The impact of 34 years of massive DEC chemotherapy on Wuchereria bancrofti infection and transmission:: the Maupiti cohort
The impact of 34 years of massive DEC chemotherapy on Wuchereria bancrofti infection and transmission:: the Maupiti cohort
复制标题
DOI：
10.1046/j.1365-3156.2001.00682.x
复制
发表时间：
2001-03-01
影响因子：
3.3
通讯作者：
Nguyen, NL
中科院分区：
文献类型：
--
作者：
Esterre, P;Plichart, C;Nguyen, NL
自1955年以来（1960-67年和1970-74年的两个时期除外），在偏远的毛皮蒂岛（法属波利尼西亚），在方案开始时，每半年进行一次大规模DEC化疗并结合病媒控制。1985年和1989年的两次调查结果报告微丝蚴血症为0%，这使人们产生了消灭淋巴丝虫病的希望。我们结合了寄生虫学标准（膜过滤法测定微丝蚴血症），免疫学（抗原血症和特异性IgG抗体的血清水平）和分子水平（基于PCR的蚊子感染评估）技术，并发现只有良好的控制寄生虫：我们发现残留微丝蚴血症的0.4%的样品，（携带者平均水平：101.2 mf/ml），4.6%的人有抗原血症（阳性者平均水平：714.4单位/ml），21.6%的人有特异性IgG（包括一名非常年幼的儿童）。此外，计算出玻里尼西亚伊蚊病媒种群的感染率为1.4%。这些数据是在1997年飓风前获得的，并在1999年得到部分证实（媒介感染率为0.1%）。连同对DEC的一些抗性的可能性，讨论了对消灭淋巴丝虫病至关重要的各种流行病学因素。
Semi-annual mass DEC chemotherapy combined with vector control at the beginning of the programme, has been administered on the remote island of Maupiti (French Polynesia) since 1955 (except two periods in 1960-67 and 1970-74). The results of two surveys in 1985 and 1989, reporting 0% microfilaraemia, led to the hope that the eradication of lymphatic filariasis had been achieved. We combined parasitological criteria (microfilaraemia by membrane filtration), immunological (antigenaemia and serum levels of specific IgG antibodies) and molecular (PCR-based evaluation of infection in mosquitoes) techniques and found only good control of the parasite: We found residual microfilaraemia in 0.4% of the sample (mean level in carriers: 101.2 mf/ml), antigenaemia in 4.6% (mean level in positive persons: 714.4 units/ml) and specific IgG in 21.6% (including in one very young child). In addition, an infection rate of 1.4% was calculated in the Aedes polynesiensis vector population. These data, obtained in 1997 just before a hurricane, were partially confirmed in 1999 (0.1%, of infection rate in the vector). Together with the possibility of some resistance to DEC, various epidemiological factors critical for the eradication of lymphatic filariasis are discussed.