Ortu Giuseppina, Ndayishimiye Onésime, Clements Michelle, Kayugi Donatien, Campbell Carl H, Lamine Mariama Sani, Zivieri Antonio, Magalhaes Ricardo Soares, Binder Sue, King Charles H, Fenwick Alan, Colley Daniel G, Jourdan Peter Mark
Schistosomiasis Control Initiative (SCI), Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom.
Programme National Intégré de lutte contre les Maladies Tropicales Négligées et la Cécité (PNIMTNC), Ministère de la Santé Publique et de la Lutte contre le SIDA, Bujumbura, Burundi.
Am J Trop Med Hyg. 2017 Mar;96(3):664-673. doi: 10.4269/ajtmh.16-0671. Epub 2017 Apr 6.
Following implementation of the national control program, a reassessment of prevalence was conducted in Burundi to determine the feasibility of moving toward elimination. A countrywide cluster-randomized cross-sectional study was performed in May 2014. At least 25 schools were sampled from each of five eco-epidemiological risk zones for schistosomiasis. Fifty randomly selected children 13-14 years of age per school were included for a single urine-circulating cathodic antigen (CCA) rapid test and, in a subset of schools, for duplicate Kato-Katz slide preparation from a single stool sample. A total of 17,331 children from 347 schools were tested using CCA. The overall prevalence of infection, when CCA trace results were considered negative, was 13.5% (zone range [zr] = 4.6-17.8%), and when CCA trace results were considered positive, it was 42.8% (zr = 34.3-49.9%). In 170 schools, prevalence of this infection determined using Kato-Katz method was 1.5% (zr = 0-2.7%). The overall mean intensity of infection determined using Kato-Katz was 0.85 eggs per gram (standard deviation = 10.86). A majority of schools (84%) were classified as non-endemic (prevalence = 0) using Kato-Katz; however, a similar proportion of schools were classified as endemic when CCA trace results were considered negative (85%) and nearly all (98%) were endemic when CCA trace results were considered positive. The findings of this nationwide reassessment using a CCA rapid test indicate that infection is still widespread in Burundi, although its average intensity is probably low. Further evidence is now needed to determine the association between CCA rapid test positivity and low-intensity disease transmission.
在国家控制项目实施之后，布隆迪对血吸虫病流行情况进行了重新评估，以确定朝着消除血吸虫病迈进的可行性。2014年5月开展了一项全国范围的整群随机横断面研究。从血吸虫病的五个生态流行病学风险区中，每个区至少抽取25所学校。每所学校随机选取50名13至14岁的儿童，进行单次尿液循环阴极抗原（CCA）快速检测，在部分学校中，还对单个粪便样本进行重复的加藤厚涂片制备。共对来自347所学校的17331名儿童进行了CCA检测。当CCA微量结果被视为阴性时，总体感染率为13.5%（区域范围[zr]=4.6 - 17.8%），当CCA微量结果被视为阳性时，总体感染率为42.8%（zr = 34.3 - 49.9%）。在170所学校中，使用加藤厚涂片法确定的这种感染的流行率为1.5%（zr = 0 - 2.7%）。使用加藤厚涂片法确定的总体平均感染强度为每克0.85个虫卵（标准差=10.86）。大多数学校（84%）使用加藤厚涂片法被归类为非流行区（流行率=0）；然而，当CCA微量结果被视为阴性时，类似比例的学校被归类为流行区（85%），而当CCA微量结果被视为阳性时，几乎所有学校（98%）都为流行区。这项使用CCA快速检测进行的全国范围重新评估的结果表明，尽管布隆迪的血吸虫病平均感染强度可能较低，但感染仍然普遍存在。现在需要进一步的证据来确定CCA快速检测阳性与低强度疾病传播之间的关联。
