Impact of a national deworming campaign on the prevalence of soil-transmitted helminthiasis in Uganda (2004-2016): Implications for national control programs.
Impact of a national deworming campaign on the prevalence of soil-transmitted helminthiasis in Uganda (2004-2016): Implications for national control programs.
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DOI：
10.1371/journal.pntd.0006520
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发表时间：
2018-07
影响因子：
3.8
通讯作者：
M Tukahebwa E
中科院分区：
文献类型：
--
作者：
Adriko M;Tinkitina B;Arinaitwe M;Kabatereine NB;Nanyunja M;M Tukahebwa E
土壤传播的蠕虫和贫血可能会降低和延缓学龄儿童的认知和身体发育，这对非洲的国家控制方案具有重大影响。经过13年的驱虫和有限的健康教育运动，开展了一项研究，以评估驱虫干预措施对乌干达学龄儿童土壤传播蠕虫感染的流行率和强度的影响。在乌干达的六个地区进行了一项横断面研究，根据该国的生态区，每个地区随机选择两个地区。研究范围包括中部的姆皮吉和纳卡松奥拉；卡拉莫贾的纳卡皮里特和科蒂多；西尼罗河的阿鲁阿和扬贝；北部的古鲁和阿列布通；东部的卡里罗和姆巴莱；西部的霍马和本迪布乔。每个学区随机抽取五所学校，每所学校随机抽取50名6-14岁的儿童。每名儿童都采集了粪便样本，并检查是否存在蠕虫感染。每个参与者都接受了一份简短的预测问卷，以了解他们对STH感染的知识、态度和行为，以及他们的控制。对学校的环境卫生进行了一般性的观察。使用GPS机器(Garmin®GPSMAP62，Garmin Ltd，英国南安普顿)对每所学校的位置进行地理参考。共调查4285名儿童，其中中部地区719名(16.82%)，东部地区718名(16.80%)，北部地区719名(16.82%)，卡拉莫贾地区689名(18.82%)，西尼罗河地区717名(16.77%)，西部地区723名(16.91%)。儿童的平均年龄为12.6岁，标准差为1.8岁，最小年龄为6岁，年龄上限为12岁。男孩(50.1%)和女孩(49.9%)的比例相当。8.8%(95%可信区间；8.0-9.7)至少感染一种性传播疾病。其次是鞭虫(1.3%；95%CI；1.0-1.7)和蛔虫(0.5%；95%CI；0.3-0.7)。一些儿童患有曼氏血吸虫，13.0%(95%可信区间：12.0-14.0)。所有儿童都知道什么是土壤传播的蠕虫(62.8%，95%CI：61.3~64.2)，最常见的信息来源是：家庭(39%，95%CI：37.1~40.8)、媒体(11%，95%CI：9.8~12.2)、学校(65.7%，95%CI：63.9~67.5)和朋友(11.5%，95%CI：10.3~12.7)。大多数人知道如何通过土壤传播蠕虫：吃受污染的食物(77.5%，95%CI：76.0-79.1)、赤脚走路(59.6%，95%CI：57.8-61.5)、饮用受污染的水(52.9%，95%CI：51.0-54.8)、在肮脏的地方玩耍(21.8%，95%CI：20.2-23.3)和脏手(2.3%，95%CI：1.7-2.9)。事实证明，每半年一次的驱虫运动在显着减少乌干达大部分地区的蠕虫感染方面是有效的。定期评价对于评估干预措施的影响和指导方案执行至关重要。我们的数据显示，在接受调查的大多数地区，感染流行率已降至STH发病率不再具有公共卫生重要性的水平。土壤传播的蠕虫可能会阻碍学龄儿童(SAC)的身体发育和认知发展，这对非洲的国家控制项目具有重大影响。在乌干达，1998年至2002年的基线调查表明，大多数地区的STH患病率超过60.0%，最常见的蠕虫感染是钩虫、蛔虫和鞭虫。2003年发起了两次全国驱虫运动，目标是1-14岁的儿童。经过十多年的驱虫运动，2016年性传播感染总患病率降至8.8%。这些发现表明，常规的驱虫运动可以减少STH的暴露和感染。定期方案评估是确定在2020年前实现消除目标所取得进展的关键。
Soil-transmitted Helminths and Anemia potentially reduce and retard cognitive and physical growth in school-age children with great implications for national control programs in Africa. After 13 years of deworming and limited health education campaigns, a study was undertaken to evaluate the impact of deworming interventions on the prevalence and intensity of soil-transmitted helminthic infections in school-age children in Uganda. A cross-sectional study was carried out in six regions of Uganda, where two districts were randomly selected per region based on the ecological zones in the country. Included in the study were the districts; Mpigi and Nakasongola from the Central; Nakapiripirit and Kotido from Karamoja; Arua and Yumbe from West Nile; Gulu and Alebtong from the North; Kaliro and Mbale from the East; Hoima and Bundibugyo in the West. Five schools were randomly selected from each district and in each school 50 children aged 6–14 years were randomly selected. Stool samples were taken each child and examined for the presence of helminthic infections. A short pretested questionnaire was administered to each participant to obtain their knowledge, attitude, and practice relating to STH infections, their control. General observations were made on environmental sanitation in the schools. The location of each school was geo-referenced using a GPS machine (Garmin®GPSMAP62, Garmin Ltd, Southampton, UK). In total, 4,285 children were assessed including 719(16.82%) from central region, 718(16.80%) from eastern region, 719 (16.82%) from northern region, 689 (18.82%) from Karamoja region, 717(16.77%) from West Nile region and 723(16.91%) from western region. The average age of the children was 12.6 years with a standard deviation, SD 1.8 years and the minimum age was 6 years and upper age limit of 12 years. The percentage of boys (50.1%) and girls (49.9%) was comparable. 8.8% (95% CI; 8.0–9.7) were infected with at least any one STH species. Hookworm was the most prevalent (7.7%; 95% CI; 6.9–8.5) followed by whipworms (Trichuris trichiura) (1.3%; 95% CI; 1.0–1.7) and roundworms (Ascaris lumbricoides) (0.5%; 95% CI; 0.3–0.7). Some children had Schistosoma mansoni, 13.0% (95% CI; 12.0–14.0). All the children knew what soil transmitted helminths were (62.8%, 95% CI: 61.3–64.2) and most common knowledge of information were from; home (39%, 95% CI: 37.1–40.8), media (radio& newspaper)(11%, 95% CI: 9.8–12.2), school(65.7%, 95% CI: 63.9–67.5) and friends(11.5%, 95% CI: 10.3–12.7). Majority were aware of how one gets infected with soil transmitted helminths through; eating contaminated food (77.5%, 95% CI: 76.0–79.1), walking barefoot (59.6%, 95% CI: 57.8–61.5), drinking contaminated water (52.9%, 95% CI: 51.0–54.8), playing in dirty places (21.8%, 95% CI: 20.2–23.3) and dirty hands (2.3%, 95% CI: 1.7–2.9). Semi-annual deworming campaigns have proved effective in significantly reducing helminthic infections in most of the districts in Uganda. Regular evaluations are vital to assess impact of the interventions and guide programme implementation. Our data shows that the prevalence of infection has been reduced to a level where STH morbidity is no longer of public health importance in most districts surveyed. Soil-transmitted Helminths potentially reduce physical growth and retard cognitive development in school-age children (SAC) with great implications for national control programs in Africa. In Uganda, baseline investigations between 1998 and 2002, indicated STH prevalence was over 60.0% in most districts, the commonest worms infections were Hookworms, Ascaris and Trichuris. Twice a year national deworming campaign was initiated in 2003 targeting aged 1–14 years. Over ten years of deworming campaigns, has reduced the overall STH prevalence to 8.8% in 2016. The findings suggest routine deworming campaigns reduce STH exposure and infections. Periodic program evaluations are key to determining the progress made in order to achieve the elimination targets by 2020.
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影响因子：
3.8
作者：
Anderson RM;Truscott JE;Pullan RL;Brooker SJ;Hollingsworth TD
通讯作者：
Hollingsworth TD
影响因子：
3.8
作者：
Anselmi M;Buonfrate D;Guevara Espinoza A;Prandi R;Marquez M;Gobbo M;Montresor A;Albonico M;Racines Orbe M;Martin Moreira J;Bisoffi Z
通讯作者：
Bisoffi Z
DOI：
10.1016/j.trstmh.2005.03.015
发表时间：
2006-03-01
影响因子：
2.2
作者：
Kabatereine, NB;Tukahebwa, E;Fenwick, A
通讯作者：
Fenwick, A
影响因子：
3.8
作者：
Echazú A;Bonanno D;Juarez M;Cajal SP;Heredia V;Caropresi S;Cimino RO;Caro N;Vargas PA;Paredes G;Krolewiecki AJ
通讯作者：
Krolewiecki AJ
影响因子：
1.8
作者：
Kabatereine N;Fleming F;Thuo W;Tinkitina B;Tukahebwa EM;Fenwick A
通讯作者：
Fenwick A