Urogenital schistosomiasis and soil-transmitted helminthiasis (STH) in Cameroon: An epidemiological update at Barombi Mbo and Barombi Kotto crater lakes assessing prospects for intensified control interventions.
Urogenital schistosomiasis and soil-transmitted helminthiasis (STH) in Cameroon: An epidemiological update at Barombi Mbo and Barombi Kotto crater lakes assessing prospects for intensified control interventions.
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DOI：
10.1186/s40249-017-0264-8
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发表时间：
2017-02-27
影响因子：
8.1
通讯作者：
Tchuem-Tchuenté LA
中科院分区：
文献类型：
--
作者：
Campbell SJ;Stothard JR;O'Halloran F;Sankey D;Durant T;Ombede DE;Chuinteu GD;Webster BL;Cunningham L;LaCourse EJ;Tchuem-Tchuenté LA
Barombi Mbo和Barombi Kotto的火山口湖是众所周知的血吸虫病和土传蠕虫病的传播地，以前曾有过几次重要的控制措施。为了收集当代流行病学信息，开展了一项横断面调查，包括：疾病症状和体征、个人治疗史、当地水、环境卫生和个人卫生(WASH)相关因素以及软化监测，并对标本进行了分子特征分析。在每个湖泊进行社区横断面调查，采用粪便和尿液寄生虫学采样相结合的方法，并进行形式问卷访谈。共有338名儿童和成年人参加。用DNA方法对来自蜗牛和寄生虫物种的材料进行了表征。在Barombi Mbo(所有轻度感染)和Barombi Kotto(21.2%重度感染)，泌尿生殖系统血吸虫病的虫卵开放患病率分别为8.7%和40.1%。无肠道血吸虫病发生。在Barombi Kotto，更多的女性报告了与女性生殖器血吸虫病有关的体征和症状。虽然巴龙比姆博的洗澡相关基础设施最近有了广泛的改善，但在感染血吸虫病的参与者(P <； 0.001)和巴龙比科托一般(P <； 0.001)中，接触水的风险得分更高。在这两个湖泊中，STH的平均患病率非常低(6.3%)，表明在过去十年中显著下降了79.0%；既没有发现类圆线虫，也没有发现蛔虫。在29个淡水采样点、13个巴伦比姆博和16个巴龙比科托调查了钉螺；不同湖泊之间的水化学差异显著(P <； 0.0001)，平均pH值(7.9vs.9.6)和平均电导率(64.3vs.64.3μS vs.202.1μS)。在Barombi Kotto中央岛屿上只发现了两只Camerunus感染了血吸虫尾蚴，但后来在这两个湖泊的Bulinus以及来自亚洲的入侵物种IndoPlanorbis exustus中检测到了血吸虫DNA。STH目前处于非常低的水平，而在Barombi Kotto，泌尿生殖系统血吸虫病是最令人担忧的。这项评估强调了进一步研究这些火山口湖泊的流行病学动态的独特机会，以评估未来加强的干预措施，无论是在Barombi Kotto获得和维持控制，还是在Barombi Mbo实现局部阻断这两种疾病的传播。本文的在线版本(doi：10.1186/s40249-0170264-8)包含补充材料，授权用户可以使用。
The crater lakes of Barombi Mbo and Barombi Kotto are well-known transmission foci of schistosomiasis and soil-transmitted helminthiasis having had several important control initiatives previously. To collect contemporary epidemiological information, a cross-sectional survey was undertaken inclusive of: signs and symptoms of disease, individual treatment histories, local water, sanitation and hygiene (WASH)-related factors and malacological surveillance, with molecular characterisation of specimens. At each lake, a community cross-sectional survey was undertaken using a combination of stool and urine parasitological sampling, and interview with pro-forma questionnaires. A total of 338 children and adults participated. Material from snail and parasite species were characterised by DNA methods. Egg-patent prevalence of urogenital schistosomiasis was 8.7% at Barombi Mbo (all light-intensity infections) and 40.1% at Barombi Kotto (21.2% heavy-intensity infections). Intestinal schistosomiasis was absent. At Barombi Kotto, significantly more women reported signs and symptoms associated with female genital schistosomiasis. While there had been extensive recent improvement in WASH-related infrastructure at Barombi Mbo, water contact risk scores were higher among schistosomiasis-infected participants (P < 0.001) and at Barombi Kotto in general (P < 0.001). Across both lakes, mean prevalence of STH was very low (6.3%) evidencing an impressive decrease of 79.0% over the last decade; neither Strongyloides stercoralis nor Ascaris lumbricoides were found. A total of 29 freshwater sampling sites were inspected for snails, 13 in Barombi Mbo and 16 in Barombi Kotto; water chemistry differed significantly (P < 0.0001) between lakes for both mean pH (7.9 v. 9.6) and mean conductivity (64.3 μS v. 202.1 μS) respectively. Only two Bulinus camerunensis found on the central island of Barombi Kotto were observed to shed schistosome cercariae, but schistosome DNA was later detected in Bulinus sampled from both lakes as well as in Indoplanorbis exustus, an invasive species from Asia. STH is currently at very low levels while urogenital schistosomiasis is of greatest concern at Barombi Kotto. This assessment highlights a unique opportunity for further study of the epidemiological dynamics at these crater lakes, to evaluate future intensified interventions both in terms of gaining and sustaining control at Barombi Kotto or in moving towards local interruption of transmission of both diseases at Barombi Mbo. The online version of this article (doi:10.1186/s40249-017-0264-8) contains supplementary material, which is available to authorized users.