Is mass treatment the appropriate schistosomiasis elimination strategy?
Is mass treatment the appropriate schistosomiasis elimination strategy?
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DOI：
10.2471/blt.07.047563
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发表时间：
2008-10-01
期刊：
影响因子：
--
通讯作者：
McGarvey, Stephen T
中科院分区：
文献类型：
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作者：
Tallo, Veronica L;Carabin, Hélène;McGarvey, Stephen T
目的2000年，菲律宾卫生部采用吡喹酮大规模化疗消灭血吸虫病。2004年，作为正在进行的流行病学研究“菲律宾血吸虫病传播和生态学”的一部分，向菲律宾西萨马50个村庄的30 187名符合条件的居民提供了大规模治疗，该研究旨在衡量灌溉对血吸虫病感染的影响。本文介绍了大众治疗活动和参与的相关因素。方法宣传，信息传播和社会动员活动进行大众化疗前。村领导主要负责社区动员。在村庄的会议霍尔斯和学校提供集体治疗。参与比例是根据2002-2003年人口普查估计的。社区参与是用参与指数来衡量的。贝叶斯分层逻辑回归模型拟合估计社会人口因素和居民之间的关联来治疗site.Findings一个村庄一级的平均53.1%的居民（范围：21.1-85.3）来到治疗现场，导致大规模治疗覆盖率平均为48.3%（范围：15.8-80.7）。在个人层面上，男性、学龄前和学龄儿童、非STEP参与者和提供粪便样本的参与比例较高。在村一级，更好的社区参与与参与增加，而更大的人口普查与减少participation.Conclusion在50个村庄的大规模治疗的进行导致参与远远低于预期。这引起了人们对发展中国家目前正在进行的大规模治疗倡议的关注。世界卫生组织公报2008;86：765-771。
Objective In the year 2000, the Philippines' Department of Health adopted mass chemotherapy using praziquantel to eliminate schistosomiasis. Mass treatment was offered to an eligible population of 30 187 residents of 50 villages in Western Samar, the Philippines, in 2004 as part of an ongoing epidemiological study, Schistosomiasis Transmission and Ecology in the Philippines (STEP), aimed at measuring the effect of irrigation on infection with schistosomiasis. This paper describes the mass-treatment activities and factors associated with participation.Methods Advocacy, information dissemination and social mobilization activities were conducted before mass chemotherapy. Village leaders were primarily responsible for community mobilization. Mass treatment was offered in village meeting halls and schools. Participation proportions were estimated based on the 2002-2003 census. Community involvement was measured using a participation index. A Bayesian hierarchical logistic regression model was fitted to estimate the association between sociodemographic factors and residents coming to the treatment site.Findings A village-level average of 53.1% of residents (range: 21.1-85.3) came to the treatment site, leading to a mass-treatment coverage with an average of 48.3% (range: 15.8-80.7). At the individual level, participation proportions were higher among males, preschool and school-age children, non-STEP participants and among those who provided a stool sample. At the village-level, better community involvement was associated with increased participation whereas a larger census was associated with decreased participation.Conclusion The conduct of mass treatment in the 50 villages resulted in far lower participation than expected. This raises concern for the ongoing mass-treatment initiatives now taking place in developing countries. Bulletin of the World Health Organization 2008;86:765-771.