布基纳法索西南大区在采取媒介控制措施后曾发生再猖獗事件，目前在消灭盘尾丝虫病方面取得了进展。
Progress towards elimination of onchocerciasis in the Region du Sud-Ouest of Burkina Faso which was previously subject to a recrudescence event after vector control.
机构信息
Ministère de l'Enseignement Supérieur, de la Recherche et de l'Innovation, Institut de Recherche en Sciences de la Santé, Direction Régionale de l'Ouest (IRSS/Bobo-Dioulasso), Ouagadougou, Burkina Faso.
Université Cheikh Anta Diop, Dakar, Sénégal.
出版信息
PLoS Negl Trop Dis. 2024 Apr 29;18(4):e0012118. doi: 10.1371/journal.pntd.0012118. eCollection 2024 Apr.
BACKGROUND
The Sud-Ouest region of Burkina Faso (especially the Bougouriba valley) has been historically problematic with respect to onchocerciasis control, with a recrudescence of infections after vector control carried out the WHO Onchocerciasis Control Programme was halted in 1989. After 1996, mass drug administration of ivermectin was instigated to control the recrudescence so that it would no longer constitute a public health problem. However, in 2010 WHO changed its recommended policy from control to elimination, and in 2013 biannual Community-Directed Treatment with Ivermectin (CDTI) was instigated. Epidemiological surveys were carried-out in 2011 and 2018 to determine whether CDTI was producing a decline in infection levels and progress towards elimination.
METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional study was conducted across 20 villages in four health districts in 2011 and 29 villages in 2018. Individuals aged five years and above were examined by skin-snip, and the prevalence and microfilarial load was determined for each village. In 2011, 75% of villages had some infections and 20% had prevalences >5%, with a mean prevalence across all villages of 2.63% (range 0.0-9.7%), and community microfilarial load ranging from 0 to 0.25 microfilariae per biopsy. In 2018, nine villages (= 31% of total) had some infections, with prevalences ranging from 0.41% to 3.54%, and a mean prevalence across all villages of 0.37%. Community microfilarial load ranged from 0 to 0.1. Amongst those people found to be microfilarial positive, 87% had a history of migration.
CONCLUSIONS/SIGNIFICANCE: The endemicity of onchocerciasis infection in the Sud-Ouest region has declined to low levels and seems to be progressing towards elimination. Our findings indicated that biannual CDTI is having good effect, but it should continue for a number of years to ensure elimination of transmission. However, progress towards elimination has a troublesome history in this region, and it would be advisable to select more sentinel villages to have confidence in any future epidemiological and entomological surveys, especially Stop-MDA surveys. With positive individuals migrating between countries, cross-border collaboration needs more attention to ensure effective treatment for onchocerciasis elimination.
背景
布基纳法索西南部地区（尤其是布古里巴河谷）在控制盘尾丝虫病方面一直存在问题，1989 年世界卫生组织停止盘尾丝虫病控制规划后，感染再次加剧。1996 年之后，开始大规模使用伊维菌素进行药物治疗，以控制感染的再次加剧，使其不再成为公共卫生问题。然而，2010 年世界卫生组织将其建议的政策从控制改为消除，2013 年开始实施两年一次的社区伊维菌素治疗（CDTI）。2011 年和 2018 年进行了流行病学调查，以确定 CDTI 是否正在降低感染水平并朝着消除的方向发展。
方法/主要发现：2011 年在四个卫生区的 20 个村庄和 2018 年在 29 个村庄进行了横断面研究。对五岁及以上的个体进行皮肤划痕检查，并确定每个村庄的流行率和微丝蚴载量。2011 年，75%的村庄存在一些感染，20%的村庄流行率>5%，所有村庄的平均流行率为 2.63%（范围为 0.0-9.7%），社区微丝蚴载量范围为 0 至 0.25 条微丝蚴/活检。2018 年，九个村庄（=总村庄的 31%）存在一些感染，流行率范围为 0.41%至 3.54%，所有村庄的平均流行率为 0.37%。社区微丝蚴载量范围为 0 至 0.1。在发现微丝蚴阳性的人群中，87%有迁移史。
结论/意义：西南部地区的盘尾丝虫病感染的流行率已降至低水平，并且似乎正在朝着消除的方向发展。我们的研究结果表明，两年一次的 CDTI 效果良好，但为了确保传播的消除，还需要继续多年。然而，该地区在实现消除方面存在令人困扰的历史，明智的做法是选择更多的哨点村庄，以对未来的流行病学和昆虫学调查，特别是停止药物治疗的调查有信心。由于阳性个体在国家之间迁移，跨境合作需要更加关注，以确保有效治疗盘尾丝虫病的消除。
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