在印度南部泰米尔纳德邦的流行地区开展基于社区的研究,以评估乙胺嗪(DEC)联合阿苯达唑(ALB)与单用乙胺嗪相比,对班氏丝虫感染的疗效。
Community-based study to assess the efficacy of DEC plus ALB against DEC alone on bancroftian filarial infection in endemic areas in Tamil Nadu, south India.
作者信息
Rajendran R, Sunish I P, Mani T R, Munirathinam A, Arunachalam N, Satyanarayana K, Dash A P
机构信息
Centre for Research in Medical Entomology, Madurai, India.
出版信息
Trop Med Int Health. 2006 Jun;11(6):851-61. doi: 10.1111/j.1365-3156.2006.01625.x.
As part of the Global Programme for Elimination of Lymphatic Filariasis (GPELF), India is implementing mass drug administration (MDA) with annual single dose of diethylcarbamazine (DEC) with and without albendazole (ALB). The impact of MDAs on filarial infections and soil-transmitted helminth (STH) infections was assessed during a 3-year period in two communities, one with DEC + ALB and the other with DEC alone. Prior to each MDA (during 2001, 2002 and 2003), filarial indices (microfilaraemia and antigenaemia) were assessed from blood samples of 450-650 persons aged 2-25 years and STH infections in stool samples (Kato-Katz method) from 325 to 500 children aged 9-10 years. Mosquitoes resting indoors were collected to determine the filarial infection status. The microfilaraemia prevalence decreased significantly (P < 0.05) in both arms, with the highest decline in the DEC + ALB arm (72%vs. 51%). Decline in micrefilaria intensity was also higher in the DEC + ALB arm (81.4%vs. 48.5%). In this arm alone, the antigenaemia prevalence was reduced significantly (62%; P < 0.001). The reduction in STH prevalence was lower in the DEC alone arm (6.5%; NS) than in the DEC + ALB arm (70.9%; P < 0.001). Also, the egg reduction in DEC alone arm was only half that of DEC + ALB arm (49%vs. 97%). Our community-based follow-up study showed higher and sustained benefits with regard to filarial and STH infections for the two-drug arm over the DEC alone arm. The trends suggest that at least 10 MDAs may be necessary to achieve the goal of elimination.
作为全球消除淋巴丝虫病规划(GPELF)的一部分,印度正在实施大规模药物给药(MDA),每年单剂量服用乙胺嗪(DEC),联合或不联合阿苯达唑(ALB)。在两个社区进行了为期3年的评估,以确定MDA对丝虫感染和土壤传播的蠕虫(STH)感染的影响,一个社区采用DEC + ALB,另一个社区仅采用DEC。在每次MDA之前(2001年、2002年和2003年期间),从450 - 650名2 - 25岁人群的血液样本中评估丝虫指标(微丝蚴血症和抗原血症),并从325至500名9 - 10岁儿童的粪便样本(加藤厚涂片法)中评估STH感染情况。收集室内栖息的蚊子以确定丝虫感染状况。两个组的微丝蚴血症患病率均显著下降(P < 0.05),DEC + ALB组下降幅度最大(72%对51%)。DEC + ALB组微丝蚴强度的下降也更高(81.4%对48.5%)。仅在该组中,抗原血症患病率显著降低(62%;P < 0.001)。仅采用DEC组的STH患病率下降幅度(6.5%;无统计学意义)低于DEC + ALB组(70.9%;P < 0.001)。此外,仅采用DEC组的虫卵减少量仅为DEC + ALB组一半(49%对97%)。我们基于社区的随访研究表明,与仅采用DEC组相比,联合用药组在丝虫和STH感染方面具有更高且持续的益处。这些趋势表明,可能至少需要10次MDA才能实现消除目标。