インドにおける伝染病の継続的な課題
T Jacob John1, Lalit Dandona, Vinod P Sharma
1Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
Lancet (London, England)
|January 14, 2011
まとめ
インドは,大規模な感染症の負担に直面しており,現在の垂直プログラムは不十分であることが証明されています. 効果的な疾病管理と全国の医療の質の向上のために,新しい統合された公衆衛生アプローチが緊急に必要とされています.
科学分野:
- 公共衛生は公衆衛生である.
- 感染症疫学 感染症疫学
- 医療政策分析 医療政策分析
背景:
- インドは,広範囲にわたる感染症と向き合っており,重要な行政責任は中央政府と州政府間で共有されています.
- 中央保健省は疾病管理を監督しているが,専用の公衆衛生部門がなく,垂直で単一疾患プログラムに依存している.
研究 の 目的:
- インドの現在の感染症対策戦略の有効性を評価する.
- 監視・対応システムにおけるギャップを特定する.
- 総合的な疾病管理のための改訂された健康政策を提案する.
主な方法:
- インドの既存の感染症対策プログラムの分析.
- 保健システム構造と行政責任の見直し.
- 病気の監視とアウトブレイク対応メカニズムの評価.
主要な成果:
- 垂直プログラムでは成功が混じっている.HIVとハンセン病のコントロールは進んでいるが,結核,マラリア,内臓リーシュマニア症のコントロールは課題に直面している.
- 媒介者の不十分な封じ込めは,デング熱,チクングンヤ熱,チフス熱の再発を引き起こす.
- 糞便で伝染する病原体や動物性感染症に対する体系的なコントロールは欠けている.
- 感染症の監視・対応システムには大きなギャップがある.
結論:
- 現在の垂直単一疾病管理のモデルは,インドにとって非効率で持続可能ではない.
- 公平で質の高い医療のために,保健システムの包括的な見直しと再設計が不可欠です.
- 統合的疾病管理のために,専門的なリーダーシップと訓練されたスタッフを持つ共有され,機能的な公衆衛生インフラストラクチャの創設が推奨されます.
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