在喀麦隆、科特迪瓦和加纳的雅司病流行卫生区开展综合性主动病例发现和皮肤性 NTD 管理。
An integrated active case detection and management of skin NTDs in yaws endemic health districts in Cameroon, Côte d'Ivoire and Ghana.
机构信息
Centre Pasteur du Cameroun, Yaoundé, Cameroon.
Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana.
出版信息
PLoS Negl Trop Dis. 2024 Oct 4;18(10):e0011790. doi: 10.1371/journal.pntd.0011790. eCollection 2024 Oct.
BACKGROUND
Integrated approaches to mapping skin Neglected Tropical Diseases (NTDs) may be cost-effective way to guide decisions on resource mobilization. Pilot studies have been carried out, but large-scale data covering multiple countries endemic for skin NTDs are lacking. Within the LAMP4YAWS project, we collected integrated data on the burden of multiple skin NTDs.
METHODS
From March 2021 to March 2023, integrated case searches for yaws alongside other skin conditions were performed in endemic health districts of yaws in Cameroon, Côte d'Ivoire, and Ghana. Integrated activities included training, social mobilization and active case detection. Initial screening involved a brief clinical examination of participants to determine if any skin conditions were suspected. Cases of skin NTDs were then referred to a health facility for appropriate management.
RESULTS
Overall 61,080 individuals screened, 11,387 (18.6%) had skin lesions. The majority of individuals (>90%) examined were children aged 15 years old and under. The proportion of serologically confirmed yaws cases was 8.6% (18/210) in Cameroon, 6.8% (84/1232) in Côte d'Ivoire, and 26.8% (440/1643) in Ghana. Other skin conditions based on clinical examination included: scabies, Buruli ulcer, leprosy, lymphatic filariasis (lymphoedema and hydrocele), tungiasis, and fungal infections. The most common conditions were scabies and superficial fungal infections. In Cameroon, scabies and superficial fungal infections accounted for 5.1% (214/4204) and 88.7% (3730/4204) respectively, 25.2% (1285/5095) and 50.4% (2567/5095) in Côte d'Ivoire. In Ghana, 20% (419/2090) of individuals had scabies but superficial fungal infections were not routinely recorded and were reported in only 1.3% (28/2090). Other skin NTDs were less common across all three countries.
CONCLUSION
This study confirms that integrated screening allows simultaneous detection of multiple skin NTDs, maximising use of scarce resources.
背景
综合方法绘制皮肤被忽视热带病（NTDs）图谱可能是一种具有成本效益的方法，可以指导资源调动决策。已经开展了试点研究，但缺乏涵盖多个皮肤 NTD 流行国家的大规模数据。在 LAMP4YAWS 项目中，我们收集了多种皮肤 NTD 负担的综合数据。
方法
从 2021 年 3 月至 2023 年 3 月，在喀麦隆、科特迪瓦和加纳的雅司病流行卫生区，对雅司病和其他皮肤疾病进行了综合病例搜索。综合活动包括培训、社会动员和主动病例发现。初步筛查包括对参与者进行简短的临床检查，以确定是否存在任何皮肤疾病。然后将皮肤 NTD 病例转诊到医疗机构进行适当管理。
结果
共有 61080 人接受了筛查，11387 人（18.6%）有皮肤损伤。接受检查的大多数人（>90%）是 15 岁以下的儿童。在喀麦隆，血清学确诊的雅司病病例比例为 8.6%（18/210），科特迪瓦为 6.8%（84/1232），加纳为 26.8%（440/1643）。基于临床检查的其他皮肤疾病包括：疥疮、布鲁里溃疡、麻风病、淋巴丝虫病（淋巴水肿和鞘膜积液）、麦地那龙线虫病和真菌感染。最常见的疾病是疥疮和浅部真菌感染。在喀麦隆，疥疮和浅部真菌感染分别占 5.1%（214/4204）和 88.7%（3730/4204），科特迪瓦分别占 25.2%（1285/5095）和 50.4%（2567/5095）。在加纳，20%（419/2090）的人患有疥疮，但浅部真菌感染并未常规记录，仅报告了 1.3%（28/2090）。其他皮肤 NTD 在所有三个国家都较少见。
结论
这项研究证实，综合筛查允许同时检测多种皮肤 NTD，最大限度地利用了稀缺资源。
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