2019 - 2023年，萨摩亚抗原阳性个体4.5年间淋巴丝虫病抗原血症和微丝蚴血症的进展情况。
Progression of lymphatic filariasis antigenaemia and microfilaraemia over 4.5 years in antigen-positive individuals, Samoa 2019-2023.
作者信息
Mayfield Helen J, Sartorius Benn, Muttucumaru Ramona, Sheridan Sarah, Howlett Maddison, Martin Beatris Mario, Hedtke Shannon M, Field Emma, Thomsen Robert, Viali Satupaitea, Graves Patricia M, Lau Colleen L
机构信息
University of Queensland Centre for Clinical Research, Faculty of Health, Medicine, and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia; School of Public Health, Faculty of Health, Medicine, and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia.
University of Queensland Centre for Clinical Research, Faculty of Health, Medicine, and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia; School of Public Health, Faculty of Health, Medicine, and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia.
出版信息
Int J Infect Dis. 2025 Jun;155:107891. doi: 10.1016/j.ijid.2025.107891. Epub 2025 Mar 15.
OBJECTIVES
The first round of triple-drug mass drug administration (MDA) for lymphatic filariasis (LF) in Samoa was in 2018. This study aims to i) examine progression of LF antigen (Ag) and microfilaria (Mf) in Ag-positive individuals from 2019-2023; and ii) compare Ag/Mf prevalence in household members of Mf-positive vs Mf-negative participants.
METHODS
In 2023, we tested Ag-positive participants (indexes) from a 2019 survey in Samoa, and their household members. We tested for Ag (Alere/Abbott Filariasis Test Strip) and Mf. We examined changes in Ag/Mf status in index participants and compared Ag/Mf prevalence between household members of Mf-positive and Mf-negative indexes.
RESULTS
We recruited 91 indexes and 317 household members. In 2023, all 17 Mf-positive indexes remained Ag-positive and 11/15 with Mf results (73.3%) were Mf-positive. Of 74 Mf-negative indexes, 79.7% remained Ag-positive in 2023 and 31.1% became Mf-positive. Household members of Mf-positive indexes were more likely to be Ag-positive (odds ratios 3.3, 95% CI 1.0-10.3) compared to those of Mf-negative indexes.
CONCLUSION
Our results raise concerns regarding long-term effectiveness of a single-dose of triple-drug MDA for sustained clearance of Mf in Samoa. Guidelines for follow-up and treatment of Ag/Mf-positive people and household members are urgently required.
目的
萨摩亚2018年开展了第一轮用于淋巴丝虫病（LF）的三药联合群体服药（MDA）。本研究旨在：i）研究2019年至2023年Ag阳性个体中LF抗原（Ag）和微丝蚴（Mf）的进展情况；ii）比较Mf阳性与Mf阴性参与者家庭成员中Ag/Mf的流行情况。
方法
2023年，我们对2019年萨摩亚一项调查中的Ag阳性参与者（索引病例）及其家庭成员进行了检测。我们检测了Ag（Alere/雅培丝虫病检测试纸条）和Mf。我们检查了索引病例中Ag/Mf状态的变化，并比较了Mf阳性和Mf阴性索引病例家庭成员之间Ag/Mf的流行情况。
结果
我们招募了91名索引病例和317名家庭成员。2023年，所有17名Mf阳性索引病例仍为Ag阳性，15名有Mf检测结果的病例中有11名（73.3%）为Mf阳性。在74名Mf阴性索引病例中，79.7%在2023年仍为Ag阳性，31.1%变为Mf阳性。与Mf阴性索引病例的家庭成员相比，Mf阳性索引病例的家庭成员更有可能为Ag阳性（优势比3.3，95%CI 1.0 - 10.3）。
结论
我们的结果引发了对单剂量三药联合MDA在萨摩亚持续清除Mf的长期有效性的担忧。迫切需要针对Ag/Mf阳性人群及其家庭成员的随访和治疗指南。
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