Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland.
Department of Biological Sciences, Federal University of Agriculture, Abeokuta, Nigeria.
Lancet Infect Dis. 2015 Aug;15(8):927-40. doi: 10.1016/S1473-3099(15)00066-3. Epub 2015 May 21.
Schistosomiasis affects more than 200 million individuals, mostly in sub-Saharan Africa, but empirical estimates of the disease burden in this region are unavailable. We used geostatistical modelling to produce high-resolution risk estimates of infection with Schistosoma spp and of the number of doses of praziquantel treatment needed to prevent morbidity at different administrative levels in 44 countries.
We did a systematic review to identify surveys including schistosomiasis prevalence data in sub-Saharan Africa via PubMed, ISI Web of Science, and African Journals Online, from inception to May 2, 2014, with no restriction of language, survey date, or study design. We used Bayesian geostatistical meta-analysis and rigorous variable selection to predict infection risk over a grid of 1 155 818 pixels at 5 × 5 km, on the basis of environmental and socioeconomic predictors and to calculate the number of doses of praziquantel needed for prevention of morbidity.
The literature search identified Schistosoma haematobium and Schistosoma mansoni surveys done in, respectively, 9318 and 9140 unique locations. Infection risk decreased from 2000 onwards, yet estimates suggest that 163 million (95% Bayesian credible interval [CrI] 155 million to 172 million; 18·5%, 17·6-19·5) of the sub-Saharan African population was infected in 2012. Mozambique had the highest prevalence of schistosomiasis in school-aged children (52·8%, 95% CrI 48·7-57·8). Low-risk countries (prevalence among school-aged children lower than 10%) included Burundi, Equatorial Guinea, Eritrea, and Rwanda. The numbers of doses of praziquantel needed per year were estimated to be 123 million (95% CrI 121 million to 125 million) for school-aged children and 247 million (239 million to 256 million) for the entire population.
Our results will inform policy makers about the number of treatments needed at different levels and will guide the spatial targeting of schistosomiasis control interventions.
European Research Council, China Scholarship Council, UBS Optimus Foundation, and Swiss National Science Foundation.
血吸虫病影响 2 亿多人，主要在撒哈拉以南非洲地区，但该地区疾病负担的经验估计值尚不可用。我们使用地质统计学模型，在 44 个国家的不同行政级别上生成了有关血吸虫感染风险和预防治疗所需的吡喹酮剂量的高分辨率估计值。
我们进行了系统综述，通过 PubMed、ISI Web of Science 和 African Journals Online 从成立到 2014 年 5 月 2 日，查找撒哈拉以南非洲地区的血吸虫病患病率数据的调查，不限制语言、调查日期或研究设计。我们使用贝叶斯地质统计学元分析和严格的变量选择，根据环境和社会经济预测因子来预测网格上 1155818 个像素（55km）的感染风险，并计算预防治疗所需的吡喹酮剂量。
文献检索确定了在 9318 个和 9140 个独特地点进行的分别针对血吸虫曼森和血吸虫血红蛋白的调查。自 2000 年以来，感染风险有所下降，但估计表明，2012 年撒哈拉以南非洲地区有 1.63 亿人（95%贝叶斯可信区间[CrI]1.55 亿至 1.72 亿；18.5%，17.6-19.5）感染了血吸虫病。莫桑比克的学龄儿童血吸虫病患病率最高（52.8%，95%CrI 48.7-57.8）。低风险国家（学龄儿童患病率低于 10%）包括布隆迪、赤道几内亚、厄立特里亚和卢旺达。每年所需的吡喹酮剂量估计为学龄儿童 1.23 亿（95%CrI 1.21 亿至 1.25 亿），总人口 2.47 亿（2.39 亿至 2.56 亿）。
我们的研究结果将为决策者提供不同级别所需的治疗数量的信息，并指导血吸虫病控制干预措施的空间定位。
欧洲研究理事会、中国国家留学基金委员会、瑞银 Optimus 基金会和瑞士国家科学基金会。
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