Lymphatic filariasis elimination endgame in an urban Indian setting: the roles of surveillance and residual microfilaremia after mass drug administration.
Lymphatic filariasis elimination endgame in an urban Indian setting: the roles of surveillance and residual microfilaremia after mass drug administration.
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DOI：
10.1186/s40249-021-00856-x
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发表时间：
2021-05-18
影响因子：
8.1
通讯作者：
Alexander N
中科院分区：
文献类型：
--
作者：
Modi A;Vaishnav KG;Kothiya K;Alexander N
为了确保淋巴丝虫病（LF）消除计划取得成果，需要关注“残留微丝虫血症阶段”，其中高危人群可能至关重要。本研究记录了大规模药物管理（MDA）对苏拉特市印度城市环境的影响，该城市的移民率很高。流行病学评估包括国家丝虫病控制计划 (NFCP) 和世界卫生组织分别推荐的常规和 MDA 前微丝虫血症调查。全年每月对约 2000-4000 人进行常规丝虫调查，而 MDA 前的调查每年在四个固定和四个随机地点对约 4000 人进行。 2016年，对小学生进行了传播评估调查（TAS）。结果是微丝丝血症（Mf）和抗原流行率；更具体地说，根据出生地、MDA 前和 2008 年至 2015 年收集的常规夜间血涂片 (NBS) 中的微丝丝血症。计算患病率和置信区间。研究期间共检查了 25 480 例 MDA 前检查和 306 198 例常规 NBS 检查。 2008 年，常规调查中的 Mf 患病率为 63/18 814 (0.33%)，下降至 2016 年的 23/39 717 (0.06%)。MDA 前调查也显示出类似的下降，从 2008 年的 47/4184 (1.1%) 下降到 2015 年的 12/4042 (0.3%)。在苏拉特，MDA 前的调查[患病率：3.17，95% 置信区间 (CI)：1.15–8.72] 和常规调查（3.31，95% CI：1.47–7.48）中，微丝蚴血症下降到传播阈值以下，但仍是其余人群的三倍多。尽管 TAS 结果表明 MDA 已达到终点，但亚组分析发现 90% 的抗原基因儿童来自高危人群家庭。广泛的长期流行病学监测表明，包括高危人群在内的所有城市人口都从ELF计划中受益。为了防止在不卫生条件有利于丝虫媒介繁殖的大城市地区再次感染，除了MDA前监测和TAS之外，还需要通过定制调查来识别残留的微丝虫血症。目前的研究结果可用于制定策略，在达到 MDA 终点后优先对高危人群进行筛查、监测和计划治疗。在线版本包含可在 10.1186/s40249-021-00856-x 获取的补充材料。
To secure the gains of lymphatic filariasis (LF) elimination programs, attention is needed to the ‘residual microfilaremia phase’, in which high-risk populations may be crucial. The present study documents the impact of mass drug administration (MDA) in the urban Indian setting of Surat City, with high rates of in-migration. Epidemiological assessment included National Filaria Control Program (NFCP) and World Health Organization recommended routine and pre-MDA microfilaremia surveys respectively. Routine filaria surveys were conducted around the year in approximately 2000–4000 people per month, while pre-MDA surveys were carried out annually among approximately 4000 people from four fixed and four random sites. In 2016, Transmission Assessment Survey (TAS) was done in primary school children. The outcomes were microfilaremia (Mf) and antigen prevalence; more specifically, microfilaremia according to place of birth, in pre-MDA and routine night blood smears (NBS) collected from 2008 to 2015. Prevalence ratios and confidence intervals were calculated. A total of 25 480 pre-MDA and 306 198 routine NBS were examined during the study. In 2008, the Mf prevalence in the routine survey was 63/18 814 (0.33%), declining to 23/39 717 (0.06%) in 2016. Pre-MDA surveys showed a similar decrease from 47/4184 (1.1%) in 2008 to 12/4042 (0.3%) in 2015. In those born outside Surat, microfilaremia decreased below transmission thresholds, but remained more than treble that of the remainder of the population, in both the pre-MDA surveys [prevalence ratio: 3.17, 95% confidence interval (CI): 1.15–8.72], and the routine surveys (3.31, 95% CI: 1.47–7.48). Though the TAS results indicated that MDA endpoints had been reached, sub-group analysis identified that 90% of antigenemic children were from families of high-risk groups. Extensive long-term epidemiological monitoring suggests that all the urban population, including high-risk groups, have benefitted from the ELF program. To prevent re-establishment of infection in large urban areas with unsanitary conditions conducive to filarial vector breeding, there is need to identify residual microfilaremia by customized surveys in addition to pre-MDA monitoring and TAS. The present findings can be used to develop strategies to prioritize screening, surveillance and plan treatment of high-risk groups after achieving MDA endpoints. The online version contains supplementary material available at 10.1186/s40249-021-00856-x.
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影响因子：
1.9
作者：
Ridout, MS;Demétrio, CGB;Firth, D
通讯作者：
Firth, D
影响因子：
3.8
作者：
Chu BK;Deming M;Biritwum NK;Bougma WR;Dorkenoo AM;El-Setouhy M;Fischer PU;Gass K;Gonzalez de Peña M;Mercado-Hernandez L;Kyelem D;Lammie PJ;Flueckiger RM;Mwingira UJ;Noordin R;Offei Owusu I;Ottesen EA;Pavluck A;Pilotte N;Rao RU;Samarasekera D;Schmaedick MA;Settinayake S;Simonsen PE;Supali T;Taleo F;Torres M;Weil GJ;Won KY
通讯作者：
Won KY
影响因子：
3.8
作者：
Gazzinelli A;Correa-Oliveira R;Yang GJ;Boatin BA;Kloos H
通讯作者：
Kloos H
影响因子：
3.8
作者：
Gass K;Beau de Rochars MV;Boakye D;Bradley M;Fischer PU;Gyapong J;Itoh M;Ituaso-Conway N;Joseph H;Kyelem D;Laney SJ;Legrand AM;Liyanage TS;Melrose W;Mohammed K;Pilotte N;Ottesen EA;Plichart C;Ramaiah K;Rao RU;Talbot J;Weil GJ;Williams SA;Won KY;Lammie P
通讯作者：
Lammie P
DOI：
10.1016/s0377-1237(06)80109-7
发表时间：
2006-10-01
期刊：
Medical journal, Armed Forces India
影响因子：
--
作者：
Agrawal, V K;Sashindran, V K
通讯作者：
Sashindran, V K