Assessing the burden and spatial distribution of Taenia solium human neurocysticercosis in Ecuador (2013-2017)
Assessing the burden and spatial distribution of Taenia solium human neurocysticercosis in Ecuador (2013-2017)
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DOI：
10.1371/journal.pntd.0008384
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发表时间：
2020-06-01
影响因子：
3.8
通讯作者：
Calvopina, Manuel
中科院分区：
文献类型：
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作者：
Coral-Almeida, Marco;Henriquez-Trujillo, Aquiles R.;Calvopina, Manuel
作者摘要猪带绦虫神经囊尾蚴病 (NCC) 是一种被忽视的人类寄生虫感染，可导致多种神经系统后遗症，如癫痫和慢性头痛。本研究的目的是利用国家统计和人口普查局 (INEC) 2013-2017 年期间的官方全国数据库来估计厄瓜多尔 NCC 的负担，并评估与 NCC 相关的四种神经系统疾病的空间集群。以残疾调整生命年 (DALY) 衡量的 NCC 负担估计为每 1000 人 3.54 至 3.56 DALY。在全国范围内发现了几个重要的 NCC 及其后遗症疾病风险增加的空间集群，其中大部分集中在塞拉利昂南部省份。我们的研究表明，在厄瓜多尔南部省份的几个“热点”中，NCC 病例的存在与癫痫、癫痫持续状态、偏头痛和脑积水等神经系统疾病的较高患病率之间可能存在空间相关性，这表明可能需要在一些地区采取预防措施来降低囊尾蚴病的传播率。 背景 估计被忽视的热带疾病的负担是支持政策制定者分配资源以控制和消除这些疾病的宝贵工具。空间分析可以识别一个国家内传染病和寄生虫病的地理分布模式，并可以评估它们与其他健康疾病可能的相关性。尽管神经囊尾蚴病 (NCC) 被认为是神经系统最重要的寄生虫病，但很少有人努力评估 NCC 在流行国家的实际负担，迄今为止，还没有研究估计南美洲 NCC 的负担。在本研究中，我们旨在使用残疾调整生命年（DALY）和空间指标作为工具来衡量2013年至2017年厄瓜多尔人类神经囊尾蚴病的影响。方法使用国家统计局的死亡率、发病率和空间数据来估计五年期间（2013-2017年）NCC的疾病负担。 NCC 病例及其两种主要后遗症（癫痫和偏头痛）按性别和年龄组进行分层，使用 R 中的 DALY 软件包计算与 NCC 相关的 DALY。 SATSCAN 软件用于评估 NCC 的空间簇及其可能的神经系统后遗症，如癫痫、癫痫持续状态、偏头痛和脑积水。 主要发现人类神经囊尾蚴病的负担范围为 56201 [95% CI 29961-89333] 至 59612 [95% CI 31854-94689] 每年 DALY，相当于每 1000 人 3.54 至 3.56 DALY。每 10 000 人每年的平均发病率为 NCC 0.23 [95% CI 0.21-0.26]，癫痫为 4.89 [95% CI 4.78-5.00]，癫痫持续状态为 0.130 [95% CI 0.11-0.15]，癫痫持续状态为 0.62 [95% CI偏头痛为 0.58-0.66]，脑积水为 1.02 [95% CI 0.98-1.07]。最重要的显着空间集群 (p
Author summaryTaenia solium-neurocysticercosis (NCC) is a neglected parasite infection in humans causing a variety of neurological sequelae like epilepsy, and chronic headache. The purpose of this study was to estimate the burden of NCC in Ecuador using official nation-wide databases from the National Institute of Statistics and Census (INEC) for the period of 2013-2017, and to assess for spatial clusters of four neurological disorders associated with NCC. The burden of NCC measured in Disability Adjusted Life Years (DALY) was estimated in 3.54 to 3.56 DALY per 1000 population. Several significant spatial clusters for augmented risk of disease were identified along the country for NCC and its sequelae, most of which converged in the southern Sierra provinces. Our study suggests a possible spatial correlation between the presence of NCC cases and a higher prevalence of neurological conditions like epilepsy, status epilepticus, migraine, and hydrocephalus in several 'hot spots' of the southern provinces of Ecuador, indicating possible areas where the application of preventive measures is necessary to reduce cysticercosis transmission rates.BackgroundEstimating the burden of neglected tropical diseases is a valuable tool to support policymakers in the resource allocation for control and elimination of these diseases. Spatial analysis allows to identify the geographical distribution patterns of infectious and parasitic diseases within a country and allows to assess their possible correlation with other health disorders. Despite being neurocysticercosis (NCC) considered as the most important parasitic disease of the nervous system, few efforts have been addressed to assess the real burden of NCC in endemic countries, to date, there are no studies estimating the burden of NCC in South America. In this study we aimed to use the Disability Adjust Life Years (DALY) and spatial indicators as tools to measure the impact of human neurocysticercosis in Ecuador between 2013 and 2017.MethodsMortality, morbidity and spatial data from the national agency of statistics were used to estimate the burden of disease of NCC during a five-year period (2013-2017). NCC cases and its two main sequelae, epilepsy and migraine headache, were stratified by sex and age group to calculate the DALY associated to NCC using the DALY package in R. SATSCAN software was used to assess spatial clusters of NCC and its possible neurological sequelae as epilepsy, status epilepticus, migraine and hydrocephalus.Principal findingsThe burden of human neurocysticercosis ranged from 56201 [95% CI 29961-89333] to 59612 [95% CI 31854-94689] DALY per year, corresponding to 3.54 to 3.56 DALY per 1000 population. Average yearly incidence rates per 10 000 person-years were 0.23 [95% CI 0.21-0.26] for NCC, 4.89 [95% CI 4.78-5.00] for epilepsy, 0.130 [95% CI 0.11-0.15] for status epilepticus, 0.62 [95% CI 0.58-0.66] for migraine headache, and 1.02 [95% CI 0.98-1.07] for hydrocephalus. Most important significant spatial clusters (p