Badia-Rius Xavier, Adamou Salissou, Taylor Mark J, Kelly-Hope Louise A
Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, UK.
Programme National de Dévolution de l'Onchocercose et Élimination de la Filariose Lymphatique, Ministère de la Santé Publique, de la Population et des Affaires Sociales, Niger.
Parasite Epidemiol Control. 2023 Apr 18;21:e00300. doi: 10.1016/j.parepi.2023.e00300. eCollection 2023 May.
The Niger Lymphatic Filariasis (LF) Programme is making good progress towards the elimination goal and scaling up morbidity management and disability prevention (MMDP) activities. Clinical case mapping and the increased availability of services has prompted patients to come forward in both endemic and non-endemic districts. The latter included Filingué, Baleyara and Abala districts of the Tillabéry region, and in 2019, 315 patients were found during a follow-up active case finding activity, suggesting it may have low transmission. The aim of this study was to assess the endemicity status in areas reporting clinical cases, 'morbidity hotspots', in three non-endemic districts of the Tillabéry region. A cross-sectional survey was conducted in 12 villages in June 2021. Filarial antigen was detected using the rapid Filariasis Test Strip (FTS) diagnostic, and information obtained on gender, age, residency length, bed net ownership and usage, and presence of hydrocoele and/or lymphoedema. Data were summarised and mapped using QGIS software. A total of 4058 participants between 5 and 105 years old were surveyed, with 29 (0.7%) participants found to be FTS positive. Baleyara district had significantly higher FTS positive rates than the other districts. No significant differences were found by gender (male 0.8%; female 0.6%), age group (<26 years 0.7%; ≥26 years 0. 7%), and residency length (<5 years 0.7%; ≥5 years 0.7%). Three villages reported no infections; seven villages <1%, one village 1.1% and one village 4.1%, which was on the border of an endemic district. Bed net ownership (99.2%) and usage (92.6%) was very high and there was no significant difference between FTS infection rates. The results indicate that there are low levels of transmission in populations, including children, living in districts previously classified as non-endemic. This has implications for the Niger LF programme in terms of delivering targeted mass drug administration (MDA) in transmission hotspots, and MMDP services, including hydrocoele surgery to patients. The use of morbidity data may be a practical proxy to trigger mapping of ongoing transmission in low endemic areas. Continued efforts to study morbidity hotspots, post-validation transmission, cross-border and cross-district endemicity are needed to meet the WHO NTD 2030 roadmap targets.
尼日尔淋巴丝虫病防治项目在实现消除目标以及扩大疾病管理和残疾预防（MMDP）活动方面取得了良好进展。临床病例测绘以及服务可得性的提高促使流行区和非流行区的患者前来就诊。后者包括蒂拉贝里地区的菲林盖、巴莱亚拉和阿巴拉区，2019年，在一次随访主动病例发现活动中发现了315名患者，这表明该地区的传播率可能较低。本研究的目的是评估蒂拉贝里地区三个非流行区报告有临床病例的地区，即“疾病热点地区”的流行状况。2021年6月在12个村庄进行了横断面调查。使用快速丝虫病检测试纸（FTS）诊断法检测丝虫抗原，并获取有关性别、年龄、居住时长、蚊帐拥有情况和使用情况以及是否存在鞘膜积液和/或淋巴水肿的信息。使用QGIS软件对数据进行汇总和绘图。共调查了4058名年龄在5至105岁之间的参与者，发现29名（0.7%）参与者FTS检测呈阳性。巴莱亚拉区的FTS阳性率显著高于其他区。在性别（男性0.8%；女性0.6%）、年龄组（<26岁0.7%；≥26岁0.7%）和居住时长（<5年0.7%；≥5年0.7%）方面未发现显著差异。三个村庄报告未发现感染；七个村庄<1%，一个村庄为1.1%，一个村庄为4.1%，该村庄位于一个流行区的边界。蚊帐拥有率（99.2%）和使用率（92.6%）非常高，FTS感染率之间没有显著差异。结果表明，生活在以前被归类为非流行区的人群，包括儿童，其传播水平较低。这对尼日尔淋巴丝虫病防治项目在传播热点地区提供有针对性的大规模药物治疗（MDA）以及为患者提供MMDP服务，包括鞘膜积液手术，具有重要意义。使用疾病数据可能是触发对低流行地区正在进行的传播进行测绘的一个实用替代方法。需要继续努力研究疾病热点地区、验证后的传播情况、跨境和跨区流行状况，以实现世界卫生组织2030年被忽视热带病路线图目标。
