加蓬农村地区土壤传播的蠕虫感染流行病学及治疗对蠕虫种类分布的差异影响。
Epidemiology of soil-transmitted helminth infections and the differential effect of treatment on the distribution of helminth species in rural areas of Gabon.
作者信息
Edoa Jean Ronald, Adégbitè Bayodé Roméo, Honkpéhèdji Yabo Josiane, Zinsou Jeannot Fréjus, Boussougou-Sambe Stravensky Térence, Woldearegai Tamirat Gebru, Mordmüller Benjamin, Adegnika Ayola Akim, Dejon-Agobé Jean Claude
机构信息
Centre de Recherches Médicales de Lambaréné, P.O. Box 242, Lambaréné, Gabon.
Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, Location AMC, Amsterdam Public Health, Amsterdam Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands.
出版信息
Trop Med Health. 2024 Jan 2;52(1):3. doi: 10.1186/s41182-023-00567-z.
BACKGROUND
Soil-transmitted helminth (STH) infections are a public health concern in endemic areas. For efficient control, the epidemiology of the disease needs to be monitored. This report assesses the prevalence, incidence, post-treatment infection (PTI) rate, and risk factors for STH infections in two rural areas of Gabon.
METHOD
In this longitudinal and prospective study, participants aged six to 30 years from the vicinity of Lambaréné and selected households using a simple randomization process were included and followed in two consecutive periods of six and nine months. Stool samples were obtained at the beginning and the end of each follow-up phase (FUP). The Kato-Katz technique was used for the detection of STH eggs, while the Harada-Mori technique and coproculture were used for the detection of larvae in stool processed within a maximum of four hours of collection. Prevalence was determined at the three main time points of the study, incidence was assessed during the two study phases, and PTI was defined as an infection detected nine months post-treatment.
RESULTS
A total of 262 participants were included. The overall prevalence of STH infections was 42% (95%CI: 34-50) and 44% (95%CI: 37-51) at baseline for the six and nine month FUPs, respectively. Trichuris trichiura was the most prevalent species at each time point of assessment. The cumulative incidence of STH at the 6- and 9-month follow-ups was 18% (95%CI: 12-27) and 35% (95%CI: 27-43), respectively, while the incidence rates were 41 (95%CI: 28-55) and 56 (95%CI: 46-67) per 100 person-years, respectively. The PTI rates at the 9-month follow-up for T. trichiura, hookworm, and Ascaris lumbricoides were 58% (95%CI: 41-74), 31% (95%CI: 11-59) and 18% (95%CI: 5-40), respectively. The STH infection intensity was generally light.
CONCLUSION
The prevalence level of STH infection is moderate in the vicinity of Lambaréné, with T. trichiura being the most prevalent species. Our results reveal a rapid spread of the disease in the population mainly following intervention, particularly for trichuriasis, and therefore call for the full implementation of the World Health Organization's recommendations in the area. Trial registration clinicaltrials.gov Identifier NCT02769013. Registered 21 April 2016, https://clinicaltrials.gov/study/NCT02769013.
背景
土壤传播的蠕虫（STH）感染是流行地区的一个公共卫生问题。为了有效控制，需要监测该疾病的流行病学情况。本报告评估了加蓬两个农村地区STH感染的患病率、发病率、治疗后感染（PTI）率及危险因素。
方法
在这项纵向前瞻性研究中，纳入了来自兰巴雷内附近年龄在6至30岁的参与者，并通过简单随机化过程从选定家庭中选取，连续两个阶段进行为期6个月和9个月的跟踪。在每个随访阶段（FUP）开始和结束时采集粪便样本。采用加藤-厚涂片法检测STH虫卵，而采用原田-森氏法和粪便培养法检测在采集后最多4小时内处理的粪便中的幼虫。在研究的三个主要时间点确定患病率，在两个研究阶段评估发病率，PTI定义为治疗9个月后检测到的感染。
结果
共纳入262名参与者。在6个月和9个月随访的基线时，STH感染的总体患病率分别为42%（95%CI：34 - 50）和44%（95%CI：37 - 51）。在每个评估时间点， Trichuris trichiura是最常见的种类。在6个月和9个月随访时，STH的累积发病率分别为18%（95%CI：12 - 27）和35%（95%CI：27 - 43），而发病率分别为每100人年41例（95%CI：28 - 55）和56例（95%CI：46 - 67）。在9个月随访时， Trichuris trichiura、钩虫和蛔虫的PTI率分别为58%（95%CI：41 - 74）、31%（95%CI：11 - 59）和18%（95%CI：5 - 40）。STH感染强度一般较轻。
结论
兰巴雷内附近STH感染的流行程度为中度，其中Trichuris trichiura是最常见的种类。我们的结果显示，该疾病在人群中主要在干预后迅速传播，特别是对于鞭虫病，因此呼吁在该地区全面实施世界卫生组织的建议。试验注册 clinicaltrials.gov标识符NCT02769013。于2016年4月21日注册，https://clinicaltrials.gov/study/NCT02769013 。
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