Ash Amanda, Okello Anna, Khamlome Boualam, Inthavong Phouth, Allen John, Thompson R C Andrew
School of Veterinary and Life Sciences, Murdoch University, Perth, Australia.
CSIRO, Australian Animal Health Laboratory (AAHL) Regional Program, Geelong, Australia; School of Biomedical Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, United Kingdom.
Acta Trop. 2017 Oct;174:171-178. doi: 10.1016/j.actatropica.2015.05.018. Epub 2015 May 19.
Taenia solium taeniasis-cysticercosis and soil-transmitted helminths (STHs) are parasitic Neglected Tropical Diseases endemic throughout Southeast Asia. Within Lao PDR, a remote northern hill tribe village had previously been identified as a hyper endemic focus for T. solium. To reduce this observed prevalence, a One Health intervention covering both pigs and humans was implemented, which included two Mass drug administrations (MDA1 and MDA2) for village residents using a triple dose albendazole 400mg treatment regime. In addition to the effect on T. solium levels, the dual impact of this anthelmintic regime on STHs within the community was also monitored. Faecal samples were collected pre and post MDA1 and MDA2 and analysed for the presence of Taenia species and the STHs Ascaris lumbricoides, Trichuris trichiura and hookworm species. The McMaster technique was used to measure the changes in both prevalence and intensity of infection. Molecular characterisation of Taenia and hookworm species was conducted to detect zoonotic species. The level of taeniasis within the sampled population decreased by 79.4% after MDA1, remained steady during the five month inter-treatment interval and decreased again by 100% after MDA2. The prevalence of STHs decreased by 65.5% and 62.8% after MDA1 and MDA2 respectively; however an increase to 62.1% of pre MDA1 levels was detected during the inter-treatment interval. Individually, hookworm prevalence decreased by 83.4% (MDA1) and 84.5% (MDA2), A. lumbricoides by 95.6% and 93.5% and T. trichiura by 69.2% and 61%. The intensity of infection within the sampled population also decreased, with egg reduction rates of 94.4% and 97.8% for hookworm, 99.4% and 99.3% for A. lumbricoides and 77.2% and 88.5% for T. trichiura. Molecular characterisation identified a T. solium tapeworm carrier from 21.6% (13/60) of households in the village. T. saginata was identified in 5% (3/60) of households. The zoonotic hookworm A. ceylanicum was detected in the resident dog population. These results suggest that the triple dose albendazole 400mg treatment regime achieved a significant reduction in the level of taeniasis whilst simultaneously reducing the STH burden within the village. The increased STH prevalence detected between MDAs reflects the need for behavioural changes and a sustained chemotherapy programme, which may also need to include the resident dog population.
猪带绦虫病-囊尾蚴病和土源性蠕虫(STH)是东南亚地区流行的被忽视热带寄生虫病。在老挝人民民主共和国,一个偏远的北部山地部落村庄此前被确定为猪带绦虫的高度流行区。为降低观察到的患病率,实施了一项涵盖猪和人的“同一健康”干预措施,其中包括对村庄居民使用400毫克阿苯达唑三剂量治疗方案进行两次群体药物给药(MDA1和MDA2)。除了对猪带绦虫水平的影响外,还监测了这种驱虫方案对社区内土源性蠕虫的双重影响。在MDA1和MDA2前后收集粪便样本,分析是否存在绦虫物种以及土源性蠕虫蛔虫、鞭虫和钩虫物种。采用麦克马斯特技术测量感染率和感染强度的变化。对绦虫和钩虫物种进行分子特征分析以检测人畜共患物种。抽样人群中的绦虫病水平在MDA1后下降了79.4%,在五个月的治疗间隔期保持稳定,在MDA2后再次下降了100%。土源性蠕虫的患病率在MDA1和MDA2后分别下降了65.5%和62.8%;然而,在治疗间隔期检测到患病率增加到MDA1前水平的62.1%。单独来看,钩虫患病率在MDA1时下降了83.4%,在MDA2时下降了84.5%,蛔虫下降了95.6%和93.5%,鞭虫下降了69.2%和61%。抽样人群中的感染强度也有所下降,钩虫的虫卵减少率分别为94.4%和97.8%,蛔虫为99.4%和99.3%,鞭虫为77.2%和88.5%。分子特征分析在该村庄21.6%(13/60)的家庭中鉴定出猪带绦虫携带者。在5%(3/60)的家庭中鉴定出牛带绦虫。在当地犬类群体中检测到了人畜共患钩虫锡兰钩虫。这些结果表明,400毫克阿苯达唑三剂量治疗方案在显著降低绦虫病水平的同时,也减轻了村庄内土源性蠕虫的负担。两次群体药物给药之间检测到的土源性蠕虫患病率增加反映出需要改变行为并实施持续的化疗方案,这可能还需要将当地犬类群体纳入其中。