采用伊维菌素进行选择性群体治疗，以控制严重受影响人群中的肠道蠕虫病和寄生虫性皮肤病。

Selective mass treatment with ivermectin to control intestinal helminthiases and parasitic skin diseases in a severely affected population.

作者信息

Heukelbach Jörg, Winter Benedikt, Wilcke Thomas, Muehlen Marion, Albrecht Stephan, de Oliveira Fabíola Araújo Sales, Kerr-Pontes Lígia Regina Sansigolo, Liesenfeld Oliver, Feldmeier Hermann

机构信息

Department of Community Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil.

出版信息

Bull World Health Organ. 2004 Aug;82(8):563-71. Epub 2004 Sep 13.

PMID:15375445

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2622929/

Abstract

OBJECTIVE

To assess the short-term and long-term impact of selective mass treatment with ivermectin on the prevalence of intestinal helminthiases and parasitic skin diseases in an economically depressed community in north-east Brazil.

METHODS

An intervention was carried out in a traditional fishing village in north-east Brazil where the population of 605 is heavily affected by ectoparasites and enteroparasites. The prevalence of intestinal helminths was determined by serial stool examination and the prevalence of parasitic skin diseases by clinical inspection. A total of 525 people out of a target population of 576 were treated at baseline. The majority of these were treated with ivermectin (200 microg/kg with a second dose given after 10 days). If ivermectin was contraindicated, participants were treated with albendazole or mebendazole for intestinal helminths or with topical deltamethrin for ectoparasites. Follow-up examinations were performed at 1 month and 9 months after treatment.

FINDINGS

Prevalence rates of intestinal helminthiases before treatment and at 1 month and 9 months after mass treatment were: hookworm disease 28.5%, 16.4% and 7.7%; ascariasis 17.1%, 0.4% and 7.2%; trichuriasis 16.5%, 3.4% and 9.4%; strongyloidiasis 11.0%, 0.6% and 0.7%; and hymenolepiasis 0.6%; 0.4% and 0.5%, respectively. Prevalence rates of parasitic skin diseases before treatment and 1 month and 9 months after mass treatment were: active pediculosis 16.1%, 1.0% and 10.3%; scabies 3.8%, 1.0% and 1.5%; cutaneous larva migrans 0.7%, 0% and 0%; tungiasis 51.3%, 52.1% and 31.2%, respectively. Adverse events occurred in 9.4% of treatments. They were all of mild to moderate severity and were transient.

CONCLUSION

Mass treatment with ivermectin was an effective and safe means of reducing the prevalence of most of the parasitic diseases prevalent in a poor community in north-east Brazil. The effects of treatment lasted for a prolonged period of time.

摘要

目的

评估在巴西东北部一个经济萧条社区进行伊维菌素选择性群体治疗对肠道蠕虫病和寄生虫性皮肤病患病率的短期和长期影响。

方法

在巴西东北部一个传统渔村开展了一项干预措施，该渔村605人的人口受外寄生虫和肠道寄生虫的严重影响。通过连续粪便检查确定肠道蠕虫的患病率，通过临床检查确定寄生虫性皮肤病的患病率。在基线时，目标人群576人中共有525人接受了治疗。其中大多数人接受了伊维菌素治疗（200微克/千克，10天后给予第二剂）。如果伊维菌素存在禁忌，则参与者接受阿苯达唑或甲苯达唑治疗肠道蠕虫，或接受外用溴氰菊酯治疗外寄生虫。在治疗后1个月和9个月进行随访检查。

结果

治疗前、群体治疗后1个月和9个月时肠道蠕虫病的患病率分别为：钩虫病28.5%、16.4%和7.7%；蛔虫病17.1%、0.4%和7.2%；鞭虫病16.5%、3.4%和9.4%；粪类圆线虫病11.0%、0.6%和0.7%；以及微小膜壳绦虫病0.6%、0.4%和0.5%。治疗前、群体治疗后1个月和9个月时寄生虫性皮肤病的患病率分别为：活动性虱病16.1%、1.0%和10.3%；疥疮3.8%、1.0%和1.5%；皮肤幼虫移行症0.7%、0%和0%；潜蚤病51.3%、52.1%和31.2%。9.4%的治疗出现了不良事件。这些事件均为轻度至中度严重程度，且为短暂性。