A Community-Based Study of Factors Associated with Continuing Transmission of Lymphatic Filariasis in Leogane, Haiti
A Community-Based Study of Factors Associated with Continuing Transmission of Lymphatic Filariasis in Leogane, Haiti
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DOI：
10.1371/journal.pntd.0000640
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发表时间：
2010-03-01
影响因子：
3.8
通讯作者：
Lammie, Patrick J.
中科院分区：
文献类型：
--
作者：
Boyd, Alexis;Won, Kimberly Y.;Lammie, Patrick J.
在淋巴丝虫病（LF）高流行地区海地Leogane进行了七轮大规模药物管理（MDA）。哨点调查显示，微丝蚴血症患病率从高达15.5%的水平降至1.1%，表明传播已减少。对2至4岁儿童进行了一项单独的30组调查，以确定MDA是否中断了传播。抗原和抗体阳性率分别为14.3%和19.7%。在6个村庄进行了后续调查，包括那些被选中进行聚类调查的村庄，以评估与LF持续传播相关的风险因素，并确定传播热点。每个村庄的100所房屋都使用GPS PDA进行了测绘，然后选择了30所房屋和10所备用房屋进行测试。在选定的房子里的所有人都被要求参加一个简短的调查，关于参加MDA，在Leogane居住的历史和LF的一般知识。调查小组在夜间返回房屋，采集血液进行抗原检测、微丝蚴血症和Bm 14抗体检测，并同时从这些社区采集蚊子。抗原流行率在6个村庄之间差异很大，最高为38.2%（Dampus），最低为2.9%（Corail Lemaire）;总体抗原流行率为18.5%。对2- 4岁儿童的初步聚类调查与社区抗原流行率无关。最近邻分析发现感染聚集的证据，表明LF感染是分布的焦点。系统性不依从MDA的个体，即从未参与MDA的个体，其抗原流行率显著高于依从个体（p
Seven rounds of mass drug administration (MDA) have been administered in Leogane, Haiti, an area hyperendemic for lymphatic filariasis (LF). Sentinel site surveys showed that the prevalence of microfilaremia was reduced to,1% from levels as high as 15.5%, suggesting that transmission had been reduced. A separate 30-cluster survey of 2- to 4-year-old children was conducted to determine if MDA interrupted transmission. Antigen and antifilarial antibody prevalence were 14.3% and 19.7%, respectively. Follow-up surveys were done in 6 villages, including those selected for the cluster survey, to assess risk factors related to continued LF transmission and to pinpoint hotspots of transmission. One hundred houses were mapped in each village using GPS-enabled PDAs, and then 30 houses and 10 alternates were chosen for testing. All individuals in selected houses were asked to participate in a short survey about participation in MDA, history of residence in Leogane and general knowledge of LF. Survey teams returned to the houses at night to collect blood for antigen testing, microfilaremia and Bm14 antibody testing and collected mosquitoes from these communities in parallel. Antigen prevalence was highly variable among the 6 villages, with the highest being 38.2% (Dampus) and the lowest being 2.9% (Corail Lemaire); overall antigen prevalence was 18.5%. Initial cluster surveys of 2- to 4-year-old children were not related to community antigen prevalence. Nearest neighbor analysis found evidence of clustering of infection suggesting that LF infection was focal in distribution. Antigen prevalence among individuals who were systematically noncompliant with the MDAs, i.e. they had never participated, was significantly higher than among compliant individuals (p