Impact of a national helminth control programme on infection and morbidity in Ugandan schoolchildren.
Impact of a national helminth control programme on infection and morbidity in Ugandan schoolchildren.
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DOI：
10.2471/blt.06.030353
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发表时间：
2007-02
影响因子：
11.1
通讯作者：
Fenwick, Alan
中科院分区：
文献类型：
--
作者：
Kabatereine, Narcis B;Brooker, Simon;Koukounari, Artemis;Kazibwe, Francis;Tukahebwa, Edridah M;Fleming, Fiona M;Zhang, Yaobi;Webster, Joanne P;Stothard, J Russell;Fenwick, Alan
我们的目的是评估乌干达针对血吸虫病和肠道线虫的国家控制计划对健康的影响，该计划自2003年以来一直提供基于人群的驱虫化疗。我们对乌干达8个地区37所学校的1871名随机选择的学龄儿童进行了感染状况、血红蛋白浓度和临床发病率的纵向调查，调查时间分为三个时间点--化疗前和每年大规模化疗后一年和两年。大量使用吡喹酮和阿苯达唑治疗导致曼氏血吸虫感染强度显著降低，治疗1年后降低70%（95%置信区间（CI）：66-73%），治疗2年后降低82%（95% CI：80-85%）。钩虫感染的强度也降低了（75%和93%;未调整）。治疗1年（0.135 g/dL（95% CI：0.126-0.144））和2年（0.303 g/dL（95% CI：0.293-0.312））后血红蛋白浓度显著升高，早期临床发病率体征显著降低。干预对S.曼氏感染率和强度与化疗对人类血吸虫病影响的数学模型预测的结果相似。血红蛋白浓度的改善在贫血或患有重度S的儿童中最大。基线时的曼氏感染。作为国家蠕虫控制方案的一部分提供的驱虫治疗可以减少学童的感染和发病率，并改善血红蛋白浓度。
We aimed to assess the health impact of a national control programme targeting schistosomiasis and intestinal nematodes in Uganda, which has provided population-based anthelmintic chemotherapy since 2003. We conducted longitudinal surveys on infection status, haemoglobin concentration and clinical morbidity in 1871 randomly selected schoolchildren from 37 schools in eight districts across Uganda at three time points — before chemotherapy and after one year and two years of annual mass chemotherapy. Mass treatment with praziquantel and albendazole led to a significant decrease in the intensity of Schistosoma mansoni — 70% (95% confidence interval (CI): 66-73%) after one year and 82% (95% CI: 80-85%) after two years of treatment. Intensity of hookworm infection also decreased (75% and 93%; unadjusted). There was a significant increase in haemoglobin concentration after one (0.135 g/dL (95% CI: 0.126-0.144)) and two years (0.303 g/dL (95% CI: 0.293-0.312)) of treatment, and a significant decrease in signs of early clinical morbidity. The impact of intervention on S. mansoni prevalence and intensity was similar to that predicted by mathematical models of the impact of chemotherapy on human schistosomiasis. Improvements in haemoglobin concentration were greatest among children who were anaemic or harbouring heavy S. mansoni infection at baseline. Anthelmintic treatment delivered as part of a national helminth control programme can decrease infection and morbidity among schoolchildren and improve haemoglobin concentration.