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淋巴丝虫病消除状况:赞比亚进行五轮有效大规模药物治疗后人群中的感染情况

Lymphatic Filariasis Elimination Status: Infections in Human Populations after Five Effective Rounds of Mass Drug Administration in Zambia.

作者信息

Matapo Belem Blamwell, Mpabalwani Evans Mwila, Kaonga Patrick, Simuunza Martin Chitolongo, Bakyaita Nathan, Masaninga Freddie, Siyumbwa Namasiku, Siziya Seter, Shamilimo Frank, Muzongwe Chilweza, Mwase Enala T, Sikasunge Chummy Sikalizyo

机构信息

School of Public Health, University of Zambia, Ridgeway Campus, Lusaka P.O. Box 50516, Zambia.

World Health Organization, Corner Andrew Mwenya/Beit Road, Lusaka P.O. Box 32346, Zambia.

出版信息

Trop Med Infect Dis. 2023 Jun 22;8(7):333. doi: 10.3390/tropicalmed8070333.

Abstract

Lymphatic filariasis (LF), also commonly known as elephantiasis, is a neglected tropical disease (NTD) caused by filarial parasites. The disease is transmitted via a bite from infected mosquitoes. The bites of these infected mosquitoes deposit filarial parasites, or , whose predilection site is the lymphatic system. The damage to the lymph system causes swelling in the legs, arms, and genitalia. A mapping survey conducted between 2003 and 2011 determined LF as being endemic in Zambia in 96 out of 116 districts. Elimination of LF is known to be possible by stopping the spread of the infection through large-scale preventive chemotherapy. Therefore, mass drug administration (MDA) with diethylcarbamazine citrate (DEC) (6 mg/kg) and Albendazole (400 mg) for Zambia has been conducted and implemented in all endemic districts with five effective rounds. In order to determine whether LF prevalence has been sufficiently reduced to levels less than 2% antigenemia and less than 1% microfilaremia, a pre-transmission assessment survey (pre-TAS) was conducted. Therefore, post-MDA pre-TAS was conducted between 2021 and 2022 in 80 districts to determine the LF prevalence. We conducted a cross-sectional seroprevalence study involving 600 participants in each evaluation unit (EU) or each district. The study sites (sentinel and spot-check sites) were from districts that were the implementation units (IUs) of the LF MDA. These included 80 districts from the 9 provinces. A total of 47,235 people from sentinel and spot-check locations were tested. Of these, valid tests were 47,052, of which 27,762 (59%) were females and 19,290 (41%) were males. The survey revealed in the 79/80 endemic districts a prevalence of antigens of 0.14% and 0.0% prevalence of microfilariae. All the surveyed districts had an optimum prevalence of less than 2% for antigenaemia, except for Chibombo district. The majority of participants that tested positive for Antigens (Ag) were those that had 2, 3, and 4 rounds of MDA. Surprisingly, individuals that had 1 round of MDA were not found to have circulating antigens of The study showed that all the surveyed districts, except for Chibombo, passed pre-TAS. This further implies that there is a need to conduct transmission assessment surveys (TASs) in these districts.

摘要

淋巴丝虫病(LF),通常也被称为象皮病,是一种由丝虫寄生虫引起的被忽视的热带病(NTD)。该疾病通过受感染蚊子的叮咬传播。这些受感染蚊子的叮咬会传播丝虫寄生虫,即班氏丝虫或马来丝虫,它们的偏好寄生部位是淋巴系统。对淋巴系统的损害会导致腿部、手臂和生殖器肿胀。2003年至2011年期间进行的一项测绘调查确定,赞比亚116个区中有96个区存在淋巴丝虫病地方流行情况。已知通过大规模预防性化疗阻止感染传播可以消除淋巴丝虫病。因此,在赞比亚所有流行区已开展并实施了五次使用枸橼酸乙胺嗪(DEC)(6毫克/千克)和阿苯达唑(400毫克)的大规模药物给药(MDA)。为了确定淋巴丝虫病的流行率是否已充分降低至抗原血症低于2%和微丝蚴血症低于1%的水平,开展了一次传播前评估调查(pre-TAS)。因此,2021年至2022年期间在80个区进行了MDA后pre-TAS,以确定淋巴丝虫病的流行率。我们在每个评估单位(EU)或每个区开展了一项涉及600名参与者的横断面血清流行率研究。研究地点(哨点和抽查点)来自作为淋巴丝虫病MDA实施单位(IU)的区。这些区包括9个省的80个区。总共对来自哨点和抽查地点的47235人进行了检测。其中,有效检测为47052人,其中女性27762人(59%),男性19290人(41%)。调查显示,在79/80个流行区中,抗原流行率为0.14%,微丝蚴流行率为0.0%。除奇博姆博区外,所有调查区的抗原血症流行率均最佳,低于2%。大多数抗原(Ag)检测呈阳性的参与者是接受过2、3和4轮MDA的人。令人惊讶的是,未发现接受过1轮MDA的个体有循环抗原。研究表明,除奇博姆博区外,所有调查区均通过了pre-TAS。这进一步意味着有必要在这些区开展传播评估调查(TAS)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f856/10383567/cc6b96fa7ab3/tropicalmed-08-00333-g001.jpg

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