複数の見捨てられた熱帯疾患に対する経口薬物療法:体系的なレビュー
Madhuri Reddy1, Sudeep S Gill, Sunila R Kalkar
1Department of Medicine, Hebrew Rehabilitation Center, Boston, Massachusetts 02131, USA. madhurireddy@hrca.harvard.edu
JAMA
|October 24, 2007
まとめ
同時に経口薬剤治療を行うことで,複数の見捨てられた熱帯疾患を効果的に管理し,効率を向上させ,疾患負担を軽減することができます. これらの治療可能な状態に対する意識の向上は,世界的なコントロールの取り組みにとって極めて重要です.
科学分野:
- トロピカルメディシンは,熱帯医学です.
- 感染症 感染症は感染症です.
- 薬理学 薬理学とは
背景:
- 忘れられた熱帯病 (NTD) は,貧困地域において,貧困を助長する病気である.
- NTDは,HIV/AIDS,結核,マラリアに匹敵する重大な疾病負担を引き起こします.
- 流行している7つのNTDには,既存の経口薬剤治療法があり,複数の疾患に対する有効性がある可能性があります.
研究 の 目的:
- NTDの経口薬物治療に関する証拠を体系的に検討する.
- NTDsの存在と治療可能性の認識を高めるために.
主な方法:
- 1966年から2007年6月に出版されたランダム化比較試験 (RCT) の系統的レビュー.
- 7つの最も一般的なNTDのうち2つまたはそれ以上の同時治療を検討するRCTのためのMEDLINEデータベースを検索しました.
- 口服薬療法に焦点を当てています.
主要な成果:
- 29のRCTが特定され,2〜4つの疾患を同時に対象とした治療法が採用されました.
- アルベンダゾールとダイエチルカルバマジン,アルベンダゾールとイヴァルメクチン,レバミゾールとメベンダゾールなどの組み合わせ療法では,疾患の罹患率が有意に低下しました.
- アルベンダゾールのみなどの単剤治療は,複数のヘルミンチス感染症に対する有効性も示しました.
結論:
- 既存の経口薬剤治療は,同時に複数の流行している見捨てられた熱帯病を効果的に標的にすることができます.
- 同時に治療する戦略は,治療の効率を高め,病気の負担を軽減します.
- NTDと利用可能な口腔療法に関する世界的な認識を高めることは,病気の制御に不可欠です.
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