosomahaematobium, S. mansoni, or S. japonicum, can cause chronic disability [4]. Schistosometransmissionoccursinornearfreshwater,andrequires thepresenceofspecificintermediatehostsnails[5].Schistosomiasisis alsostronglyassociatedwithpoverty—snail-bearingwatermustbe contaminated by human sewage for the snails to acquire their infection. Then, in turn, people must come into conta