Ouedraogo Micheline O, Meda Ivlabèhirè Bertrand, Kourouma Karifa, Wienne Fanny Yago, Nare Dieudonné, Bougouma Clarisse, Compaore Justin, Kouanda Seni
Helen Keller International, Ouagadougou 06 P.O. Box 9515, Burkina Faso.
African Institute of Public Health (IASP), Ouagadougou 12 P.O. Box 199, Burkina Faso.
Trop Med Infect Dis. 2024 Sep 9;9(9):207. doi: 10.3390/tropicalmed9090207.
Almost the entire country of Burkina Faso was endemic to onchocerciasis. Onchocerciasis control efforts thus brought the prevalence of to a level where the disease was no longer a public health problem in 2002. A resurgence of onchocerciasis cases has been observed in two regions (Cascades and the Southwest) located around several river basins in 2010-2011. In accordance with WHO guidelines for the management of resurgent cases, community-directed treatment with ivermectin (CDTI) was implemented in the affected areas. The aim of this study was to determine the effects of this intervention on parasitological indices of onchocerciasis, depending on the distance between villages and rivers.
We conducted a paired pre-post study using aggregated village-level data from two cross-sectional surveys conducted in each region. A Wilcoxon signed-rank test was used to compare the standardized microfilarodermia prevalence and community microfilarial load (CMFL).
A total of 43 villages in 6 health districts, in the Southwest (18) and Cascades (25) regions were included in the study. The key findings were that standardized microfilaria prevalence and CMFL decreased significantly after the implementation of CDTI in both regions ( < 0.0001). The median standardized microfilaria prevalence was 2.8 [interquartile range (IQR): 0.2-6.6] before CDTI and 0.72 [IQR: 0.0-2.17] after CDTI. The results showed also a decline in standardized microfilaria prevalence and CMFL in all villages, regardless of the distance separating the village from the streams. However, the results were not statistically significant for the villages located 5 km or more from streams ( = 0.0816 and 0.0542 for standardized microfilaria prevalence and CMFL, respectively).
Our results thus show that the implementation of effective CDTI could stop the transmission of in these two regions. The main challenge for stopping transmission could be the migration of populations to neighboring countries and migration of the vector from one country to another, as Burkina Faso shares some river basins with neighboring countries.
布基纳法索几乎整个国家都曾是盘尾丝虫病的流行区。因此，盘尾丝虫病防治工作使该病的流行率降至一定水平，到2002年时，该病已不再是一个公共卫生问题。2010 - 2011年，在几个流域周边的两个地区（瀑布区和西南部）观察到盘尾丝虫病病例有所回升。按照世界卫生组织关于复发病例管理的指南，在受影响地区实施了伊维菌素社区定向治疗（CDTI）。本研究的目的是根据村庄与河流之间的距离，确定该干预措施对盘尾丝虫病寄生虫学指标的影响。
我们使用每个地区进行的两次横断面调查汇总的村庄层面数据进行了配对前后研究。采用Wilcoxon符号秩检验来比较标准化微丝蚴血症患病率和社区微丝蚴负荷（CMFL）。
研究纳入了西南部（18个）和瀑布区（25个）地区6个卫生区的共43个村庄。主要发现是，在两个地区实施CDTI后，标准化微丝蚴患病率和CMFL均显著下降（<0.0001）。CDTI实施前标准化微丝蚴患病率中位数为2.8[四分位间距（IQR）：0.2 - 6.6]，实施后为0.72[IQR：0.0 - 2.17]。结果还显示，所有村庄的标准化微丝蚴患病率和CMFL均有所下降，无论村庄与溪流之间的距离如何。然而，对于距离溪流5公里或更远的村庄，结果无统计学意义（标准化微丝蚴患病率和CMFL分别为=0.0816和0.0542）。
我们的结果表明，实施有效的CDTI可以在这两个地区阻止盘尾丝虫病的传播。由于布基纳法索与邻国共享一些流域，阻止传播的主要挑战可能是人口向邻国迁移以及病媒从一个国家迁移到另一个国家。
