子どもの下痢:発展途上国と先進国の間のインターフェース
Nikhil Thapar1, Ian R Sanderson
1Centre for Adult and Paediatric Gastroenterology, Institute of Cell and Molecular Science, Barts and the London, Queen Mary School of Medicine and Dentistry, University of London, London, UK. thaparn@doctors.org.uk
Lancet (London, England)
|February 28, 2004
まとめ
下痢性疾患は,世界の子どもたちの健康にとって大きな脅威であり続けています. 改善された栄養,衛生,ワクチンによる予防は,幼児死亡率と発病率を減らすための鍵です.
科学分野:
- 胃腸内科 胃腸内科
- 小児の感染症について
- グローバル・パブリック・ヘルス
背景:
- 下痢性疾患は,世界中で子供の死亡と発症の主な原因です.
- 病原体は複雑なメカニズムを使用して下痢疾患を引き起こし,免疫媒介性腸内疾患は,微生物-表皮の相互作用が妨げられて発生する可能性があります.
- 栄養不良は,下痢に関連する死亡率の予後に影響を与える重要な要因です.
研究 の 目的:
- 子どもにおける下痢疾患に関する現在の理解をレビューする.
- 口腔再水分補給,栄養補助,新たな治療法など,管理戦略について議論する.
- 全世界の下痢疾患の負担を減らすために予防措置の重要性を強調する.
主な方法:
- 下痢疾患の病原性,管理,予防に関する文献レビュー.
- 感染症,免疫媒介疾患,栄養不良の役割に関する分析.
- 現在のおよび潜在的な治療および予防介入の評価.
主要な成果:
- 経口補水療法 (Oral rehydration therapy) は,胃腸炎の主な治療法である.
- 分泌性下痢を標的とする新薬とプロバイオティクスは有望である.
- ワクチンや栄養,衛生,水へのアクセスに関する改善されたグローバルな政策を含む予防戦略は,最大の可能性を秘めています.
結論:
- 進展はあったものの,下痢性疾患は依然として,子どもたちの健康に重大な世界的な課題となっている.
- 効果的な管理には,口腔リヒダレーションと栄養支援が含まれ,標的型薬物療法とプロバイオティクスが将来の可能性を提示します.
- 社会経済的不平等に対処する世界的な予防戦略は,下痢性疾患の負担を長期的に減らすために不可欠です.
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