Wolfson Wellcome Biomedical Laboratories, Department of Zoology, Natural History Museum, London SW7 5BD, UK.
Trans R Soc Trop Med Hyg. 2009 Oct;103(10):1031-44. doi: 10.1016/j.trstmh.2009.03.024. Epub 2009 May 5.
As part of a 4-year control programme beginning in 2003 and entitled Piga Vita Kichocho, around 140,000 school-aged children on Unguja Island, Zanzibar were treated annually with a combination of praziquantel and albendazole. To provide information on the impact of this intervention, a subset of children, originating from 24 sentinel schools, were monitored in 2004, 2005 and 2006 using both parasitological and behavioural questionnaire methods. Overall, prevalence of urinary schistosomiasis fell by 52%, intensity by 55% and gross haematuria by 82%. There was a positive and statistically significant correlation between areas of elevated disease prevalence and areas of predicted high transmission based upon local occurrence of the permissive intermediate snail host. In areas of low transmission, urinary schistosomiasis was greatly reduced, but, by contrast, other intervention strategies are needed to complement and synergise with chemotherapy in high transmission areas. Whereas significant reductions were documented in the prevalence of both Trichuris trichiura and hookworm, prevalence of Ascaris lumbricoides significantly increased over the monitoring period. Through a detailed analysis of named child records, evidence of predisposition to helminth (re)infection and individual bias towards polyparasitism was detected, highlighting the often overlapping distribution of these parasites within the school-aged child.
作为始于 2003 年、名为“Piga Vita Kichocho”的为期 4 年的控制规划的一部分，桑给巴尔 Unguja 岛上约 14 万名学龄儿童每年接受吡喹酮和阿苯达唑联合治疗。为了提供该干预措施效果的相关信息，在 2004 年、2005 年和 2006 年，使用寄生虫学和行为问卷调查方法，对来自 24 所哨点学校的部分儿童进行了监测。总体而言，尿血吸虫病的流行率下降了 52%，感染强度下降了 55%，肉眼血尿下降了 82%。疾病流行率高的地区与基于当地允许性中间螺宿主出现而预测的高传播地区之间存在正相关关系，且具有统计学意义。在低传播地区，尿血吸虫病大大减少，但需要其他干预策略来补充和协同高传播地区的化疗。虽然钩虫和鞭虫的流行率显著降低，但在监测期间，蛔虫的流行率显著增加。通过对特定儿童记录的详细分析，发现了对蠕虫（再）感染的易感性和个体多寄生虫感染的偏向性的证据，突出了这些寄生虫在学龄儿童中的重叠分布。
