Pion Sébastien D S, Chesnais Cédric B, Bopda Jean, Louya Frédéric, Fischer Peter U, Majewski Andrew C, Weil Gary J, Boussinesq Michel, Missamou François
Unité Mixte Internationale 233, Institut de Recherche pour le Développement and University of Montpellier 1, Montpellier, France; Centre for Research on Filariasis and Other Tropical Diseases (CRFilMT), Yaoundé, Cameroon; Programme National de Lutte contre l'Onchocercose, Ministère de la Santé et de la Population, Brazzaville, Republic of Congo; Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
Unité Mixte Internationale 233, Institut de Recherche pour le Développement and University of Montpellier 1, Montpellier, France; Centre for Research on Filariasis and Other Tropical Diseases (CRFilMT), Yaoundé, Cameroon; Programme National de Lutte contre l'Onchocercose, Ministère de la Santé et de la Population, Brazzaville, Republic of Congo; Infectious Diseases Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri.
Am J Trop Med Hyg. 2015 May;92(5):959-66. doi: 10.4269/ajtmh.14-0661. Epub 2015 Mar 9.
Implementation of mass drug administration (MDA) with ivermectin plus albendazole (ALB) for lymphatic filariasis (LF) has been delayed in central Africa because of the risk of serious adverse events in subjects with high Loa loa microfilaremia. We conducted a community trial to assess the impact of semiannual MDA with ALB (400 mg) alone on LF and soil-transmitted helminth (STH) infections in the Republic of Congo. Evaluation at 12 months showed that ALB MDA had not significantly reduced Wuchereria bancrofti antigenemia or microfilaria (mf) rates in the community (from 17.3% to 16.6% and from 5.3% to 4.2%, respectively). However, the geometric mean mf count in mf-positive subjects was reduced from 202.2 to 80.9 mf/mL (60% reduction, P = 0.01). The effect of ALB was impressive in 38 subjects who were mf-positive at baseline and retested at 12 months: 37% had total mf clearance, and individual mf densities were reduced by 73.0%. MDA also dramatically reduced the hookworm infection rate in the community from 6.5% to 0.6% (91% reduction), with less impressive effects on Ascaris and Trichuris. These preliminary results suggest that semiannual community MDA with ALB is a promising strategy for controlling LF and STH in areas with coendemic loiasis.
由于高盘尾丝虫微丝蚴血症患者存在严重不良事件风险，在非洲中部，使用伊维菌素加阿苯达唑（ALB）进行大规模药物治疗（MDA）以防治淋巴丝虫病（LF）的工作已被推迟。我们开展了一项社区试验，以评估每半年单独使用ALB（400毫克）进行MDA对刚果共和国LF和土壤传播蠕虫（STH）感染的影响。12个月时的评估显示，ALB MDA并未显著降低社区中班氏吴策线虫抗原血症或微丝蚴（mf）率（分别从17.3%降至16.6%和从5.3%降至4.2%）。然而，mf阳性受试者的mf几何平均计数从202.2降至80.9 mf/mL（降低60%，P = 0.01）。对于38名基线时mf阳性且在12个月时重新检测的受试者，ALB的效果令人印象深刻：37%的受试者mf完全清除，个体mf密度降低了73.0%。MDA还使社区中的钩虫感染率从6.5%大幅降至0.6%（降低91%），对蛔虫和鞭虫的效果则不太显著。这些初步结果表明，每半年在社区进行一次ALB MDA是在罗阿丝虫病共同流行地区控制LF和STH的一种有前景的策略。
