Characteristics of persistent hotspots of Schistosoma mansoni in western Cote d'Ivoire
Characteristics of persistent hotspots of Schistosoma mansoni in western Cote d'Ivoire
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DOI：
10.1186/s13071-020-04188-x
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发表时间：
2020-07-02
影响因子：
3.2
通讯作者：
Utzinger, Juerg
中科院分区：
文献类型：
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作者：
Assare, Rufin K.;N'Tamon, Romeo N.;Utzinger, Juerg
背景：吡喹酮预防性化疗是控制血吸虫病的基石。然而，在一些社会生态环境中，尽管进行了多轮预防性化疗，血吸虫感染的患病率和/或强度并没有显着降低，这种现象被称为持续热点（PHS）。我们评估了科特迪瓦曼氏血吸虫流行区的PHS特征。方法：2016年10月，在多轮预防性化疗一年后，对科特迪瓦西部地区的14所学校进行了横断面调查。每所学校的 50 名 9 至 12 岁儿童提供了两份粪便样本和一份尿液样本。对粪便样本进行三次 Kato-Katz 厚涂片检测。曼索尼诊断。通过过滤方法检查尿样中的链球菌。血红蛋白蛋。 PHS 的定义是未能降低 S 的患病率。曼氏菌感染减少至少 35% 和/或感染强度降低至少 50%。对六所学校进行了更为详细的调查，包括人口特征问卷调查和软体动物学调查。结果：在六所进行详细调查的学校中，S.的总体患病率。曼索尼亚和S.埃及草炭含量分别为 9.5% 和 2.6%。四所学校被列为 PHS。 TheS。四所 PHS 学校的曼索尼流行率为 10.9%，而其余两所学校的曼索尼流行率为 6.6%。 TheS。曼氏菌感染强度（以受感染儿童每克粪便的算术平均虫卵数 (EPG) 表示）在 PHS 中为 123.8 EPG，在其他两所学校中为 18.7 EPG。在开放的淡水水体中沐浴的儿童发生这种情况的几率更高。曼氏菌感染（比值比：4.5，95% 置信区间：1.6-12.6）。共检查了 76 个人水接触点（小灵通 53 个，其他学校 23 个），收集钉螺 688 只，其中包括血吸虫潜在中间宿主钉螺（Biomphalaria pfeifferi、Bulinus forskalii、Bu. globosus 和 Bu. truncatus）。 较多接触血吸虫传播。我们的研究结果呼吁采取综合控制方法，用其他干预措施补充预防性化疗，特别是在 PHS 环境中。
Background: Preventive chemotherapy with praziquantel is the cornerstone of schistosomiasis control. However, in some social-ecological settings, the prevalence and/or intensity ofSchistosomainfection does not lower meaningfully despite multiple rounds of preventive chemotherapy, a phenomenon termed persistent hotspot (PHS). We assessed the characteristics of PHS in aSchistosoma mansoni-endemic area of Cote d'Ivoire.Methods: In October 2016, a cross-sectional survey was conducted in 14 schools in the western part of Cote d'Ivoire, one year after multiple rounds of preventive chemotherapy. In each school, 50 children aged 9-12 years provided two stool samples and one urine sample. Stool samples were subjected to triplicate Kato-Katz thick smears forS. mansonidiagnosis. Urine samples were examined by a filtration method forS. haematobiumeggs. PHS was defined as failure to achieve a reduction in the prevalence ofS. mansoniinfection of at least 35% and/or a reduction of infection intensity of at least 50%. Six schools underwent more detailed investigations, including a questionnaire survey for demographic characteristics and a malacological survey.Results: In the six schools subjected to detailed investigations, the overall prevalence ofS. mansoniandS. haematobiumwas 9.5% and 2.6%, respectively. Four schools were classified as PHS. TheS. mansoniprevalence in the four PHS was 10.9% compared to 6.6% in the remaining two schools. TheS. mansoniinfection intensity, expressed as arithmetic mean eggs per gram of stool (EPG) among infected children, was 123.8 EPG in PHS and 18.7 EPG in the other two schools. Children bathing in open freshwater bodies were at higher odds ofS. mansoniinfection (odds ratio: 4.5, 95% confidence interval: 1.6-12.6). A total of 76 human-water contact sites (53 in PHS and 23 in the other schools) were examined and 688 snails were collected, including potential intermediate host snails ofSchistosoma(Biomphalaria pfeifferi,Bulinus forskalii,Bu. globosusandBu. truncatus).Conclusion: Children in PHS schools bathed more frequently in open freshwater bodies, and hence, they are more exposed toSchistosomatransmission. Our findings call for an integrated control approach, complementing preventive chemotherapy with other interventions, particularly in PHS settings.