Study and implementation of urogenital schistosomiasis elimination in Zanzibar (Unguja and Pemba islands) using an integrated multidisciplinary approach.
Study and implementation of urogenital schistosomiasis elimination in Zanzibar (Unguja and Pemba islands) using an integrated multidisciplinary approach.
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DOI：
10.1186/1471-2458-12-930
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发表时间：
2012-10-30
影响因子：
4.5
通讯作者：
Rollinson D
中科院分区：
文献类型：
--
作者：
Knopp S;Mohammed KA;Ali SM;Khamis IS;Ame SM;Albonico M;Gouvras A;Fenwick A;Savioli L;Colley DG;Utzinger J;Person B;Rollinson D
血吸虫病是一种寄生虫感染，在许多发展中国家仍然是一个主要的公共卫生问题，仅在非洲就造成估计至少140万残疾调整生命年的负担。重要的是，在包括桑给巴尔在内的世界一些地区，血吸虫病的发病率已大大降低。桑给巴尔政府现在致力于消灭泌尿系统血吸虫病。在接下来的3-5年内，所有高危人群将每两年接受两次吡喹酮(40 mg/kg)治疗。此外，将在选定的社区实施钉螺控制和行为改变干预措施，并在随机干预试验中衡量结果和影响。在这项为期5年的研究中，将在温加岛和奔巴岛每年用尿液过滤和试纸对45个社区的4,500名9-12岁学龄儿童、4,500名一年级学童和2,250名成人进行尿路血吸虫病评估。此外，还将采集一年级学童的手指血样，检查血吸虫感染的生物标志物。将每年对流行率和感染强度的变化进行评估。在45个社区中，15个社区被随机分成两年一次的氯硝柳胺灭螺组，与预防性化疗活动一致。将调查球形泥螺和感染血吸虫的钉螺种群的减少情况。在其他15个社区中，已经设计了引发行为改变的干预措施，并将与社区合作实施。每年将通过重点小组讨论和对学童、教师、家长和社区领袖的深入访谈，对知识、态度和做法的变化进行评估。在所有45个社区中，卫生系统、水和卫生基础设施的变化将通过标准化问卷--与社区领导人的访谈--每年进行跟踪。可能影响研究结果和所有产生的费用的其他问题将被记录下来，并进行纵向监测。消灭血吸虫病已成为桑给巴尔政府和国际社会议程上的优先事项。我们的研究将有助于确定除了预防性化疗外，还需要做些什么来预防、控制和最终消灭血吸虫病，并为非洲和其他地区当前和未来的血吸虫病消灭方案吸取经验教训。ISRCTN48837681
Schistosomiasis is a parasitic infection that continues to be a major public health problem in many developing countries being responsible for an estimated burden of at least 1.4 million disability-adjusted life years (DALYs) in Africa alone. Importantly, morbidity due to schistosomiasis has been greatly reduced in some parts of the world, including Zanzibar. The Zanzibar government is now committed to eliminate urogenital schistosomiasis. Over the next 3–5 years, the whole at-risk population will be administered praziquantel (40 mg/kg) biannually. Additionally, snail control and behaviour change interventions will be implemented in selected communities and the outcomes and impact measured in a randomized intervention trial. In this 5-year research study, on both Unguja and Pemba islands, urogenital schistosomiasis will be assessed in 45 communities with urine filtration and reagent strips in 4,500 schoolchildren aged 9–12 years annually, and in 4,500 first-year schoolchildren and 2,250 adults in years 1 and 5. Additionally, from first-year schoolchildren, a finger-prick blood sample will be collected and examined for Schistosoma haematobium infection biomarkers. Changes in prevalence and infection intensity will be assessed annually. Among the 45 communities, 15 were randomized for biannual snail control with niclosamide, in concordance with preventive chemotherapy campaigns. The reduction of Bulinus globosus snail populations and S. haematobium-infected snails will be investigated. In 15 other communities, interventions triggering behaviour change have been designed and will be implemented in collaboration with the community. A change in knowledge, attitudes and practices will be assessed annually through focus group discussions and in-depth interviews with schoolchildren, teachers, parents and community leaders. In all 45 communities, changes in the health system, water and sanitation infrastructure will be annually tracked by standardized questionnaire-interviews with community leaders. Additional issues potentially impacting on study outcomes and all incurring costs will be recordedand monitored longitudinally. Elimination of schistosomiasis has become a priority on the agenda of the Zanzibar government and the international community. Our study will contribute to identifying what, in addition to preventive chemotherapy, needs to be done to prevent, control, and ultimately eliminate schistosomiasis, and to draw lessons for current and future schistosomiasis elimination programmes in Africa and elsewhere. ISRCTN48837681
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DOI：
10.4269/ajtmh.1995.52.549
发表时间：
1995-06-01
影响因子：
3.3
作者：
ETARD, JF;AUDIBERT, M;DABO, A
通讯作者：
DABO, A
影响因子：
2.4
作者：
Aagaard-Hansen, J.;Mwanga, J. R.;Bruun, B.
通讯作者：
Bruun, B.
影响因子：
3.3
作者：
Guidi, A.;Andolina, C.;Haji, H. Juma
通讯作者：
Haji, H. Juma
影响因子：
2.4
作者：
Gower, C. M.;Shrivastava, J.;Webster, J. P.
通讯作者：
Webster, J. P.
影响因子：
56.3
作者：
Gray, Darren J.;McManus, Donald P.;Ross, Allen G.
通讯作者：
Ross, Allen G.