A Persistent Hotspot of Schistosoma mansoni Infection in a Five-Year Randomized Trial of Praziquantel Preventative Chemotherapy Strategies.
A Persistent Hotspot of Schistosoma mansoni Infection in a Five-Year Randomized Trial of Praziquantel Preventative Chemotherapy Strategies.
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DOI：
10.1093/infdis/jix496
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发表时间：
2017-12-12
期刊：
影响因子：
--
通讯作者：
Secor WE
中科院分区：
文献类型：
--
作者：
Wiegand RE;Mwinzi PNM;Montgomery SP;Chan YL;Andiego K;Omedo M;Muchiri G;Ogutu MO;Rawago F;Odiere MR;Karanja DMS;Secor WE
在一项预防性化疗策略的试验中，发现了曼氏血吸虫感染的热点。1年后，热点村与非热点村差异有统计学意义。根据之前的数据准确地预测了第5年的村庄会议终点。在大规模给药(MDA)控制血吸虫病后，已经描述了持续的热点，但在多年的MDA计划过程中，还没有对它们进行研究。在一项为期5年的基于学校和全村的曼氏血吸虫预防性化疗策略研究的数据中，使用空间扫描统计数据在3个人群中寻找感染热点：5至8岁儿童、9至12岁儿童和成年人。使用负二项回归分析自基线以来的变化，并使用接收者操作特征分析来预测哪些村庄将达到流行和强度终点。我们确定了一个持续的热点，与研究ARM无关，在那里曼氏葡萄球菌感染的流行率和强度没有热点外的村庄减少得那么多。经过1年的丙二醛治疗后，我们发现了与基线的显著差异：我们没有发现缓和这种关系的因素。根据前一年的数据，以中等高的敏感度和特异度预测了在第5年达到指定终点的村庄。与其他村庄相比，MDA策略在降低热点地区的患病率和强度方面效果较差。可以更早地检测到达到第5年终点的村庄，这可能为修改干预策略提供机会。
During a trial of preventive chemotherapy strategies, a hotspot of Schistosoma mansoni infection was found. Significant differences between hotspot and nonhotspot villages were found after 1 year. Villages meeting endpoints at year 5 were predicted from prior data with accuracy. Persistent hotspots have been described after mass drug administration (MDA) for the control of schistosomiasis, but they have not been studied during the course of a multiyear MDA program. In data from a 5-year study of school-based and village-wide preventive chemotherapy strategies for Schistosoma mansoni, spatial scan statistics were used to find infection hotspots in 3 populations: 5- to 8-year-olds, 9- to 12-year-olds, and adults. Negative binomial regression was used to analyze changes from baseline, and receiver operating characteristic analyses were used to predict which villages would reach prevalence and intensity endpoints. We identified a persistent hotspot, not associated with study arm, where S. mansoni infection prevalence and intensity did not decrease as much as in villages outside the hotspot. Significant differences from baseline were realized after 1 year of MDA: we did not identify factors that moderated this relationship. Villages meeting specified endpoints at year 5 were predicted from prior year data with moderately high sensitivity and specificity. The MDA strategies were less effective at reducing prevalence and intensity in the hotspot compared with other villages. Villages that reached year 5 endpoints could be detected earlier, which may provide the opportunity to amend intervention strategies.
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DOI：
10.1126/science.1259504
发表时间：
2015-09-04
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Johnson PT;de Roode JC;Fenton A
通讯作者：
Fenton A
中华人民共和国急性血吸虫病的减少模式。
影响因子：
3.8
作者：
Li SZ;Zheng H;Abe EM;Yang K;Bergquist R;Qian YJ;Zhang LJ;Xu ZM;Xu J;Guo JG;Xiao N;Zhou XN
通讯作者：
Zhou XN
影响因子：
3.8
作者：
Nagi S;Chadeka EA;Sunahara T;Mutungi F;Justin YK;Kaneko S;Ichinose Y;Matsumoto S;Njenga SM;Hashizume M;Shimada M;Hamano S
通讯作者：
Hamano S
影响因子：
0.8
作者：
Kulldorff, M
通讯作者：
Kulldorff, M
影响因子：
11.8
作者：
Crellen, Thomas;Walker, Martin;Webster, Joanne P.
通讯作者：
Webster, Joanne P.