The impact of repeated rounds of mass drug administration with diethylcarbamazine plus albendazole on bancroftian filariasis in Papua New Guinea.
The impact of repeated rounds of mass drug administration with diethylcarbamazine plus albendazole on bancroftian filariasis in Papua New Guinea.
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DOI：
10.1371/journal.pntd.0000344
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发表时间：
2008
影响因子：
3.8
通讯作者：
Bockarie MJ
中科院分区：
文献类型：
--
作者：
Weil GJ;Kastens W;Susapu M;Laney SJ;Williams SA;King CL;Kazura JW;Bockarie MJ
这项研究采用了各种监测方法，以评估在巴布亚新几内亚，其中有最大的丝虫病问题在太平洋地区的班氏丝虫病的影响，重复轮的大规模药物管理（MDA）。马当附近的农村居民进行了研究之前和一年后，每三轮的MDA与乙胺嗪加阿苯达唑管理根据世界卫生组织（WHO）的指南。平均MDA依从率为72.9%。三轮MDA使微丝蚴血症率（Mf，通过过滤器收集1 ml夜间血液）从MDA前的18.6%降低到第三轮MDA后的1.3%（降低94%）。感染者经1、2和3轮MDA治疗后，MF清除率分别为71%、90.7%和98.1%。经3轮MDA治疗后，卡片试验（成虫感染的标志物）评估的丝虫抗原血症率从47.5%下降至17.1%（下降64%）。丝虫抗体率（Bm 14的IgG 4抗体，丝虫感染状况和/或接触蚊媒感染性幼虫的指标）从59.3%下降到25.1%（下降54.6%）。与老年人相比，11岁以下儿童的MF、抗原和抗体率下降更快（分别为100%、84.2%和76.8%），这可能反映了他们在MDA之前感染较轻和暴露/感染持续时间较短。在MDA治疗后，微丝蚴血症、丝虫抗原血症和抗丝虫抗体的发病率也显著降低。最近吸食过血的斑点按蚊的丝虫DNA率从15.1%下降到1.0%（下降了92.3%）。MDA对研究地区的所有丝虫病参数都有显着的影响，也降低了发病率。需要进行后续研究，以确定这些村庄居民的残余感染率是否足以支持An的持续传播。punctulatus媒介如果MDA能够有效地提供给流行人群，那么在巴布亚新几内亚消灭淋巴丝虫病应该是可行的。淋巴丝虫病（LF）是一种由蚊子传播的寄生蠕虫引起的变形和致残疾病。虽然许多国家已经启动了基于大规模药物管理（MDA）的LF消除计划，但关于MDA对人群丝虫病患病率和发病率的影响的可靠信息相对较少。这项研究评估了三轮MDA（单剂量乙胺嗪和阿苯达唑）对巴布亚新几内亚村庄丝虫病感染率的影响，巴布亚新几内亚是太平洋地区丝虫病问题最严重的国家。MDA显着降低所有丝虫病感染标志物检测率。这些包括微丝蚴血症（血液中传播感染所必需的寄生虫），丝虫抗原血症（成虫感染的标志物），抗丝虫抗体（表明感染或严重暴露于寄生虫），以及传播感染的蚊子中的寄生虫。除了治愈现有的感染外，MDA还将研究人群的新感染率降低到非常低的水平。这些结果表明，它应该是可能的，以消除LF在巴布亚新几内亚，如果MDA可以有效地提供给流行人群。
This study employed various monitoring methods to assess the impact of repeated rounds of mass drug administration (MDA) on bancroftian filariasis in Papua New Guinea, which has the largest filariasis problem in the Pacific region. Residents of rural villages near Madang were studied prior to and one year after each of three rounds of MDA with diethylcarbamazine plus albendazole administered per World Health Organization (WHO) guidelines. The mean MDA compliance rate was 72.9%. Three rounds of MDA decreased microfilaremia rates (Mf, 1 ml night blood by filter) from 18.6% pre-MDA to 1.3% after the third MDA (a 94% decrease). Mf clearance rates in infected persons were 71%, 90.7%, and 98.1% after 1, 2, and 3 rounds of MDA. Rates of filarial antigenemia assessed by card test (a marker for adult worm infection) decreased from 47.5% to 17.1% (a 64% decrease) after 3 rounds of MDA. The filarial antibody rate (IgG4 antibodies to Bm14, an indicator of filarial infection status and/or exposure to mosquito-borne infective larvae) decreased from 59.3% to 25.1% (a 54.6% decrease). Mf, antigen, and antibody rates decreased more rapidly in children <11 years of age (by 100%, 84.2%, and 76.8%, respectively) relative to older individuals, perhaps reflecting their lighter infections and shorter durations of exposure/infection prior to MDA. Incidence rates for microfilaremia, filarial antigenemia, and antifilarial antibodies also decreased significantly after MDA. Filarial DNA rates in Anopheles punctulatus mosquitoes that had recently taken a blood meal decreased from 15.1% to 1.0% (a 92.3% decrease). MDA had dramatic effects on all filariasis parameters in the study area and also reduced incidence rates. Follow-up studies will be needed to determine whether residual infection rates in residents of these villages are sufficient to support sustained transmission by the An. punctulatus vector. Lymphatic filariasis elimination should be feasible in Papua New Guinea if MDA can be effectively delivered to endemic populations. Lymphatic filariasis (LF) is a deforming and disabling disease that is caused by parasitic worms that are transmitted by mosquitoes. While a number of countries have initiated LF elimination programs based on mass drug administration (MDA), relatively little good information is available on the impact of MDA on filariasis prevalence and incidence rates in populations. This study assessed the impact of three rounds of MDA (with single doses of diethylcarbamazine and albendazole) on filariasis infection rates in villages in Papua New Guinea, which has the largest filariasis problem in the Pacific region. MDA dramatically reduced rates for all filariasis infection markers tested. These included microfilaremia (parasites in blood that are necessary for transmission of the infection), filarial antigenemia (a marker for adult worm infection), anti-filarial antibodies (which indicate infection or heavy exposure to the parasite), and parasites in mosquitoes that transmit the infection. In addition to curing existing infections, MDA also reduced new infection rates in the study population to very low levels. These results suggest that it should be possible to eliminate LF in Papua New Guinea if MDA can be effectively delivered to endemic populations.
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DOI：
10.1186/1475-2883-3-9
发表时间：
2004-09-03
期刊：
Filaria journal
影响因子：
--
作者：
Lammie, Patrick J;Weil, Gary;Ottesen, Eric
通讯作者：
Ottesen, Eric
DOI：
10.4269/ajtmh.2007.76.502
发表时间：
2007-03-01
影响因子：
3.3
作者：
Fischer, Peter;Erickson, Sara M.;Weil, Gary J.
通讯作者：
Weil, Gary J.
DOI：
10.1016/0035-9203(86)90210-5
发表时间：
1986-01-01
影响因子：
2.2
作者：
BRYAN, JH
通讯作者：
BRYAN, JH
DOI：
10.1080/00034983.1987.11812140
发表时间：
1987-08-01
影响因子：
--
作者：
CHARLWOOD, JD;BRYAN, JH
通讯作者：
BRYAN, JH
DOI：
10.4269/ajtmh.2004.70.191
发表时间：
2004-02-01
影响因子：
3.3
作者：
El Setouhy, M;Ramzy, RMR;Weil, GJ
通讯作者：
Weil, GJ