After a decade of annual dose mass ivermectin treatment in Cameroon and Uganda, onchocerciasis transmission continues
After a decade of annual dose mass ivermectin treatment in Cameroon and Uganda, onchocerciasis transmission continues
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DOI：
10.1111/j.1365-3156.2008.02126.x
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发表时间：
2008-09-01
影响因子：
3.3
通讯作者：
Richards, Frank O.
中科院分区：
文献类型：
--
作者：
Katabarwa, Moses;Eyamba, Albert;Richards, Frank O.
目的评估10年的年度单剂量伊维菌素治疗对盘尾丝虫病在喀麦隆和乌干达的高流行地区的传播的有效性。方法基线结节和微丝蚴（“皮肤切片”）的患病率数据可从10个高流行的哨点社区在喀麦隆（从1996年）和高流行的20个哨点社区在乌干达（从1993年）。2005年，也就是上一次伊维菌素年度分发10个月后，我们回到这些村庄，重复横断面调查。每个哨点社区报告合格人员的平均间隔治疗覆盖率> 88%（范围37-100%）。对6200多人的检查数据进行了分析。在喀麦隆，1996年基线调查时对719名10岁以上儿童进行了检查，2005年后续调查时对838名儿童进行了检查。在乌干达，1993年基线调查时对1 590名10岁以上的人进行了检查，2005年后续调查时对2 122人进行了检查。我们还检查了喀麦隆（1996年，n = 185; 2005年，n = 448）和乌干达（1993年，n = 177; 2005年，n = 130）的10岁以下儿童。在乌干达，2005年切除的80个结节采用标准组织学标准判断蠕虫的活力。喀麦隆哨点社区的年龄（>= 10岁）从70.1%下降到7.04%（P < 0.0001）;结核携带者从58%上升到9.55%（P < 0.0001）。同样，在乌干达，在13年的治疗期间，微丝蚴携带者的患病率从71.9%降至7.49%（P < 0.0001），结核携带者的患病率从53.21%降至9.66%（P < 0.0001）。喀麦隆10岁以下儿童中微丝蚴携带者从29.73%下降到3.8%（P < 0.0001），乌干达从33.89%下降到3.1%（P < 0.0001）。在2005年，蠕虫切除结节在乌干达，81.4%的男性仍然活着，64%的女性，其中24%的人inseptioned.Conclusion一个十年或更多的年度单剂量伊维菌素治疗在高流行地区已减少盘尾丝虫病的“低地方病”，但盘尾丝虫病传播持续存在。目前，应在以前的中流行区和高流行区继续每年用伊维菌素治疗。
OBJECTIVE To evaluate the effectiveness of 10 years' annual single dose ivermectin treatment on onchocerciasis transmission in hyperendemic areas of Cameroon and Uganda.METHODS Baseline nodule and microfilaria ('skin snip') prevalence data were available from 10 hyperendemic sentinel communities in Cameroon (from 1996) and hyperendemic 20 sentinel communities in Uganda (from 1993). We returned to these villages in 2005, 10 months after the last annual ivermectin distribution, to repeat the cross-sectional surveys. Each sentinel community reported a mean interval treatment coverage of eligible persons of > 88% (range 37-100%). Data were analyzed for more than 6200 person examinations. In Cameroon, 719 people >= 10 years were examined at the baseline survey in 1996 and 838 at the follow-up survey in 2005. In Uganda, 1590 people >= 10 years were examined at the baseline survey in 1993 and 2122 people at the follow-up survey in 2005. We also examined children under 10 in Cameroon (1996, n = 185; 2005, n = 448) and Uganda (1993, n = 177; 2005, n = 130). In Uganda, the vitality of worms was judged using standard histological criteria in 80 nodules excised in 2005.RESULTS The prevalence of microfilaria carriers among older children and adults (>= 10 years) in Cameroon sentinel communities dropped from 70.1% to 7.04% (P < 0.0001) over the 10-year treatment period; that of nodule carriers from 58% to 9.55% (P < 0.0001). Similarly, in Uganda, the prevalence of microfilaria carriers fell from 71.9% to 7.49% (P < 0.0001) over the 13-year treatment period, and that of nodule carriers from 53.21% to 9.66% (P < 0.0001). The number of microfilaria carriers among children < 10 years in Cameroon decreased from 29.73% to 3.8% (P < 0.0001), and in Uganda from 33.89% to 3.1% (P < 0.0001). In 2005, worms excised from nodules in Uganda, 81.4% of males remained alive, and 64% of females, with 24% of them inseminated.CONCLUSION A decade or more of annual single dose ivermectin treatment in hyperendemic areas has reduced onchocerciasis to 'hypoendemicity', but onchocerciasis transmission persists. For now, annual treatment with ivermectin should be continued in formerly mesoendemic and hyperendemic zones.