Impact of two rounds of mass treatment with diethylcarbamazine plus albendazole on Wuchereria bancrofti infection and the sensitivity of immunochromatographic test in Malindi, Kenya
Impact of two rounds of mass treatment with diethylcarbamazine plus albendazole on Wuchereria bancrofti infection and the sensitivity of immunochromatographic test in Malindi, Kenya
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DOI：
10.1016/j.trstmh.2008.04.039
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发表时间：
2008-10-01
影响因子：
2.2
通讯作者：
Molyneux, D. H.
中科院分区：
文献类型：
--
作者：
Njenga, S. M.;Wamae, C. N.;Molyneux, D. H.
建议将地方性人群的年度单剂集体治疗方案作为消除淋巴丝虫病方案的主要方案，联合使用二乙基丙咪嗪(DEC)或伊维菌素加阿苯达唑。我们在肯尼亚一个流行地区的试点消除计划中评估了DEC和阿苯达唑两轮年度大规模药物管理(MDA)对班克罗夫斯坦丝虫病的影响。在两个MDA后，微丝虫病的总体患病率下降了65.4%，而社区微丝虫病负荷下降了84%。免疫层析试验(ICT)检测的寄生虫抗原血症患病率在两次MDA后显著下降了43.5%。我们还研究了大规模治疗对ICT敏感性的影响。虽然治疗前敏感性较高(89.9%；K=0.909)，但两次MDA后敏感性较低(59.3%；K=0.644)。这一发现引起了人们对信息和通信技术在长期监测感染和建立方案终点方面的可靠性的关注。本研究的结果表明，使用DEC/阿苯达唑联合使用丙二醛对班氏吴氏杆菌感染有相对较高的疗效，因此，这可能是在无盘尾丝虫病地区消除淋巴丝虫病的有用策略。(C)2008年皇家热带医学和卫生学会。爱思唯尔有限公司出版。保留所有权利。
Annual single-dose mass treatment of endemic populations with a combination of either diethylcarbamazine (DEC) or ivermectin plus albendazole is recommended as the mainstay of lymphatic filariasis elimination programmes. We evaluated the impact of two rounds of annual mass drug administration (MDA) of DEC and albendazole on bancroftian filariasis in a pilot elimination programme in an endemic area of Kenya. Overall prevalence of microfilaraemia decreased by 65.4%, whereas community microfilarial load decreased by 84% after the two MDAs. The prevalence of parasite antigenaemia determined by immunochromatographic test (ICT) declined significantly by 43.5% after the two MDAs. We also studied the effect of mass treatment on the sensitivity of the ICT. Although the sensitivity of the test before treatment was high (89.9%; K =0.909) sensitivity was lower after two MDAs (59.3%; K = 0.644). The finding raises concern about the reliability of the ICT in long-term monitoring of infection and for establishing programmatic endpoints. The results of the present study indicate a relatively high effectiveness of MDA using a DEC/albendazole combination against Wuchereria bancrofti infection and, therefore, it may be a useful strategy to eliminate lymphatic filariasis in onchocerciasis-free areas. (c) 2008 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.