Academic literature on the topic 'Antihelmintika'

Abstract Despite a large and rapidly growing volume of research activity and output, primarily on the biological bases of antimicrobial resistance (AMR), epidemiological understanding of the causal mechanisms at play behind the apparent recent global rise in prevalence of AMR has, arguably, progressed very little. Despite this inconvenient fact, political imperative and expedience, among other drivers, have given substantial impetus to an interventionist approach against what are considered to be the culprits for the apparent growing prevalence of AMR and its impacts. Concern about the rise in prevalence of microbial infections that are resistant to therapeutic agents designed to kill them has arisen almost exclusively in relation to human health. (Public awareness and concern about antihelmintic resistance, for which the impacts are much more substantial for animal health, at least in developed temperate countries, are trivial by comparison). Nevertheless, antimicrobial drugs have been, and are, widely used in animal health and production throughout the world, and the contribution of this diverse usage to the ‘global AMR problem’ has historically been controversial. There is growing acceptance, notwithstanding the limitations in causal understanding noted previously, of AMR as an ecological problem of competing populations of microorganisms experiencing both natural and anthropogenic selection pressures in compartments that transcend species and other boundaries. Typifying what is described as a ‘One Health’ problem, AMR is therefore considered to be most amenable to conjoint mitigation efforts in all compartments: i.e. interventions in human health, animal health, food and the environment in a coherent manner. In animals, this calls into question the motivations and practices for antimicrobial drug usage, the majority of which are justified on the basis of promoting animal health and welfare and securing a food supply for a growing human population. Not surprisingly, there are great differences in animal husbandry and food demand, and in availability, access and regulation of antimicrobial usage in animals, and in surveillance of AMR, which are likely to be starkest between developed and developing countries. Thus, it is unlikely that the impacts of AMR, and the impacts of efforts to mitigate AMR that are directed to the ‘animal compartment’ of the ecosystem, will be felt equally across the world.

Strongyloides stercoralis and hookworms are common soil-transmitted nematodes in tropical and subtropical regions. After the organisms penetrate exposed skin, most infections are asymptomatic, but heavy infections can result in significant morbidity. The roundworm S. stercoralis infects an estimated 30 million to 100 million people. Infection is persistent and may present decades after exposure. Diagnosis is usually by microscopy or culture of stool; serology is useful as a screening test. Treatment is typically with ivermectin or albendazole. Improved sanitation and appropriate footwear can reduce the acquisition of infection. Hookworm infections, mainly caused by Ancylostoma duodenale and Necator americanus, affect more than 500 million people, predominantly in sub-Saharan Africa and Asia. Population-based control programmes, using single-dose antihelmintic therapies, aim to reduce anaemia, and improve childhood growth and cognitive development in countries with high prevalence of soil-transmitted helminths.