The global distribution of lymphatic filariasis, 2000-18: a geospatial analysis
The global distribution of lymphatic filariasis, 2000-18: a geospatial analysis
复制标题
DOI：
10.1016/s2214-109x(20)30286-2
复制
发表时间：
2020-09-01
影响因子：
34.3
通讯作者：
Cromwell, Elizabeth A.
中科院分区：
文献类型：
--
作者：
Cromwell, Elizabeth A.
背景淋巴丝虫病是一种被忽视的热带疾病，可通过破坏淋巴系统导致永久性残疾。这种疾病是由蚊子传播的寄生蠕虫引起的。世界卫生组织（WHO）建议大规模使用抗蠕虫药物，以消除淋巴丝虫病这一公共卫生问题。本研究的目的是产生第一个地理空间估计的全球流行的淋巴丝虫病感染随着时间的推移，量化消除进展，并确定地理分布的变化infection.Methods地理参考调查的位置的全球数据集被用来模拟每年2000-18淋巴丝虫病流行的73个当前或以前流行的国家。我们应用贝叶斯模型为基础的地统计学和时间序列方法，以产生空间连续估计全球所有年龄段2000-18年淋巴丝虫病感染率映射在5公里（2）的分辨率和汇总估计总人数infected.Findings我们使用了14927 datapoints，以适应地理空间模型。据估计，2000年全世界共有1.99亿人（95%不确定区间为1.74 - 2.34亿）感染了淋巴丝虫病，世卫组织各区域的总数从美洲区域的310万（160 - 570万）到东南亚区域的1.07亿（910 - 1.34亿）不等。到2018年，估计有5100万人（4300万至6300万）被感染。在全球范围内观察到广泛的患病率下降，但在非洲和东南亚的重点地区仍然不太可能达到感染流行率阈值提出实现本地elimination.Interpretation虽然自2000年以来，淋巴丝虫病感染的患病率已经下降，MDA仍然是必要的，在非洲和亚洲的大量人口。我们绘制的估计值可用于确定满足感染阈值的概率较低的地区，并且当预测存在较大的不确定性时，表明在MDA计划停止之前可能需要进行额外的数据收集或干预。版权所有（C）2020作者。爱思唯尔有限公司出版
Background Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA) of antihelmintics is recommended by WHO to eliminate lymphatic filariasis as a public health problem. This study aims to produce the first geospatial estimates of the global prevalence of lymphatic filariasis infection over time, to quantify progress towards elimination, and to identify geographical variation in distribution of infection.Methods A global dataset of georeferenced surveyed locations was used to model annual 2000-18 lymphatic filariasis prevalence for 73 current or previously endemic countries. We applied Bayesian model-based geostatistics and time series methods to generate spatially continuous estimates of global all-age 2000-18 prevalence of lymphatic filariasis infection mapped at a resolution of 5 km(2) and aggregated to estimate total number of individuals infected.Findings We used 14927 datapoints to fit the geospatial models. An estimated 199 million total individuals (95% uncertainty interval 174-234 million) worldwide were infected with lymphatic filariasis in 2000, with totals for WHO regions ranging from 3.1 million (1.6-5.7 million) in the region of the Americas to 107 million (91-134 million) in the South-East Asia region. By 2018, an estimated 51 million individuals (43-63 million) were infected. Broad declines in prevalence are observed globally, but focal areas in Africa and southeast Asia remain less likely to have attained infection prevalence thresholds proposed to achieve local elimination.Interpretation Although the prevalence of lymphatic filariasis infection has declined since 2000, MDA is still necessary across large populations in Africa and Asia. Our mapped estimates can be used to identify areas where the probability of meeting infection thresholds is low, and when coupled with large uncertainty in the predictions, indicate additional data collection or intervention might be warranted before MDA programmes cease. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.