Specific schistosomiasis treatment as a strategy for disease control
Specific schistosomiasis treatment as a strategy for disease control
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DOI：
10.1590/s0074-02762010000400040
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发表时间：
2010-07-01
期刊：
影响因子：
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通讯作者：
Conceição, Maria José
中科院分区：
文献类型：
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作者：
Coura, José Rodrigues;Conceição, Maria José
血吸虫病治疗的巨大希望开始于奥胺喹和吡喹酮的开发。这些药物可以单次口服，疗效高，副作用小。在这项研究中，我们进行了涉及3,782人的实地实验。在米纳斯吉拉斯州多塞河和杰基廷洪哈河流域的四个地方对人口进行了调查。在这个队列中，有1790例感染了曼氏血吸虫的患者（47.3%），我们发现只有1403例（78.4%）患者可以单次口服12.5- 20mg /kg奥氨喹治疗。另外387人（21.6%）由于禁忌症（怀孕或性障碍疾病）、缺席或拒绝在第一阶段未接受治疗。结果发现，平均8.8-17%的感染患者在治疗后2个月结束时仍在排出曼氏梭菌卵，30-32%的患者在治疗后24个月结束时仍在感染。在我们总共随访了30年的一个地区，曼氏链球菌感染的流行率从60.8-19.3%下降，肝脾型曼氏链球菌感染的流行率从5.8-1.3%下降。我们的结论是，血吸虫病的特异性治疗在短期内降低了感染的流行率，在中长期内降低了血吸虫病的发病率，但无助于控制疾病的传播。
The great hope for schistosomiasis treatment began with the development of oxamniquine and praziquantel. These drugs can be administered orally in a single dose and have a high curative power with minor side effects. In this study, we carried out afield experiment involving a population of 3,782 people. The population was examined at four localities in Minas Gerais within the valleys of the Doce and Jequitinhonha Rivers. In this cohort, there were 1,790 patients infected with Schistosoma mansoni (47.3%) and we showed that only 1,403 (78.4%) could be treated with oxamniquine in a single dose of 12.5-20 mg/kg orally. The other 387 (21.6%) were not treated during the first stage because of contraindications (pregnancy or impeditive diseases), absences or refusals. It was observed that, on average, 8.8-17% of the infected patients continued to excrete S. mansoni eggs at the end of the 2nd month after treatment and 30-32% of the cohort was infected by the end of the 24th month. In one of the areas that we followed-up for a total of 30 years, the prevalence of the infection with S. mansoni fell from 60.8-19.3% and the hepatosplenic form of the disease dropped from 5.8-1.3%. We conclude that specific treatment of schistosomiasis reduces the prevalence of infection in the short-term and the morbidity due to schistosomiasis in medium to long-term time frames, but does not help to control disease transmission.