N'Goran E K, Utzinger J, N'Guessan A N, Müller I, Zamblé K, Lohourignon K L, Traoré M, Sosthène B A, Lengeler C, Tanner M
UFR Biosciences, Université de Cocody, Abidjan, Côte d'Ivoire.
Trop Med Int Health. 2001 Oct;6(10):817-25. doi: 10.1046/j.1365-3156.2001.00785.x.
We present the comparative evaluation of school-based chemotherapy with praziquantel on Schistosoma haematobium reinfection patterns, 6, 12, 18 and 24 months after systematic treatment of schoolchildren in four villages of south-central Côte d'Ivoire. At baseline, very high S. haematobium infection prevalences of 88-94% were found in Taabo Village, located adjacent to a large man-made lake, and in Batera and Bodo, where small dams were constructed. In Assinzé, a village with no man-made environmental alterations, the baseline infection prevalence was significantly lower (67%). The parasitological cure rate, assessed 4 weeks after praziquantel administration in the village with the highest prevalence and intensity of infection, was high (82%), and showed a clear association with infection intensity prior to treatment. Six months after chemotherapy, significant reductions in the prevalence and intensity of infection were observed in all villages. However, infection prevalence was again high in Taabo Village (63%) and in Batera (49%). Different patterns of reinfection occurred in the four villages: rapid reinfection in Taabo Village to reach almost baseline infection prevalence 12 months post-treatment; slow but gradual increase in the prevalence and intensity of infection in Bodo; marked increase in prevalence and intensity of infection during the second year of the follow-up in Assinzé; and prevalence and intensity of infection that remained almost constant between 6 and 24 months post-treatment in Batera. Our study confirms that S. haematobium reinfection patterns largely depend on the local epidemiological setting, which is of central importance to tailoring treatment strategies that are well adapted to these different settings.
我们对科特迪瓦中南部四个村庄的在校儿童进行系统性治疗后6个月、12个月、18个月和24个月，采用吡喹酮进行的校本化疗对埃及血吸虫再感染模式的比较评估。在基线时，在紧邻一个大型人工湖的塔博村以及建有小型水坝的巴特拉和博多村，发现埃及血吸虫感染率非常高，达88%-94%。在没有人为环境改变的阿辛泽村，基线感染率显著较低（67%）。在感染率和感染强度最高的村庄，吡喹酮给药4周后评估的寄生虫学治愈率很高（82%），并且与治疗前的感染强度有明显关联。化疗6个月后，所有村庄的感染率和感染强度均显著降低。然而，塔博村（63%）和巴特拉村（49%）的感染率再次很高。四个村庄出现了不同模式的再感染：塔博村快速再感染，在治疗后12个月达到几乎基线感染率；博多村感染率和感染强度缓慢但逐渐增加；在阿辛泽村随访的第二年，感染率和感染强度显著增加；在巴特拉村，治疗后6至24个月期间，感染率和感染强度几乎保持不变。我们的研究证实，埃及血吸虫再感染模式在很大程度上取决于当地的流行病学情况，这对于制定适合这些不同情况的治疗策略至关重要。
