Malaria eradication on islands
Malaria eradication on islands
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DOI：
10.1016/s0140-6736(00)03127-5
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发表时间：
2000-11-04
期刊：
影响因子：
168.9
通讯作者：
Björkman, A
中科院分区：
文献类型：
--
作者：
Kaneko, A;Taleo, G;Björkman, A
要成功。疟疾控制方案需要根据当地的流行病学特点进行调整。瓦努阿图由西南太平洋上80个有人居住的岛屿组成，有低地方性和中地方性疟疾，有持续消灭寄生虫的适宜条件。我们的目的是评估是否可以在孤立的岛屿上消灭疟疾。方法1991年雨季来临前，对Aneityum岛718名居民每周进行氯喹、乙胺嘧啶/磺胺多辛（Fansidar）和伯氨喹的大规模给药，为期9周。在发放药物的同时，向全体人口分发了浸渍氯菊酯的蚊帐。在几个已确定的法劳按蚊繁殖地也引入了食饵鱼。定期疟疾监测在过去9年中一直在继续。瓦努阿图另外两个岛屿，一个有疟疾传播，一个没有疟疾传播，已进行监测以作比较。通过药物依从性（88.3%）和蚊帐供应（每位村民0.94顶蚊帐）衡量的高社区参与导致了Aneityum疟疾传播的持续中断。调查显示，在大规模用药后，恶性疟原虫完全消失，间日疟原虫从1996年起消失，除了两例输入性感染（1993年一例混合感染和1999年一例间日疟原虫感染）。如果有高度的社区参与，通过适应良好的短期大规模药物管理和持续的病媒控制，可以在孤岛上消灭疟疾。
Background To be successful. a malaria control programme needs to be tailored to the local epidemiological characteristics. Vanuatu consists of 80 inhabited islands in the Southwest Pacific, with hypoendemic and mesoendemic malaria and suitable conditions for sustained parasite elimination. We aimed to assess whether malaria can be eliminated on isolated islands.Methods Weekly mass drug administration of chloroquine, pyrimethamine/sulfadoxine (Fansidar), and primaquine was carried out on the entire population of 718 inhabitants of Aneityum island for 9 weeks in 1991 before the onset of the rainy season. Simultaneously with the administration of drugs, permethrin-impregnated bednets were distributed to the entire population. Larvivorous fish were also introduced into several identified breeding sites of Anopheles farauti. Periodic malariometric monitoring has continued for the past 9 years. Two additional islands of Vanuatu, one with and one without malaria transmission, have been monitored for comparison.Findings High community involvement as measured by drug compliance (88.3%) and bednet provision (0.94 nets per villager) has resulted in sustained interruption of malaria transmission in Aneityum. The surveys showed complete absence of Plasmodium falciparum after mass drug administration, and P vivax disappeared from 1996 onwards, with the exception of two instances of imported infections (one mixed infection in 1993 and one P vivax infection in 1999).Interpretation Malaria can be eliminated on isolated islands with well-adapted short-term mass drug administration and sustained vector control if there is a high degree of community participation.