9I制作厂免费

Dr. Greg Matlashewski

听

World Health Organization, Geneva
and Professor, Department of Microbiology and Immunology,
9I制作厂免费, Montreal

"Visceral leishmaniasis: Elimination with existing interventions"

听

听

Abstract

There are over 500,000 visceral leishmaniasis cases each year worldwide with 70% of these cases occurring in border regions of Northern India, Southern Nepal and Bangladesh. In these countries, leishmaniasis remains embedded in the endemic villages where people either die or suffer for many months before seeking treatment. For 2 years, I have worked with the World Health Organization and leading experts and policy makers from India, Nepal and Bangladesh to establish a unified strategy to eliminate leishmaniasis from these countries. The elimination target is a 95% reduction from the current level of about 20 cases in 10,000 in the highly endemic areas. Unique epidemiological features of this disease in the Indian sub-continent make elimination possible, including; (1) humans are the only reservoir, (2) only one Sandfly vector species, (3) the Sandfly is susceptible to insecticides and (4) the geographic distribution is limited and highly clustered. The elimination strategy must be simple, using inexpensive and effective interventions that work on a larger scale. The strategy will combine the training of village ASHAs (village health personnel) in active case finding in the endemic villages and holding fever camps. Suspect cases will be transported by rickshaw to primary health centers located within several kilometers of the endemic villages and treated with a "single dose" of intravenous AmBisome that has been shown to be safe and provide a 95% cure rate. Therefore, patients will be diagnosed and treated on the same day near their village. This approach directly attacks the disease through actively reducing the human reservoir and reducing transmission. Rapid diagnosis and treatment will be further supported by vector control programs including insecticide treated bednets and other novel approaches focused on the endemic villages. If a deadly disease like visceral leishmaniasis can be eliminated using these simple strategies, shouldn鈥檛 this approach be one of the highest priorities for global public health.