Spatiotemporal distribution and population at risk of soil-transmitted helminth infections following an eight-year school-based deworming programme in Burundi, 2007-2014
Spatiotemporal distribution and population at risk of soil-transmitted helminth infections following an eight-year school-based deworming programme in Burundi, 2007-2014
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DOI：
10.1186/s13071-017-2505-x
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发表时间：
2017-11-23
影响因子：
3.2
通讯作者：
Magalhaes, Ricardo J. Soares
中科院分区：
文献类型：
--
作者：
Assoum, Mohamad;Ortu, Giuseppina;Magalhaes, Ricardo J. Soares
背景：调查连续的年度驱虫轮次对土壤传播蠕虫(STH)感染流行率和风险数量的时空分布的影响有助于确定即将消灭的社区和需要进一步干预的社区。在这项研究中，我们旨在量化为期8年的大规模药物管理计划(2007年至2014年)对布隆迪STH感染流行的时空分布的影响，并估计布隆迪学龄儿童感染STH的数量。方法：在2007年至2011年布隆迪年度纵向学校调查期间，共收集了40656名儿童的STH感染和人体测量数据；这些数据与2014年进行的全国调查数据相补充。基于贝叶斯模型的地统计学(MBG)被用来生成每个STH物种和年份的预测流行地图。根据预测流行图和人口密度图估计2008-2014年间每个区的高危儿童感染人数。结果：总体上，2008-2011年间STH感染的空间聚集性程度有所下降；2014年所有STH感染的地理聚集性重新出现。该国中部和中部北部的蛔虫和鞭虫感染率下降幅度较小。我们的钩虫预测流行地图表明，该国外围地区的流行率有所下降。在2007至2011年间，预计感染任何STH物种的儿童人数大幅下降，但在2014年，预计感染伦布里亚疟原虫和毛滴虫的儿童人数有所增加。2014年，预计儿童感染伦革热、毛滴虫和钩虫人数最多的地区分别是Kibuye区(n=128,903)、Mabayi区(n=35,302)和Kiemba(n=87,511)。结论：虽然布隆迪的MDA计划导致STH患病率下降，但这种下降在时空上是不同的，仍有一些高患病率，建议应评估治疗覆盖范围和补充干预措施，以提高影响。
Background: Investigating the effect of successive annual deworming rounds on the spatiotemporal distribution of infection prevalence and numbers at risk for soil-transmitted helminths (STHs) can help identify communities nearing elimination and those needing further interventions. In this study, we aim to quantify the impact of an 8-year mass drug administration (MDA) programme (from 2007 to 2014) on the spatiotemporal distribution of prevalence of STH infections and to estimate the number of school-aged children infected with STHs in Burundi.Methods: During annual longitudinal school-based surveys in Burundi between 2007 and 2011, STH infection and anthropometric data for a total of 40,656 children were collected; these data were supplemented with data from a national survey conducted in 2014. Bayesian model based geostatistics (MBG) were used to generate predictive prevalence maps for each STH species and year. The numbers of children at-risk of infection per district between 2008 and 2014 were estimated as the product of the predictive prevalence maps and population density maps.Results: Overall, the degree of spatial clustering of STH infections decreased between 2008 and 2011; in 2014 the geographical clusters of all STH infections reappeared. The reduction in prevalence was small for Ascaris lumbricoides and Trichuris trichiura in the centre and central north of the country. Our predictive prevalence maps for hookworm indicate a reduction in prevalence along the periphery of the country. The predicted number of children infected with any STH species decreased substantially between 2007 and 2011, but in 2014 there was an increase in the predicted number of children infected with A. lumbricoides and T. trichiura. In 2014, the districts with the highest predicted number of children infected with A. lumbricoides, T. trichiura and hookworms were Kibuye district (n = 128,903), Mabayi district (n = 35,302) and Kiremba (n = 87,511), respectively.Conclusions: While the MDA programme in Burundi resulted in a reduction in STH prevalence, this reduction was spatiotemporally heterogeneous, with some pockets of high prevalence remaining, suggesting that treatment coverage and complementary interventions should be evaluated to improve impact.