Transmission of onchocerciasis in wadelai focus of northwestern Uganda has been interrupted and the disease eliminated.
Transmission of onchocerciasis in wadelai focus of northwestern Uganda has been interrupted and the disease eliminated.
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DOI：
10.1155/2012/748540
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发表时间：
2012
影响因子：
2.2
通讯作者：
Richards FO
中科院分区：
文献类型：
--
作者：
Katabarwa MN;Walsh F;Habomugisha P;Lakwo TL;Agunyo S;Oguttu DW;Unnasch TR;Unoba D;Byamukama E;Tukesiga E;Ndyomugyenyi R;Richards FO
Wadelai是乌干达西北部一个孤立的盘尾丝虫病集中地，被选为消除盘尾丝虫病战略的试点，该战略最终成为全国消除盘尾丝虫病政策的先驱。Wadelai的重点战略是将伊维菌素治疗频率从每年增加到每半年，并扩大地理区域，以包括结核率低于20%的社区。这些社区没有被以前的政策所覆盖，以前的政策只把盘尾丝虫病作为一个公共卫生问题加以控制。从2006年到2010年，Wadelai计划成功地实现了最终治疗目标（UTG），治疗覆盖率≥ 90%，尽管从19个社区扩大到34个社区，从5，600个年度治疗增加到29，000个半年治疗。2009年的评估显示，在接受检查的500多人的皮肤切片中没有发现微丝蚴，3 011名儿童中只有1名对OV 16重组抗原呈IgG 4抗体阳性。没有发现模拟病毒载体，它们的消失可能加速了传播的中断。虽然每年两次治疗在阻断传播方面的作用尚不清楚，但经验表明，在乌干达，每年两次治疗是可行的。监测数据支持这样的结论，即盘尾丝虫病已从乌干达的Wadelai重点地区消除。
Wadelai, an isolated focus for onchocerciasis in northwest Uganda, was selected for piloting an onchocerciasis elimination strategy that was ultimately the precursor for countrywide onchocerciasis elimination policy. The Wadelai focus strategy was to increase ivermectin treatments from annual to semiannual frequency and expand geographic area in order to include communities with nodule rate of less than 20%. These communities had not been covered by the previous policy that sought to control onchocerciasis only as a public health problem. From 2006 to 2010, Wadelai program successfully attained ultimate treatment goal (UTG), treatment coverage of ≥90%, despite expanding from 19 to 34 communities and from 5,600 annual treatments to over 29,000 semiannual treatments. Evaluations in 2009 showed no microfilaria in skin snips of over 500 persons examined, and only 1 of 3011 children was IgG4 antibody positive to the OV16 recombinant antigen. No Simulium vectors were found, and their disappearance could have sped up interruption of transmission. Although twice-per-year treatment had an unclear role in interruption of transmission, the experience demonstrated that twice-per-year treatment is feasible in the Ugandan setting. The monitoring data support the conclusion that onchocerciasis has been eliminated from the Wadelai focus of Uganda.