Olsen A
Danish Bilharziasis Laboratory, Charlottenlund, Denmark.
Trans R Soc Trop Med Hyg. 1998 Mar-Apr;92(2):144-8. doi: 10.1016/s0035-9203(98)90721-0.
The present study used data from a community-based epidemiological survey of 752 persons in 3 villages in Kisumu District, western Kenya, to examine the proportion of infected persons who would be treated, as well as the effect on helminth egg production, if anthelmintics were provided to schoolchildren. Overall prevalences of hookworm, Ascaris lumbricoides, Trichuris trichiura and Schistosoma mansoni infections were 63%, 16%, 24% and 24% respectively, and intensities were low for all infections. Only 79% of the school-aged children were enrolled. For all 4 infections, a school-based programme would treat between 76% and 86% of infected school-age children and would theoretically eliminate between 83% and 92% of the number of eggs excreted by this age group. Of the total population, school-based programmes would treat only between 31% and 50% of the infected persons and eliminate only 15%, 46%, 29% and 27% of the total number of hookworm, Ascaris, Trichuris and S. mansoni eggs excreted, respectively. Provided that school attendance rates were high in the study area, school-based programmes would be efficient in improving the helminth infection status of school-aged children. On the other hand, adults, non-enrolled school-aged children and preschool children not offered treatment represented more than half of the helminth-infected persons and they excreted between half and 85% of the total burden of helminth eggs in the area. Hence, mass chemotherapy of schoolchildren would be less effective in the control of at least hookworm and S. mansoni infections in this specific community. There should therefore be a community-based approach to helminth control in combination with a school-based programme.
本研究使用了来自肯尼亚西部基苏木区3个村庄752人的社区流行病学调查数据，以检验若为学童提供驱虫药，接受治疗的感染者比例以及对蠕虫卵产出的影响。钩虫、蛔虫、鞭虫和曼氏血吸虫感染的总体患病率分别为63%、16%、24%和24%，所有感染的感染强度均较低。只有79%的学龄儿童入学。对于所有4种感染，以学校为基础的项目将治疗76%至86%的受感染学龄儿童，理论上可消除该年龄组排出虫卵数量的83%至92%。在总人口中，以学校为基础的项目只能治疗31%至50%的感染者，分别只能消除钩虫、蛔虫、鞭虫和曼氏血吸虫排出虫卵总数的15%、46%、29%和27%。假设研究地区的入学率较高，以学校为基础的项目将有效地改善学龄儿童的蠕虫感染状况。另一方面，未接受治疗的成年人、未入学的学龄儿童和学龄前儿童占蠕虫感染者的一半以上，他们排出的蠕虫卵占该地区虫卵总负担的一半至85%。因此，在这个特定社区，对学童进行群体化疗在控制至少钩虫和曼氏血吸虫感染方面效果较差。因此，应该采用基于社区的蠕虫控制方法并结合以学校为基础的项目。
