曼氏血吸虫病传播焦点的识别：将干预目标从埃塞俄比亚的地区缩小到传播焦点。
Identification of transmission foci of Schistosoma mansoni: narrowing the intervention target from district to transmission focus in Ethiopia.
机构信息
School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.
Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
出版信息
BMC Public Health. 2020 May 24;20(1):769. doi: 10.1186/s12889-020-08904-1.
BACKGROUND
Schistosoma mansoni (S. mansoni) infection is a significant public health problem in Ethiopia, and has wide distribution in the country. The impact of the disease is particularly high on school-age children. Nationwide 385 endemic districts were identified, whereby control and elimination interventions are underway using school-based annual mass drug administration (MDA) with praziquantel. The national elimination program targets endemic districts as a whole. The aim of this study was to identify the transmission foci of Schistosoma mansoni and determine prevalence of soil-transmitted helminths (STHs) in Abeshge district.
METHODS
The study was conducted from April to May, 2019 among school-age children randomly selected from public elementary schools in Abeshge district, South-central Ethiopia. Demographic information and data on risk factors of S. mansoni infection were gathered using pre-tested questionnaire. Moreover, a stool sample was collected from each child and examined using Kato-Katz thick smear technique. The data were analyzed using STATA_MP version 12.
RESULTS
A total of 389 school-age children from five public elementary schools were included in the study. The overall prevalence of S. mansoni and STHs was 19.3% (75/389) and 35% (136/389), respectively. The prevalence of S. mansoni was 60.6% in Kulit Elementary school, while it was zero in Geraba. The prevalence of S. mansoni was significantly higher among males (AOR = 2.6, 95% CI 1.3-5.1), those with habit of swimming and/or bathing in rivers (AOR = 2.9, 95%CI 1.3-5.1) and involved in irrigation activities (AOR = 2.9, 95% CI 1.0-8.3). Overall, the prevalence of S. mansoni was significantly higher among school children attending Kulit Elementary School compared to those attending the remaining schools (AOR = 12.5, 95%CI 6.2-25.1).
CONCLUSION
A wide variation of S. mansoni prevalence was observed among the school children in the different schools. Control interventions better identify and target foci of S. mansoni transmission, instead of targeting the district homogenously.
背景
曼氏血吸虫（S. mansoni）感染是埃塞俄比亚的一个重大公共卫生问题，该国有广泛的分布。该疾病对学龄儿童的影响尤其大。全国共确定了 385 个流行地区，这些地区正在使用基于学校的年度大规模药物治疗（MDA）联合吡喹酮进行控制和消除干预。国家消除计划以整个流行地区为目标。本研究旨在确定曼氏血吸虫的传播焦点，并确定埃塞俄比亚中南部阿贝斯格地区土壤传播性蠕虫（STHs）的流行情况。
方法
本研究于 2019 年 4 月至 5 月在阿贝斯格区的公立小学中随机选择学龄儿童进行，使用预先测试的问卷收集了人口统计信息和曼氏血吸虫感染危险因素的数据。此外，从每个儿童收集粪便样本，并使用加藤厚涂片技术进行检查。使用 STATA_MP 版本 12 对数据进行分析。
结果
共有来自五所公立小学的 389 名学龄儿童参加了这项研究。曼氏血吸虫和 STHs 的总流行率分别为 19.3%（75/389）和 35%（136/389）。Kulit 小学的曼氏血吸虫流行率为 60.6%，而 Geraba 小学则为零。男性（AOR=2.6，95%CI 1.3-5.1）、有在河流中游泳和/或洗澡习惯（AOR=2.9，95%CI 1.3-5.1）和从事灌溉活动（AOR=2.9，95%CI 1.0-8.3）的儿童中，曼氏血吸虫的流行率明显更高。总体而言，与就读于其他学校的学生相比，就读于 Kulit 小学的学生中曼氏血吸虫的流行率明显更高（AOR=12.5，95%CI 6.2-25.1）。
结论
在不同学校的学龄儿童中，曼氏血吸虫的流行率存在很大差异。控制干预措施更好地识别和针对曼氏血吸虫传播的焦点，而不是以整个地区为目标。
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