Onzo-Aboki Ablavi, Ibikounlé Moudachirou, Boko Pélagie Mimonnou, Savassi Boris S, Doritchamou Justin, Siko Edoux Joel, Daré Aboudou, Batcho Wilfrid, Massougbodji Achille, Tougoue Jean Jacques, Kaboré Achille
Department of Zoology, Faculty of Sciences and Techniques, University of Abomey-Calavi, 01BP526 Cotonou, Benin.
Department of Zoology, Faculty of Sciences and Techniques, University of Abomey-Calavi, 01BP526 Cotonou, Benin; National Control Program of Communicable Diseases, Ministry of Health of Benin, 01BP882 Cotonou, Benin.
Acta Trop. 2019 Mar;191:185-197. doi: 10.1016/j.actatropica.2019.01.004. Epub 2019 Jan 8.
A national mapping of human schistosomiasis was conducted in Benin to provide the baseline epidemiological data required to implement the national strategy for schistosomiasis control and elimination to achieve the WHO's goal of reaching at least 75% of school-age children in endemic areas by 2020.
Parasitological surveys were conducted from 2013 to 2015, among 19,250 children aged 8-14 years randomly sampled in 385 units (schools/villages) across all districts. Urine and stool samples were examined using parasite-egg filtration for urine samples and the Kato-Katz technique for stool specimens.
Human schistosome eggs from two major species (S. haematobium and S. mansoni) were detected in the surveyed population with variable prevalence and parasite intensity. Urinary schistosomiasis due to S. haematobium was widely distributed and detected in 76/77 districts with a national average prevalence of 17.56% (95 °CI:16.80%- 18.32%), compared to S. mansoni detected in 28/77 districts with a national prevalence of 2.45% (95 °CI:2.14%-2.76%). The combined national prevalence of schistosomiasis, defined by infections with either or both schistosome species was 19.78% (95% CI:18.90% -20.49%), and was detected in 76/77 districts. Based on our findings, 31 districts were classified as low-risk (>0% and <10%); 37 as moderate-risk (≥10% and <50%); and 8 as high-risk (≥50%) of schistosome infection. No infection was detected in Kpomassè district in this study. In several districts where the two species were endemic with prevalence ≥10%, S. haematobium was the most prevalent schistosome species. Boys were relatively more infected than girls (18.29% v 16.82%, p = 0.007). Of note, heavy infections with S. haematobium (>50 eggs/10 mL) were detected in several districts of Atacora, Donga, Borgou, Collines, Ouémé and Atlantique departments.
The schistosomiasis mapping reported here clearly present a nationwide view of the epidemiological pattern of Schistosoma infections and the baseline data for implementing an effective control strategy by preventive chemotherapy (PCT). Although PCT might not be required in 32/77 districts, a yearly and bi-annual deworming is needed in 2 and 43 districts, respectively. If no environmental change occurs, and no mass treatment is delivered, prevalence is likely to remain stable for many years owing to poor hygiene and sanitation.
在贝宁开展了一项全国人体血吸虫病测绘，以提供实施国家血吸虫病控制与消除战略所需的基线流行病学数据，从而实现世界卫生组织在2020年使流行地区至少75%的学龄儿童受益的目标。
2013年至2015年期间，在所有行政区的385个单位（学校/村庄）中随机抽取了19250名8至14岁儿童进行寄生虫学调查。尿液样本采用寄生虫卵过滤法检查，粪便标本采用加藤厚涂片法检查。
在被调查人群中检测到两种主要血吸虫（埃及血吸虫和曼氏血吸虫）的虫卵，其流行率和寄生虫感染强度各不相同。埃及血吸虫引起的泌尿血吸虫病广泛分布，在76/77个行政区中均有发现，全国平均流行率为17.56%（95%置信区间：16.80%-18.32%），相比之下，曼氏血吸虫在28/77个行政区中被检测到，全国流行率为2.45%（95%置信区间：2.14%-2.76%）。由一种或两种血吸虫感染定义的全国血吸虫病综合流行率为19.78%（95%置信区间：18.90%-20.49%），在76/77个行政区中均有发现。根据我们的研究结果，31个行政区被归类为低风险（>0%且<10%）；37个为中度风险（≥10%且<50%）；8个为高风险（≥50%）的血吸虫感染区。在本研究中，科波马塞行政区未检测到感染病例。在两种血吸虫流行率≥10%的几个行政区中，埃及血吸虫是最常见的血吸虫种类。男孩的感染率相对高于女孩（18.29%对16.82%，p = 0.007）。值得注意的是，在阿塔科拉、东加、博尔古、科利纳、韦梅和大西洋省的几个行政区检测到了埃及血吸虫的重度感染（>50个虫卵/10毫升）。
本报告中的血吸虫病测绘清晰地呈现了全国范围内血吸虫感染的流行病学模式以及通过预防性化疗（PCT）实施有效控制策略的基线数据。尽管77个行政区中的32个可能不需要PCT，但分别有2个和4个行政区需要每年和每两年进行一次驱虫。如果环境没有变化，且不进行大规模治疗，由于卫生条件差，流行率可能会在许多年内保持稳定。
