アジトロマイシンによる単発治療の後に再発した: 縦断的な研究

Oriol Mitjà¹, Charmie Godornes², Wendy Houinei³

¹Barcelona Institute for Global Health, Hospital Clinic-University of Barcelona, Barcelona, Spain; Division of Public Health, School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea; Lihir Medical Center, International SOS-Newcrest Mining, Lihir Island, Papua New Guinea.

Lancet (London, England)

|February 12, 2018

まとめ

WHOのヤウズ撲滅戦略は短期的には成功したが,アジトロマイシン耐性菌が再発したため長期的には失敗した. 大量処理を繰り返すのが必要かもしれません.

科学分野:

熱帯医学
感染症の疫学
抗菌剤耐性

背景:

熱帯地域の子供に慢性的な潰瘍を引き起こす.
世界保健機関 (WHO) は大量アジトロマイシン治療によるヤウズ撲滅の戦略を採用しました.
パイロット試験では,ヤウスの流行の短期的な減少が示されました.

研究の目的:

WHOのヤウズ撲滅戦略の長期的効果を評価する.
大量治療後に再発する卵巣の評価.
治療の失敗と耐性を引き起こす要因を特定する.

主な方法:

パプアニューギニアのヤウ島で縦断的な研究が行われました
臨床検査,血清検査,PCR検査は42ヶ月間にわたって行われました.
遺伝子型と旅行歴は,感染の輸入と拡散を追跡するために使用されました.

主要な成果:

大量アジトロマイシン治療は18ヶ月で活発なヤウを1. 8%から0. 1%に減少させましたが,42ヶ月で0. 4%に再現しました.
アジトロマイシン耐性変異はヤウ株で検出され,一部の症例では臨床失敗が観察されました.
潜伏のヤウと株の遺伝的多様性の減少は,伝播の減少を示したが,排除は示さなかった.

結論:

WHOの戦略では病原性の高い地域社会で長期にわたるヤウスの撲滅を達成できませんでした
集団治療中に欠席し,その後再発する個人が重要な課題でした.
アジトロマイシンに耐性のあるTreponema pallidum pertenueの出現は,強化された監視と重複した大量治療の可能性を必要とします.

さらに関連する動画

07:12

Individualized rTMS Treatment for Depression using an fMRI-Based Targeting Method

Published on: August 2, 2021

4.3K

11:39

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Published on: July 11, 2013

39.5K

関連する概念動画

01:26

Longitudinal Studies

538

Longitudinal studies are also widely used in other medical and social science fields. For instance, in cardiovascular research, they can monitor patients' health over decades to identify risk factors for heart disease, such as high cholesterol or smoking, and evaluate the long-term effectiveness of preventive measures. Similarly, in mental health studies, researchers might follow individuals from adolescence into adulthood to understand the development and progression of conditions like...

538

02:20

Longitudinal Research

13.5K

Sometimes we want to see how people change over time, as in studies of human development and lifespan. When we test the same group of individuals repeatedly over an extended period of time, we are conducting longitudinal research. Longitudinal research is a research design in which data-gathering is administered repeatedly over an extended period of time. For example, we may survey a group of individuals about their dietary habits at age 20, retest them a decade later at age 30, and then again...

13.5K

01:27

Open Angle Glaucoma: Treatment

1.0K

In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...

1.0K

02:56

Treatment Resistant Cancers

3.8K

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...

3.8K

01:24

Parkinson's Disease: Treatment

1.2K

Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...

1.2K

01:22

Alzheimer's Disease: Treatment

987

Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...

987

関連する実験動画