Wiegand Ryan E, Secor W Evan, Fleming Fiona M, French Michael D, King Charles H, Montgomery Susan P, Evans Darin, Utzinger Jürg, Vounatsou Penelope, de Vlas Sake J
Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Swiss Tropical and Public Health Institute, Basel, Switzerland.
Open Forum Infect Dis. 2021 Apr 15;8(7):ofab179. doi: 10.1093/ofid/ofab179. eCollection 2021 Jul.
Current World Health Organization guidelines utilize prevalence of heavy-intensity infections (PHIs), that is, ≥50 eggs per 10 mL of urine for and ≥400 eggs per gram of stool for , to determine whether a targeted area has controlled schistosomiasis morbidity or eliminated schistosomiasis as a public health problem. The relationship between these PHI categories and morbidity is not well understood.
School-age participants enrolled in schistosomiasis monitoring and evaluation cohorts from 2003 to 2008 in Burkina Faso, Mali, Niger, Tanzania, Uganda, and Zambia were surveyed for infection and morbidity at baseline and after 1 and 2 rounds of preventive chemotherapy. Logistic regression was used to compare morbidity prevalence among participants based on their school's PHI category.
Microhematuria levels were associated with the PHI categories at all 3 time points. For any other or morbidity that was measured, PHI categories did not differentiate morbidity prevalence levels consistently.
These analyses suggest that current PHI categorizations do not differentiate the prevalence of standard morbidity markers. A reevaluation of the criteria for schistosomiasis control is warranted.
世界卫生组织当前的指南利用高强度感染率（PHIs）来确定目标地区是否已控制血吸虫病发病率或消除作为公共卫生问题的血吸虫病，即每10毫升尿液中≥50个虫卵用于[此处信息缺失]，每克粪便中≥400个虫卵用于[此处信息缺失]。这些PHI类别与发病率之间的关系尚不清楚。
对2003年至2008年在布基纳法索、马里、尼日尔、坦桑尼亚、乌干达和赞比亚参加血吸虫病监测与评估队列的学龄参与者在基线时以及进行1轮和2轮预防性化疗后进行感染和发病率调查。采用逻辑回归根据参与者所在学校的PHI类别比较发病率。
在所有3个时间点，镜下血尿水平均与PHI类别相关。对于所测量的任何其他[此处信息缺失]或[此处信息缺失]发病率，PHI类别并未始终如一地区分发病率水平。
这些分析表明，当前的PHI分类无法区分标准发病标志物的患病率。有必要重新评估血吸虫病控制标准。
