Irvine Michael A, Njenga Sammy M, Gunawardena Shamini, Njeri Wamae Claire, Cano Jorge, Brooker Simon J, Hollingsworth T Deirdre
School of Life Sciences, University of Warwick, Coventry, CV4 7AL, UK
Kenya Medical Research Institute (KEMRI), P.O. Box 54840, Post Code 00200, Nairobi, Kenya.
Trans R Soc Trop Med Hyg. 2016 Feb;110(2):118-24. doi: 10.1093/trstmh/trv096.
Lymphatic filariasis is a debilitating neglected tropical disease that affects impoverished communities. Rapid diagnostic tests of antigenaemia are a practical alternative to parasitological tests of microfilaraemia for mapping and surveillance. However the relationship between these two methods of measuring burden has previously been difficult to interpret.
A statistical model of the distribution of worm burden and microfilariae (mf) and resulting antigenaemic and mf prevalence was developed and fitted to surveys of two contrasting sentinel sites undergoing interventions. The fitted model was then used to explore the relationship in various pre- and post-intervention scenarios.
The model had good quantitative agreement with the data and provided estimates of the reduction in mf output due to treatment. When extrapolating the results to a range of prevalences there was good qualitative agreement with published data.
The observed relationship between antigenamic and mf prevalence is a natural consequence of the relationship between prevalence and intensity of adult worms and mf production. The method described here allows the estimation of key epidemiological parameters and consequently gives insight into the efficacy of an intervention programme.
淋巴丝虫病是一种影响贫困社区的使人衰弱的被忽视热带病。抗原血症快速诊断检测是用于绘图和监测的微丝蚴血症寄生虫学检测的一种实用替代方法。然而，此前这两种测量疾病负担方法之间的关系难以解释。
建立了蠕虫负担和微丝蚴（mf）分布以及由此产生的抗原血症和微丝蚴血症患病率的统计模型，并将其应用于两个正在接受干预的对比哨兵点的调查。然后使用拟合模型探索各种干预前和干预后情景下的关系。
该模型与数据具有良好的定量一致性，并提供了因治疗导致的微丝蚴产出减少的估计值。将结果外推到一系列患病率时，与已发表数据具有良好的定性一致性。
观察到的抗原血症患病率与微丝蚴血症患病率之间的关系是成虫患病率和强度与微丝蚴产生之间关系的自然结果。这里描述的方法允许估计关键的流行病学参数，从而深入了解干预计划的效果。
