Mani T R, Rajendran R, Sunish I P, Munirathinam A, Arunachalam N, Satyanarayana K, Dash A P
Centre for Research in Medical Entomology, Madurai, India.
Trop Med Int Health. 2004 Sep;9(9):1030-5. doi: 10.1111/j.1365-3156.2004.01298.x.
A longitudinal community-trial on the control of soil-transmitted helminths (STHs), as part of a lymphatic filariasis elimination campaign, was taken up in two revenue blocks of southern India in the years 2001 and 2002 to assess the impact of two annual single-dose mass drug administration (MDA) of diethylcarbamazine (DEC) + albendazole (ALB) with that of DEC alone. The prevalences and intensities of STHs were studied among cross-sectional samples of school children aged 9-10 years by using the Kato-Katz technique at baseline and 11 months after each MDA. The combined drug mass treatment produced a higher reduction in the prevalence (RIP) (51-77%) and the egg reduction rate (ERR) (92-98%) compared with 12-15% RIP and 58-62% ERR of DEC alone mass treatment. The effect of two-drug therapy after two annual treatments was relatively long lasting as shown by RIP and ERR indicating that the reinfection rates were relatively lower in this approach than single-drug therapy. This study demonstrates that mass drug co-administration of DEC + ALB in Global Programme for Elimination of Lymphatic Filariasis (GPELF) targeted at the community had a synergistic and sustainable effect against soil-transmitted helminthiasis and provided considerable 'beyond filariasis' benefits. The additional advantages accrued to the community underscore the importance of scaling-up GPELF to cover the entire population at risk.
作为消除淋巴丝虫病运动的一部分,2001年和2002年在印度南部的两个行政区开展了一项关于控制土壤传播蠕虫(STH)的纵向社区试验,以评估每年单剂量服用两次乙胺嗪(DEC)+阿苯达唑(ALB)与仅服用DEC的效果。在基线以及每次大规模药物给药(MDA)后11个月,采用加藤-厚涂片法对9至10岁学童的横断面样本进行STH患病率和感染强度研究。与仅使用DEC进行大规模治疗时12 - 15%的患病率降低率(RIP)和58 - 62%的虫卵减少率(ERR)相比,联合药物大规模治疗使患病率降低率(RIP)更高(51 - 77%),虫卵减少率(ERR)更高(92 - 98%)。两次年度治疗后两药联合疗法的效果持续时间相对较长,RIP和ERR表明这种方法的再感染率比单药疗法相对更低。本研究表明,在全球消除淋巴丝虫病计划(GPELF)中针对社区进行DEC + ALB的大规模药物联合使用,对土壤传播的蠕虫病具有协同和可持续的效果,并带来了相当多的“丝虫病之外”的益处。社区获得的额外优势凸显了扩大GPELF覆盖所有高危人群的重要性。