Neglected Tropical Disease Control Section, National Directorate for Public Health, Ministry of Health Angola, Luanda, Angola.
Institute for Global Health, University College London, London, United Kingdom.
PLoS Negl Trop Dis. 2022 Jun 30;16(6):e0010458. doi: 10.1371/journal.pntd.0010458. eCollection 2022 Jun.
Schistosomiasis (SCH) and soil transmitted helminthiases (STH) have been historically recognized as a major public health problem in Angola. However, lack of reliable, country wide prevalence data on these diseases has been a major hurdle to plan and implement programme actions to target these diseases. This study aimed to characterize SCH and STH prevalence and distribution in Angola.
A country wide mapping was conducted in October 2018 (1 province) and from July to December 2019 (14 provinces) in school aged (SAC) children in 15 (of 18) provinces in Angola, using WHO protocols and procedures. A total of 640 schools and an average of 50 students per school (N = 31,938 children) were sampled. Stool and urine samples were collected and processed using the Kato-Katz method and Urine Filtration. Prevalence estimates for SCH and STH infections were calculated for each province and district with 95% confidence intervals. Factors associated with SCH and STH infection, respectively, were explored using multivariable logistic regression accounting for clustering by school.
Of the 131 districts surveyed, 112 (85.5%) are endemic for STH, 30 (22.9%) have a prevalence above 50%, 24 (18.3%) are at moderate risk (prevalence 20%-50%), and 58 (44.3%) are at low risk (<20% prevalence); similarly, 118 (90,1%) of surveyed districts are endemic for any SCH, 2 (1.5%) are at high risk (>50% prevalence), 59 (45.0%) are at moderate risk (10%-50% prevalence), and 57 (43.5%) are at low risk (<10% prevalence). There were higher STH infection rates in the northern provinces of Malanje and Lunda Norte, and higher SCH infection rates in the southern provinces of Benguela and Huila.
This mapping exercise provides essential information to Ministry of Health in Angola to accurately plan and implement SCH and STH control activities in the upcoming years. Data also provides a useful baseline contribution for Angola to track its progress towards the 2030 NTD roadmap targets set by WHO.
血吸虫病（SCH）和土壤传播性蠕虫病（STH）在安哥拉曾被认为是一个主要的公共卫生问题。然而，由于缺乏可靠的全国性疾病流行数据，规划和实施针对这些疾病的方案行动一直是一个主要障碍。本研究旨在描述安哥拉 SCH 和 STH 的流行情况和分布特征。
2018 年 10 月（1 个省）和 2019 年 7 月至 12 月（14 个省），在安哥拉 18 个省中的 15 个省，采用世界卫生组织的方案和程序，对学龄儿童（SAC）进行了全国范围的绘图。共抽取了 640 所学校，平均每所学校 50 名学生（N=31938 名儿童）。采集粪便和尿液样本，采用加藤厚涂片法和尿液过滤法进行处理。分别用多变量逻辑回归，对各省份和地区的 SCH 和 STH 感染率进行计算，以 95%置信区间表示。
在所调查的 131 个区中，有 112 个（85.5%）存在 STH 流行，30 个（22.9%）的流行率超过 50%，24 个（18.3%）处于中度风险（流行率 20%-50%），58 个（44.3%）处于低度风险（流行率<20%）；同样，有 118 个（90.1%）被调查的区存在任何 SCH 流行，2 个（1.5%）处于高度风险（流行率>50%），59 个（45.0%）处于中度风险（流行率 10%-50%），57 个（43.5%）处于低度风险（流行率<10%）。在北部省份马兰热和北隆达，STH 感染率较高，在南部省份本格拉和威拉，SCH 感染率较高。
本次绘图工作为安哥拉卫生部提供了重要信息，以便在未来几年准确规划和实施 SCH 和 STH 控制活动。该数据还为安哥拉提供了一个有用的基线，以跟踪其在实现世卫组织制定的 2030 年 NTD 路线图目标方面的进展情况。
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