Strongyloidiasis is a soil-transmitted helminthiasis that is estimated to affect 300–600 million people across Asia, Africa, South and central America, and the Pacific. This neglected parasitic disease is most known for its ability to persist as a lifelong infection due to autoinfection and its risk of hyperinfection and disseminated disease during immunosuppression, which has a more than 60% case fatality. Despite the large global burden of strongyloidiasis, there have been no large-scale public health programmes or WHO guidelines directed towards its control and elimination. However, over the past decade, key scientific and policy changes along with requests from endemic countries have led to WHO incorporating strongyloidiasis into its 2021–30 roadmap and public health targets for control and elimination of neglected tropical diseases. In 2024, WHO published its first guideline on public health control of strongyloidiasis with a single recommendation: in endemic settings with a Strongyloides stercoralis infection prevalence of 5% or higher (measured either with Baermann or agar plate culture from stool specimens), WHO conditionally recommends mass drug administration with single-dose ivermectin (200 μg/kg; oral therapy) in all age groups from 5 years and older to reduce strongyloidiasis. This Review, written by the 2023–24 strongyloidiasis guidelines development group along with WHO colleagues and international experts, presents a summary of the recently published WHO guideline recommendation for strongyloidiasis, and the supporting evidence, considerations for public health implementation, and future research needs.

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WHO 关于预防性化疗用于类圆线虫病公共卫生控制的指南综述


类圆线虫病是一种土壤传播的蠕虫病，估计影响亚洲、非洲、南美洲和中美洲以及太平洋地区的 300-6 亿人。这种被忽视的寄生虫病最广为人知的是它能够因自身感染而持续存在终生感染，并且在免疫抑制期间存在重度感染和播散性疾病的风险，其病死率超过 60%。尽管类圆线虫病的全球负担沉重，但尚未有针对控制和消除类圆线虫病的大规模公共卫生规划或 WHO 指南。然而，在过去十年中，关键的科学和政策变化以及流行国家的要求导致世卫组织将类圆线虫病纳入其 2021-30 年路线图和公共卫生目标，以控制和消除被忽视的热带病。2024 年，WHO 发布了第一份关于类圆线虫病公共卫生控制的指南，其中有一项建议：在粪类圆线虫感染患病率为 5% 或更高的流行地区（通过粪便标本的 Baermann 或琼脂板培养物测量），WHO 有条件地建议对 5 岁及以上的所有年龄组使用单剂量伊维菌素（200 μg/kg;口服治疗）进行大规模给药，以减少类圆线虫病。本综述由 2023-24 年类圆线虫病指南制定小组与 WHO 同事和国际专家共同撰写，总结了最近发布的 WHO 类圆线虫病指南建议，以及支持证据、公共卫生实施的注意事项和未来的研究需求。