Mass Drug Administration with or Without Insecticide

有或没有杀虫剂的大规模药物管理

• 批准号: 6970382
• 负责人: James Walter Kazura
• 金额: $ 17.54万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-01 至 2010-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6970382
• 关键词: Anopheles; Papua New Guinea; Wuchereria; anthelmintics; clinical research; communicable disease transmission; comorbidity; cooperative study; disease vectors; drug adverse effect; drug resistance; filariasis; genetic polymorphism; human subject; insect control; insecticide resistance; insecticides; longitudinal human study; microorganism disease chemotherapy; ultrasonography

The global program to eliminate lymphatic filariasis (GPELF) is based on the expectation that 4 to 6 annual mass drug administrations (MDA) will reduce LF morbidity to an acceptable level and interrupt transmission, thereby leading to extinction of LF. This strategy is based on as yet limited data from field settings where the burden of LF infection and morbidity are high. Our long terms goals are to assess the proscribed GPELF strategy has been sustained in an area of Papua New Guinea where we have previously nearly completed eliminated LF infection and transmission with four annual cycles of MDA, evaluate in new populations whether integration of MDA with vector control enhances morbidity control and transmission elimination, and under what levels of LF endemicity these complementary interventions are most effective. The specific aims are: 1.To determine the long-term impact of the currently recommended GPELF MDA strategy on reduction of LF morbidity and infection. We will determine whether reduction/elimination of LF-related disease and human infection indicators resulting from 4 consecutive rounds of MDA are sustained 7 to 8 years after cessation of any systematic intervention. 2.To quantify the added benefit of vector control (insecticide impregnated mosquito nets, ITN) to MDA (annual single dose DEC plus albendazole) on Anopheles mosquito-transmitted Wuchereria bancrofti. This aim compares changes in LF morbidity and infection following institution of ITN plus MDA or MDA alone in previously untreated residents of high transmission and moderate transmission areas. 3. To estimate the impact of MDA and ITN on infection levels and transmission of soil transmitted helminths and associated co-morbidities. This aim determines whether MDA that includes albendazole increases the well being of school children, and the possible emergence of parasite resistance against benzimidazole in MDA-treated populations. This work complements parallel studies of the mosquito vector and provides empirical data for mathematical modeling of LF ecology and eradication. Results of these inter-related projects will inform public health policy not only in Papua New Guinea but also other areas of the world where both LF and malaria are transmitted by Anopheles mosquitoes, such as sub-Saharan Africa.

消除淋巴丝虫病全球计划（GPELF）基于这样的预期：每年4至6次大规模药物给药（MDA）将使LF发病率降低到可接受的水平，并中断传播，从而导致LF消失。这一战略是基于来自LF感染和发病率高的实地环境的有限数据。我们的长期目标是评估被禁止的GPELF策略在巴布亚新几内亚的一个地区是否持续，我们之前已经几乎完成了消除LF感染和传播的四个年度周期的MDA，评估在新的人群中MDA与媒介控制的整合是否增强了发病率控制和传播消除，以及在LF流行的什么水平下这些补充干预措施最有效。具体目标是：1.确定目前推荐的GPELF MDA策略对降低LF发病率和感染的长期影响。我们将确定在停止任何系统性干预后，连续4轮MDA治疗导致的LF相关疾病和人类感染指标的减少/消除是否持续7至8年。2.量化媒介控制（杀虫剂浸渍蚊帐，ITN）对MDA（每年单剂量DEC+阿苯达唑）对按蚊传播的班氏吴策线虫的附加效益。本研究旨在比较高传播和中等传播地区既往未经治疗的居民在ITN加MDA或MDA单独治疗后LF发病率和感染率的变化。3.评估MDA和ITN对土壤传播蠕虫感染水平和传播以及相关并发症的影响。这一目标决定了包括阿苯达唑在内的MDA是否能增加学龄儿童的健康，以及是否可能在MDA治疗人群中出现寄生虫对苯并咪唑的耐药性。 这项工作补充了蚊子媒介的平行研究，并为LF生态学和根除的数学建模提供了经验数据。这些相互关联的项目的结果不仅将为巴布亚新几内亚的公共卫生政策提供信息，而且还将为世界上由按蚊传播LF和疟疾的其他地区（如撒哈拉以南非洲）的公共卫生政策提供信息。