Wolfson Wellcome Biomedical Laboratories, Department of Zoology, Natural History Museum, Cromwell Road, London SW7 5BD, UK.
Acta Trop. 2013 Nov;128(2):292-302. doi: 10.1016/j.actatropica.2012.09.010. Epub 2012 Sep 26.
Following major water development schemes in the 1980s, schistosomiasis has become a serious parasitic disease of children living in the Senegal River Basin. Both urogenital (Schistosoma haematobium) and intestinal (Schistosoma mansoni) schistosomiasis can be highly prevalent in school-aged children, with many individuals infected with both parasites. In order to investigate the transmission and re-infection dynamics of both parasite species, single and mixed infection foci at three villages (Nder and Temeye; S. mansoni and S. haematobium foci and Guia; S. haematobium focus) were studied. In each focus infected children were identified and selected for a 12-month study involving two treatments with praziquantel (40mg/kg) three weeks apart at the beginning of the study and again 6 months into the study. Urine and stool samples were examined for schistosome eggs before and at 6 weeks and 6 months after chemotherapy. Prevalence and intensity of infection were recorded for each child at each time point. Before treatment, in all three villages, the prevalence and intensity of infection was extremely high for both S. mansoni (79-100%) and S. haematobium (81-97%). With the first round of chemotherapy sufficient cure rates (CRs) of both species were achieved in all villages (38-96%) with high egg reduction rates (ERRs) (97-99%). The data show that high and rapid re-infection rates occur, especially for S. mansoni, within a six-month period following treatment. Re-infection must be highly linked to ecological and seasonal factors. The persistence of S. mansoni in Nder could raise concern as levels of infection intensity remain high (geometric mean intensity at baseline 653epg changed to 705epg at 12 months) after four rounds of chemotherapy. This phenomenon could be explained by extremely rapid re-infection dynamics or a sub-optimal efficacy of praziquantel against S. mansoni in this village. High intensities in mixed infections may influence disease epidemiology and control warranting further studies. The disease situation in the SRB must be monitored closely and new treatment regimes should be designed and implemented to control schistosomiasis in the school-age population.
20 世纪 80 年代,随着大型水利工程的开展,裂体吸虫病成为塞内加尔河流域儿童的严重寄生虫病。尿路(曼氏血吸虫)和肠道(埃及血吸虫)血吸虫病在学龄儿童中均有高度流行,许多个体同时感染两种寄生虫。为了研究这两种寄生虫的传播和再感染动态,对三个村庄(Nder 和 Temeye;曼氏血吸虫和埃及血吸虫感染点以及 Guia;埃及血吸虫感染点)的单一和混合感染点进行了研究。在每个感染点,确定并选择了受感染的儿童,进行为期 12 个月的研究,包括在研究开始时和研究进行到 6 个月时用吡喹酮(40mg/kg)进行两次治疗,间隔 3 周。在化疗前和化疗后 6 周和 6 个月,对尿液和粪便样本进行了血吸虫卵检查。在每个时间点记录每个儿童的感染率和感染强度。在治疗前,在所有三个村庄中,曼氏血吸虫(79-100%)和埃及血吸虫(81-97%)的感染率和感染强度都极高。第一轮化疗后,所有村庄的两种物种的治愈率(CR)都很高(38-96%),虫卵减少率(ERR)很高(97-99%)。数据表明,在治疗后 6 个月内,尤其是曼氏血吸虫,会发生高且快速的再感染率。再感染肯定与生态和季节性因素密切相关。在经过四轮化疗后,Nder 中的曼氏血吸虫感染水平仍然很高(基线时的几何平均强度为 653epg,12 个月时变为 705epg),这可能令人担忧。这种现象可能是由于再感染动态极为迅速,或者吡喹酮对该村庄的曼氏血吸虫的疗效不佳。混合感染中的高强度可能会影响疾病的流行病学和控制,需要进一步研究。必须密切监测塞内加尔河流域的疾病状况,并设计和实施新的治疗方案,以控制学龄人口的血吸虫病。