Distribution of Schistosomiasis and Soil Transmitted Helminthiasis in Zimbabwe: Towards a National Plan of Action for Control and Elimination
Distribution of Schistosomiasis and Soil Transmitted Helminthiasis in Zimbabwe: Towards a National Plan of Action for Control and Elimination
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DOI：
10.1371/journal.pntd.0003014
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发表时间：
2014-08-01
影响因子：
3.8
通讯作者：
Mutapi, Francisca
中科院分区：
文献类型：
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作者：
Midzi, Nicholas;Mduluza, Takafira;Mutapi, Francisca
背景：血吸虫病和性病是世界卫生组织考虑控制的被忽视的热带病之一。虽然这两种疾病在津巴布韦都是地方病，但没有在全国范围内采取控制措施。为此，津巴布韦卫生和儿童保育部于2009年将这两种疾病纳入了2009-2013年国家卫生战略，强调了解这两种疾病的分布和负担的重要性，以此作为消除这两种疾病的干预措施的先决条件。方法：2010年9月至2011年8月，在全国68个地区的280所小学进行了横断面调查。使用尿液过滤技术诊断出埃及血吸虫。曼氏血吸虫（Schistosoma mansoni）和STH（钩虫、鞭虫、蛔虫）的诊断采用Kato Katz和甲醛乙醚浓缩技术。S.埃及血吸虫为18.0%，而S.曼索尼为7.2%。钩虫是最常见的STH，患病率为3.2%，其次是A。蚯蚓和T.鞭毛虫的患病率分别为2.5%和0.1%。WHO定义的任何有害物种的重度感染强度的患病率为5.8%（地区范围为0%-18.3%）。仅观察到STH种属的轻度至中度感染强度。血吸虫病和STH的分布在省、区、校之间差异显著（p < 0.001）。总体而言，血吸虫病和STH合并感染的患病率为1.5%。血吸虫病和STH的实际共流行观察到43（63.2%）的68个districsscreen.Conclusion和建议：本研究提供了全面的基线数据分布的血吸虫病和STH的基础上，启动一个国家控制和消除这两个被忽视的热带疾病在津巴布韦的计划。
Background: Schistosomiasis and STH are among the list of neglected tropical diseases considered for control by the WHO. Although both diseases are endemic in Zimbabwe, no nationwide control interventions have been implemented. For this reason in 2009 the Zimbabwe Ministry of Health and Child Care included the two diseases in the 2009-2013 National Health Strategy highlighting the importance of understanding the distribution and burden of the diseases as a prerequisite for elimination interventions. It is against this background that a national survey was conducted.Methodology: A countrywide cross-sectional survey was carried out in 280 primary schools in 68 districts between September 2010 and August 2011. Schistosoma haematobium was diagnosed using the urine filtration technique. Schistosoma mansoni and STH (hookworms, Trichuris trichiura, Ascaris lumbricoides) were diagnosed using both the Kato Katz and formol ether concentration techniques.Main findings: Schistosomiasis was more prevalent country-wide (22.7%) than STH (5.5%). The prevalence of S. haematobium was 18.0% while that of S. mansoni was 7.2%. Hookworms were the most common STH with a prevalence of 3.2% followed by A. lumbricoides and T. trichiura with prevalence of 2.5% and 0.1%, respectively. The prevalence of heavy infection intensity as defined by WHO for any schistosome species was 5.8% (range 0%-18.3% in districts). Only light to moderate infection intensities were observed for STH species. The distribution of schistosomiasis and STH varied significantly between provinces, districts and schools (p < 0.001). Overall, the prevalence of co-infection with schistosomiasis and STH was 1.5%. The actual co-endemicity of schistosomiasis and STH was observed in 43 (63.2%) of the 68 districts screened.Conclusion and recommendations: This study provided comprehensive baseline data on the distribution of schistosomiasis and STH that formed the basis for initiating a national control and elimination programme for these two neglected tropical diseases in Zimbabwe.