Effectiveness of a community-based educational programme in reducing the cumulative incidence and prevalence of human Taenia solium cysticercosis in Burkina Faso in 2011-14 (EFECAB): a cluster-randomised controlled trial.
Effectiveness of a community-based educational programme in reducing the cumulative incidence and prevalence of human Taenia solium cysticercosis in Burkina Faso in 2011-14 (EFECAB): a cluster-randomised controlled trial.
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DOI：
10.1016/s2214-109x(18)30027-5
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发表时间：
2018-04
期刊：
影响因子：
--
通讯作者：
Ganaba R
中科院分区：
文献类型：
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作者：
Carabin H;Millogo A;Ngowi HA;Bauer C;Dermauw V;Koné AC;Sahlu I;Salvator AL;Preux PM;Somé T;Tarnagda Z;Gabriël S;Cissé R;Ouédraogo JB;Cowan LD;Boncoeur-Martel MP;Dorny P;Ganaba R
无药物干预措施在控制人类囊虫病方面的有效性尚不清楚。我们的目的是评估以社区为基础的教育干预措施在降低布基纳法索人囊虫病发病率方面的有效性。我们在2011年至2014年间进行了一项随机分组对照试验。来自三个省（Boulkiemdé，Sanguié和Nayala）的60个合格村庄被随机分配到干预组或对照组。养猪的村庄，如果不是地区首府或位于主要道路上，距离瓦加杜古超过20公里或彼此相距5公里，则符合资格。在每个村庄，要求60名参与者在基线、18个月后（随机化前）和随机化后18个月采集血样。在随机化前访视后，立即按养猪部门对村庄进行区组随机化（1：1）。干预的目的是提高知识的猪带绦虫传播和控制，通过筛选和结构化讨论的52分钟的电影，并通过自尊，联想优势，足智多谋，行动规划，责任（SARAR）的方法，通过预防性卫生和卫生改造（PHAST）模型，以提高社区的自我效能。主要结果是活动性囊虫病，定义为使用B158/B60 ELISA检测循环抗原的存在。在村一级衡量的效果估计使用三个贝叶斯分层模型。本研究注册于ClinicalTrials.gov，编号NCT 0309339。排除了同一随机区组中的两个村庄，最终样本量为58个村庄。总体而言，干预措施倾向于降低活动性囊虫病从基线至随机化后的累积发生率（校正的累积发病率比0·65，95%贝叶斯可信区间[95% CrI] 0·39-1·05）和活动性囊虫病患病率从基线至随机化后降低（校正患病比例比0.84; 95%CrI 0.59 ~ 1.18）。干预措施在Nayala和Sanguié有效，但在Boulkiemdé无效。在一些资源匮乏的环境中，社区参与性干预措施可有效降低囊虫病的发病率和流行率。美国国立卫生研究院（国家神经疾病和中风研究所，Fogarty国际中心和国家普通医学科学研究所）。
The effectiveness of drug-free interventions in controlling human cysticercosis is not well known. We aimed to estimate the effectiveness of a community-based educational intervention in reducing the frequency of human cysticercosis in Burkina Faso. We did a cluster-randomised controlled trial between 2011 and 2014. 60 eligible villages from three provinces (Boulkiemdé, Sanguié, and Nayala) were randomly allocated to the intervention or control group. Villages raising pigs, that were not a regional capital or located on a main road, that were more than 20 km from Ouagadougou or 5 km from one another, were eligible. In each village, 60 participants were asked for blood samples at baseline, 18 months later (before randomisation), and 18 months after randomisation. Villages were block randomised (1:1) by pig-raising department immediately after the pre-randomisation visit. The intervention aimed to improve knowledge of Taenia solium transmission and control through screening and structured discussion of a 52-min movie, and to increase community self-efficacy through a Self-esteem, Associative strengths, Resourcefulness, Action planning, Responsibility (SARAR) approach via the Participatory Hygiene and Sanitation Transformation (PHAST) model. The primary outcome was active cysticercosis, defined as the presence of circulating antigens detected by use of B158/B60 ELISA. Effectiveness measured at the village level was estimated by use of three Bayesian hierarchical models. This study is registered with ClinicalTrials.gov, number NCT0309339. Two villages in the same randomisation block were excluded, resulting in a final sample size of 58 villages. Overall, the intervention tended towards a decrease in the cumulative incidence of active cysticercosis from baseline to after randomisation (adjusted cumulative incidence ratio 0·65, 95% Bayesian credible interval [95% CrI] 0·39–1·05) and a decrease in active cysticercosis prevalence from baseline to after randomisation (adjusted prevalence proportion ratio 0·84; 95% CrI 0·59–1·18). The intervention was shown to be effective in Nayala and Sanguié but not in Boulkiemdé. Community-engaged participatory interventions can be effective at reducing the incidence and prevalence of cysticercosis in some low-resource settings. US National Institutes of Health (National Institute of Neurological Disorders and Stroke, Fogarty International Center, and National Institute of General Medical Sciences).