Increase of intestinal schistosomiasis after praziquantel treatment in a Schistosoma haematobium and Schistosoma mansoni mixed focus
Increase of intestinal schistosomiasis after praziquantel treatment in a Schistosoma haematobium and Schistosoma mansoni mixed focus
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DOI：
10.1016/s0001-706x(99)00013-3
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发表时间：
1999-07-30
期刊：
影响因子：
2.7
通讯作者：
Sellin, B
中科院分区：
文献类型：
--
作者：
Ernould, JC;Ba, K;Sellin, B
最近在塞内加尔河下游三角洲出现了埃及血吸虫和曼氏血吸虫混合疫源地，需要采取适当的控制方案。 1994 年 4 月，地方当局在三个村庄组织了一次大规模吡喹酮治疗，并对居民进行了检查。共有 2042 名受试者参与。在萨瓦涅，S. haematobium 盛行（患病率为 53%），在迪亚甘巴利，S. haematobium (64%) 和 S. mansoni (76%) 都很丰富，在邦杜姆，S. mansoni 盛行 (53%)。根据代表性样本评估治疗覆盖率 (80%)。 968 名接受治疗的受试者在治疗后 40、100、200 和 300 天进行了随访。治疗六周后，埃及沙门氏菌的平均排卵量减少了 95%，萨瓦涅的排卵量从 23 降至每 10 英里 1 个，迪亚甘巴尔的排量从每 10 英里 14 降至 1 个。相反，曼氏沙门氏菌的卵排泄量仅减少了 75%，在 Boundoum 从 23 蛋/克减少到 6 枚蛋/克，在 Diagambal 则从 69 蛋/克减少到 16 蛋/克，这表明曼氏沙门氏菌当地菌株对吡喹酮的敏感性较低。治疗十个月后，萨瓦涅的埃及沙门氏菌再感染率仍然很低（2 个卵/10 毫升），而邦杜姆的曼氏沙门氏菌的再次感染率很高（24 个卵/克），从而补偿了治疗引起的负荷减少。在迪亚甘巴尔，治疗前存在两种寄生虫，治疗后尿路血吸虫病消失，而肠道血吸虫病急剧增加。曼氏沙门氏菌卵排泄量比处理前高出七倍（478 卵/克）。根据三个村庄的传播生态来讨论这些不同的治疗效果。 (C) 1999 Elsevier Science B.V. 保留所有权利。
The recent emergence of a mixed focus of Schistosoma haematobium-Schistosoma mansoni, in the lower delta of the Senegal river, requires adapted control programmes. A mass treatment with praziquantel was organised in April 1994 by local authorities in three villages where populations had been examined. A total of 2042 subjects participated. In Savoigne S. haematobium prevailed (53% for prevalence), in Diagambaly S. haematobium (64%) and S. mansoni (76%) were both abundant, and in Boundoum S. mansoni prevailed (53%). Therapeutic coverage (80%) was assessed on a representative sample. A cohort of 968 treated subjects were followed-up 40, 100, 200 and 300 days after treatment. Six weeks after treatment, the average of egg excretion decreased by 95% for S. haematobium, ranging from 23 to one egg(s)/10 mi at Savoigne and from 14 to one egg(s)/10 mi at Diagambal. Conversely, egg excretion only decreased by 75% for S. mansoni, from 23 to six eggs/g at Boundoum and from 69 to 16 eggs/g at Diagambal, showing evidence of the low susceptibility of S. mansoni local strain to praziquantel. Ten months after treatment, reinfections with S. haematobium remained weak at Savoigne (two eggs/10 ml) while those with S. mansoni were so high at Boundoum (24 eggs/g) that they compensated the reduction of load induced by the treatment. At Diagambal, where the two parasites were present before treatment, the disappearance of the urinary schistosomiasis after treatment concurred with a dramatic increase of intestinal schistosomiasis. S. mansoni egg excretion was seven times higher than before treatment (478 eggs/g). These different effects of treatment are discussed according to the ecology of transmission in the three villages. (C) 1999 Elsevier Science B.V. All rights reserved.