Dolo Housseini, Coulibaly Yaya I, Sow Moussa, Dembélé Massitan, Doumbia Salif S, Coulibaly Siaka Y, Sangare Moussa B, Dicko Ilo, Diallo Abdallah A, Soumaoro Lamine, Coulibaly Michel E, Diarra Dansine, Colebunders Robert, Nutman Thomas B, Walker Martin, Basáñez Maria-Gloria
Lymphatic Filariasis Research Unit, International Center of Excellence in Research, Faculty of Medicine and Odontostomatology, Point G, Bamako, Mali.
Global Health Institute, University of Antwerp, Antwerp, Belgium.
Clin Infect Dis. 2021 May 4;72(9):1585-1593. doi: 10.1093/cid/ciaa318.
Ivermectin-based onchocerciasis elimination, reported in 2009-2012, for Bakoye and Falémé, Mali, supported policy-shifting from morbidity control to elimination of transmission (EOT). These foci are coendemic with lymphatic filariasis (LF). In 2007-2016 mass ivermectin plus albendazole administration was implemented. We report Ov16 (onchocerciasis) and Wb123 (LF) seroprevalence after 24-25 years of treatment to determine if onchocerciasis EOT and LF elimination as a public health problem (EPHP) have been achieved.
The SD Bioline Onchocerciasis/LF Ig[immunoglobulin]G4 biplex rapid diagnostic test (RDT) was used in 2186 children aged 3-10 years in 13 villages (plus 2 hamlets) in Bakoye and in 2270 children in 15 villages (plus 1 hamlet) in Falémé. In Bakoye, all-age serosurveys were conducted in 3 historically hyperendemic villages (1867 individuals aged 3 -78 years).
In Bakoye, IgG4 seropositivity was 0.27% (95% confidence interval [CI] = .13%-.60%) for both Ov16 and Wb123 antigens. In Falémé, Ov16 and Wb123 seroprevalence was 0.04% (95% CI = .01%-.25%) and 0.09% (95% CI = .02%-.32%), respectively. Ov16-seropositive children were from historically meso/hyperendemic villages. Ov16 positivity was <2% in ≤14 year-olds, and 16% in ≥40 year-olds. Wb123 seropositivity was <2% in ≤39 year-olds, reaching 3% in ≥40 year-olds.
Notwithstanding uncertainty in the biplex RDT sensitivity, Ov16 and Wb123 seroprevalence among children in Bakoye and Falémé is consistent with EOT (onchocerciasis) and EPHP (LF) since stopping treatment in 2016. The few Ov16-seropositive children should be skin-snip polymerase chain reaction tested and followed up.
2009 - 2012年报告了在马里的巴科耶和法莱梅基于伊维菌素的盘尾丝虫病消除情况，这支持了从发病率控制向传播阻断（EOT）的政策转变。这些疫源地同时流行淋巴丝虫病（LF）。在2007 - 2016年实施了伊维菌素加阿苯达唑的群体给药。我们报告了治疗24 - 25年后的Ov16（盘尾丝虫病）和Wb123（LF）血清阳性率，以确定是否实现了盘尾丝虫病的EOT和作为公共卫生问题的LF消除（EPHP）。
在巴科耶的13个村庄（加2个小村庄）的2186名3 - 10岁儿童以及法莱梅的15个村庄（加1个小村庄）的2270名儿童中使用了SD Bioline盘尾丝虫病/LF Ig[免疫球蛋白]G4双抗原快速诊断检测（RDT）。在巴科耶，对3个历史上高度流行的村庄（1867名3 - 78岁个体）进行了全年龄血清学调查。
在巴科耶，Ov16和Wb123抗原的IgG4血清阳性率均为0.27%（95%置信区间[CI]=0.13% - 0.60%）。在法莱梅，Ov16和Wb123的血清阳性率分别为0.04%（95% CI = 0.01% - 0.25%）和0.09%（95% CI = 0.02% - 0.32%）。Ov16血清阳性儿童来自历史上的中度/高度流行村庄。≤14岁儿童中Ov16阳性率<2%，≥40岁儿童中为16%。≤39岁儿童中Wb123血清阳性率<2%，≥40岁儿童中达到3%。
尽管双抗原RDT敏感性存在不确定性，但自2016年停止治疗以来，巴科耶和法莱梅儿童中的Ov16和Wb123血清阳性率与盘尾丝虫病的EOT（盘尾丝虫病）和LF的EPHP（LF）一致。少数Ov16血清阳性儿童应进行皮肤切片聚合酶链反应检测并随访。
