Diakité Nana R, Ouattara Mamadou, Bassa Fidèle K, Coulibaly Jean T, Tian-Bi Yves-Nathan T, Meïté Aboulaye, Hattendorf Jan, Utzinger Jürg, N'Goran Eliézer K
Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan 22 BP 770, Ivory Coast.
Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan 01 BP 1303, Ivory Coast.
Trop Med Infect Dis. 2021 Jan 8;6(1):7. doi: 10.3390/tropicalmed6010007.
In order to assess the impact of different control strategies against in seasonal transmission foci in Côte d'Ivoire, a three-year cluster randomized trial was implemented. The decrease in prevalence among children aged 9-12 years was the primary outcome. In the first step, an eligibility survey was conducted, subjecting 50 children aged 13-14 years to a single urine filtration. Sixty-four villages with a prevalence of of ≥4% were selected and randomly assigned to four intervention arms consisting of annual mass drug administration (MDA) before (arm 1) and after (arm 2) the peak transmission, biannual treatment with praziquantel before and after the peak transmission season (arm 3), and annual MDA before the peak transmission season, coupled with focal chemical snail control using molluscicides (arm 4). At baseline, we observed a prevalence of 24.8%, 10.1%, 13.9%, and 15.9% in study arms 1, 2, 3, and 4, respectively. One year after the first intervention, the prevalence decreased in all study arms by about two-thirds or more. The prevalence in arm 2 was lower than in arm 1 (3.5% vs. 8.1%), but the difference was not statistically significant (odds ratio (OR) = 0.42, 95% confidence interval (CI) = 0.10-1.80). After adjusting for baseline prevalence, arms 1 and 2 performed roughly similarly (adjusted odds ratio (aOR) = 1.03, 95% CI = 0.34-3.07). The prevalence in arms 3 and 4 (1.9% and 2.2%) were significantly lower compared to arm 1 in the unadjusted and the adjusted models (arm 3 vs. arm 1, OR = 0.22, 95% CI = 0.05-0.95, aOR = 0.19, 95% CI = 0.08-0.48; arm 4 vs. arm 1, OR = 0.26, 95% CI = 0.08-0.85, aOR = 0.23, 95% CI = 0.06-0.87). The initial intervention showed a significant impact on the prevalence of . It will be interesting to monitor the comparative impact of the different intervention arms and to determine whether the interruption of seasonal transmission of can be achieved in this epidemiological setting within three years.
为评估不同防控策略对科特迪瓦季节性传播疫源地的影响，开展了一项为期三年的整群随机试验。9至12岁儿童患病率的下降是主要结果。第一步，进行了一项资格调查，让50名13至14岁的儿童接受单次尿液过滤。选择了64个患病率≥4%的村庄，并随机分为四个干预组，分别为在传播高峰期之前（第1组）和之后（第2组）进行年度群体药物治疗（MDA）、在传播高峰期前后进行吡喹酮双年度治疗（第3组），以及在传播高峰期之前进行年度MDA并结合使用杀螺剂进行局部化学灭螺（第4组）。在基线时，我们观察到第1、2、3和4组的患病率分别为24.8%、10.1%、13.9%和15.9%。首次干预一年后，所有研究组的患病率均下降了约三分之二或更多。第2组的患病率低于第1组（3.5%对8.1%），但差异无统计学意义（优势比（OR）=0.42，95%置信区间（CI）=0.10 - 1.80）。在对基线患病率进行调整后，第1组和第2组的表现大致相似（调整后优势比（aOR）=1.03，95%CI =0.34 - 3.07）。在未调整和调整后的模型中，第3组和第4组的患病率（1.9%和2.2%）与第1组相比显著更低（第3组对第1组，OR =0.22，95%CI =0.05 - 0.95，aOR =0.19，95%CI =0.08 - 0.48；第4组对第1组，OR =0.26，95%CI =0.08 - 0.85，aOR =0.23，95%CI =0.06 - 0.87）。初始干预对的患病率产生了显著影响。监测不同干预组的比较影响，并确定在这种流行病学环境下能否在三年内实现的季节性传播中断，将是很有意思的。 （注：原文中“”部分有缺失信息，这里按原样翻译）
