Midzi Nicholas, Mutsaka-Makuvaza Masceline Jenipher, Phiri Isaac, Palatio Karen, Bakajika Didier, Zouré Honorat M, Juma Elizabeth, Anderson Molly, Mwabvu Rebecca, Bockarie Moses J, Cano Jorge, Njenga Sammy M
National Institute of Health Research, Ministry of Health and Child Care, Harare, Zimbabwe.
National Institute of Health Research, Ministry of Health and Child Care, Harare, Zimbabwe; Department of Microbiology and Parasitology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, Butare, Rwanda.
Int J Infect Dis. 2025 Mar;152:107791. doi: 10.1016/j.ijid.2025.107791. Epub 2025 Jan 27.
Zimbabwe is endemic for lymphatic filariasis (LF) with 39 districts identified for mass drug administration (MDA) in 2014. The objective of this study was to reassess the current population requiring MDA.
The LF confirmatory mapping method was used to evaluate the prevalence of circulating filarial antigens among school-aged children (9-14 years) in previously endemic districts. This was achieved through a cross-sectional survey between 2021 and 2023, applying a cluster sampling approach across 39 districts, targeting 18,720 children to assess ongoing LF transmission.
The findings revealed a significant decline in LF prevalence, with an overall rate of 0.43%. Importantly, 82.05% of districts previously identified as endemic were reclassified as nonendemic. Only seven districts retained endemic status, necessitating continued MDA using the triple-drug therapy regimen. Population estimates based on 2022 census data indicated that 1.19 million individuals across these districts require MDA, representing an 84.4% reduction compared to previous estimates. Despite the progress, the persistence of low-level transmission in certain districts highlights the need for sustained surveillance and morbidity management services, including hydrocele surgery and lymphedema care.
There was a significant reduction in the number of people requiring MDA. The decline in LF endemicity is attributed to a combination of factors, including prior rounds of MDA and vector control initiatives including historical interventions, such as dichlorodiphenyltrichloroethane spraying against human African trypanosomiasis.
津巴布韦是淋巴丝虫病（LF）的流行地区，2014年确定了39个地区进行大规模药物治疗（MDA）。本研究的目的是重新评估目前需要进行MDA的人群。
采用LF确诊地图绘制方法，评估以前流行地区学龄儿童（9至14岁）中循环丝虫抗原的流行情况。这是通过2021年至2023年的横断面调查实现的，在39个地区采用整群抽样方法，目标是18720名儿童，以评估LF的持续传播情况。
研究结果显示LF流行率显著下降，总体率为0.43%。重要的是，先前被确定为流行的地区中有82.05%被重新归类为非流行地区。只有七个地区保持流行状态，需要继续使用三联药物治疗方案进行MDA。根据2022年人口普查数据进行的人口估计表明，这些地区有119万人需要进行MDA，与先前的估计相比减少了84.4%。尽管取得了进展，但某些地区低水平传播的持续存在凸显了持续监测和发病管理服务的必要性，包括鞘膜积液手术和淋巴水肿护理。
需要进行MDA的人数显著减少。LF流行率的下降归因于多种因素的综合作用，包括先前几轮的MDA和病媒控制举措，包括历史干预措施，如针对人类非洲锥虫病喷洒二氯二苯三氯乙烷。
