Meyrowitsch D W, Simonsen P E, Makunde W H
Danish Bilharziasis Laboratory, Charlottenlund, Denmark.
Trans R Soc Trop Med Hyg. 1996 Jan-Feb;90(1):74-9. doi: 10.1016/s0035-9203(96)90485-x.
The efficacy of 2 strategies for the control of bancroftian filariasis using diethylcarbamazine (DEC) mass chemotherapy delivered through community participation was evaluated and compared in 2 endemic communities in Tanzania with pre-treatment microfilarial (mf) prevalences of 34.7% and 31.0%, and mf geometric mean intensities (GMI) of 1122 mf/mL and 933 mf/mL, respectively. In the first community, all individuals aged > or = 1 year were offered treatment for one year with a low monthly dose (50 mg DEC to children aged < 15 years and 100 mg DEC to adults aged > or = 15 years; given independently of body weight), and in the second community all households were offered 0.33% w/w DEC-medicated cooking salt for one year. Both treatment strategies resulted in dramatic reductions in the mf loads. Among those microfilaraemic before treatment, the low monthly dose and the DEC-medicated salt gave mf clearance rates of 55.3% and 92.1%, respectively, and the pre-treatment mf GMIs were reduced by 99.4% and 99.9%, respectively, one year after starting treatment. At community level, the mf prevalences were reduced to 15.8% and 2.4% (reductions of 54.5% and 92.3%) and the mf GMIs were reduced to 100 mf/mL and 32 mf/mL (reductions of 91.1% and 96.6%), one year after starting treatment with the low monthly dose and DEC-medicated salt respectively. Males with hydrocele before treatment improved remarkably one year after the start of treatment. Since both strategies were simple to administer and well accepted by the communities, they appear highly feasible for integration into large scale control programmes based on community participation.
在坦桑尼亚的两个流行社区，对通过社区参与实施乙胺嗪（DEC）群体化疗来控制班氏丝虫病的两种策略的效果进行了评估和比较。这两个社区治疗前的微丝蚴（mf）患病率分别为34.7%和31.0%，mf几何平均强度（GMI）分别为1122 mf/mL和933 mf/mL。在第一个社区，为所有年龄≥1岁的个体提供为期一年的低剂量每月治疗（15岁以下儿童50 mg DEC，15岁及以上成人100 mg DEC；与体重无关），在第二个社区，为所有家庭提供为期一年的0.33% w/w DEC药盐。两种治疗策略均使mf负荷显著降低。在治疗前有微丝蚴血症的人群中，低剂量每月治疗和DEC药盐的mf清除率分别为55.3%和92.1%，开始治疗一年后，治疗前的mf GMI分别降低了99.4%和99.9%。在社区层面，开始低剂量每月治疗和DEC药盐治疗一年后，mf患病率分别降至15.8%和2.4%（降低了54.5%和92.3%），mf GMI分别降至100 mf/mL和32 mf/mL（降低了91.1%和96.6%）。治疗前患有鞘膜积液的男性在开始治疗一年后有显著改善。由于两种策略实施简单且社区接受度高，它们似乎非常适合纳入基于社区参与的大规模控制项目。
