Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research (LCNTDR), Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom.
MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom.
Elife. 2022 Aug 19;11:e76988. doi: 10.7554/eLife.76988.
Infection by poses a major burden across endemic countries. The World Health Organization (WHO) 2021-2030 Neglected Tropical Diseases roadmap has proposed that 30% of endemic countries achieve intensified control in hyperendemic areas by 2030. Understanding geographical variation in age-prevalence profiles and force-of-infection (FoI) estimates will inform intervention designs across settings. Human taeniasis (HTT) and human cysticercosis (HCC) age-prevalence data from 16 studies in Latin America, Africa, and Asia were extracted through a systematic review. Catalytic models, incorporating diagnostic performance uncertainty, were fitted to the data using Bayesian methods, to estimate rates of antibody (Ab)-seroconversion, infection acquisition and Ab-seroreversion or infection loss. HCC FoI and Ab-seroreversion rates were also estimated across 23 departments in Colombia from 28,100 individuals. Across settings, there was extensive variation in all-ages seroprevalence. Evidence for Ab-seroreversion or infection loss was found in most settings for both HTT and HCC and for HCC Ab-seroreversion in Colombia. The average duration until humans became Ab-seropositive/infected decreased as all-age (sero)prevalence increased. There was no clear relationship between the average duration humans remain Ab-seropositive and all-age seroprevalence. Marked geographical heterogeneity in transmission rates indicate the need for setting-specific intervention strategies to achieve the WHO goals.
在流行地区，寄生虫感染造成了重大负担。世界卫生组织（WHO）2021-2030 年被忽视热带病路线图提出，到 2030 年，30%的流行地区在高度流行地区实现强化控制。了解年龄流行率分布和感染率（FoI）估计的地理差异将为各地区的干预设计提供信息。通过系统评价，从拉丁美洲、非洲和亚洲的 16 项研究中提取了人类带绦虫病（HTT）和人类囊尾蚴病（HCC）的年龄流行率数据。采用贝叶斯方法，将包含诊断性能不确定性的催化模型拟合到数据中，以估计抗体（Ab）-血清转化率、感染获得率和 Ab 血清转化率或感染损失率。还从哥伦比亚的 23 个部门的 28100 个人中估计了 HCC 的 FoI 和 Ab 血清转化率。在所有环境中，所有年龄段的血清阳性率都存在广泛的差异。在大多数环境中，无论是 HTT 还是 HCC，以及在哥伦比亚的 HCC Ab 血清转化率，都发现了 Ab 血清转化率或感染损失的证据。人类开始 Ab 血清阳性/感染的平均持续时间随着全年龄（血清）流行率的增加而缩短。人类保持 Ab 血清阳性的平均持续时间与全年龄血清流行率之间没有明显的关系。传播率的明显地理异质性表明，需要制定特定于环境的干预策略来实现世卫组织的目标。
