Schistosomiasis is a parasitic disease of the tropics which is estimated to affect up to 300 million people worldwide. While it is being successfully controlled in many countries, it remains a major public health prob...Schistosomiasis is a parasitic disease of the tropics which is estimated to affect up to 300 million people worldwide. While it is being successfully controlled in many countries, it remains a major public health problem, especially in developing countries including Ghana. Extensive work on schistosomiasis has been undertaken along theVoltaRiverbasin, leaving very little data and information on this infection in the urban and peri-urban areas inGhana. This study was aimed at determining the urinary schistosomiasis burden among children of school going age within Zenu, a suburb of the capital city. Urine samples were taken from 274 school children within the Zenu community and examined with urine chemistry dipsticks for detection and confirmation of haematuria, followed by microscopy for detection of Schistosoma haematobium ova. Prevalence of urinary schistosomiasis was 30.7% (95% CI: 25.2-36.2). 44 (52%) of the positive samples were collected from males whiles 40 (48%) were collected from females, but prevalence of the infection was not significantly associated with gender (χ2 = 0.041, DF = 1, P-Value = 0.839). Among the S. haematobium positive children, haematuria was detected by the dipstick in 88.1% (74/84, 95% CI: 81.2- 95.0), but it was not detected in 11.9% (10/84, 95% CI: 5.0-18.8). Meanwhile, the dipstick detected haematuria in 7.3% (20/274, 95% CI: 4.3-7.3) of the total population but microscopy could not detect the presence of Schistosoma ova in those children. An association was found between Schistosoma infection and haematuria detected by dipstick (χ2 = 84.715, DF = 1,展开更多
Introduction: Lymphatic filariasis (LF) is one of the neglected tropical diseases targeted for elimination as a public health issue in the world by 2020. To achieve this goal, one of the strategies is interruption of ...Introduction: Lymphatic filariasis (LF) is one of the neglected tropical diseases targeted for elimination as a public health issue in the world by 2020. To achieve this goal, one of the strategies is interruption of transmission using chemotherapy (mass drug administration). Burkina Faso in west Africa, an endemic country, has endorsed this resolution. In 2000, all Sanitary Districts (SD) in the country were endemic, and then a national elimination program has made it possible to stop mass treatment in 45 out of 70 SD over 12 years. Sixteen years later, 13 other SD were reeligible for Transmission Assessment Surveys (TAS). This study aimed to determine the current level of the Mass drugs Administration (MDA) impact indicators in these 13 targeted SD in order to decide whether we need to continue MDA. Method: It was a descriptive study that took place from June to September 2017 in 13 SD regrouped into 7 Evaluation Units (EU). The population of the study was 6 to 7 years old children. The community-based cluster survey method was used. The diagnostic test used to detect Wuchereria bancrofti’s circulating antigen (W. bancrofti) is the Filariasis Test Strip (FTS). The critical threshold of positivity was set at 18 positive subjects per EU. Results: We sampled a total of 12,060 children, 48.9% were female and 51.1% male. In the 7 EU, 13 children were positive to W. bancrofti test. The average antigenic prevalence was 0.11% (13/12,060). In all EU, the number of positive subjects was below the critical threshold. Conclusion: At the end of this evaluation of the transmission of lymphatic filariasis in 13 SD of Burkina Faso, we can tell the MDA could be stopped in these areas without risk of resurgence of the disease, according to the current recommendations of WHO. This can be possible by setting up post-TMM surveillance, considering migratory flows, and including villages where positive cases were found to search possible residual transmission zones.展开更多
Background In 2018,Kenya introduced triple-drug therapy with ivermectin,diethylcarbamazine,albendazole(IDA)through mass drug administration(MDA)to accelerate the elimination of lymphatic filariasis(LF).This communityb...Background In 2018,Kenya introduced triple-drug therapy with ivermectin,diethylcarbamazine,albendazole(IDA)through mass drug administration(MDA)to accelerate the elimination of lymphatic filariasis(LF).This communitybased surveillance study assessed the safety and effectiveness of IDA-MDA in reducing LF-antigenemia prevalence and circulating filarial antigens(CFA)clearance among LF infected individuals.Methods A total of 8928 residents in Mombasa,Kenya,were screened for CFA using the Filarial Test Strip:3464 were screened in 2018 and 5464 in 2021 after two annual IDA-MDA rounds.CFA-positive individuals in 2021 were re-tested at two and four months of post-MDA for CFA-clearance rates.Adverse events(AEs)associated with IDA-MDA were monitored via door-to-door visits on days 1,2,and 7 post-MDA to document the incidence,type and risk factors.Efficacy outcomes included post-MDA LF-antigenemia prevalence reduction after two rounds of annual MDA and CFA clearance rate.Chi-square test compared proportions,and logistic regression analysis identified AE predictors.Results LF antigenemia prevalence significantly decreased from 1.39%(n=48)in 2018 to 0.66%(n=36)in 2021[P<0.001;95%confidence interval(CI)for difference in proportions:0.003-0.012].CFA clearance rates were 63.2%(12/19,95%CI:41.0-80.1%)at 2 months and 68.4%(13/19,95%CI:46.0-86.6%)at 4 months post-MDA.Among 53 CFA-positive individuals monitored,the cumulative 7-day AE incidence was 37.7%(95%CI:25.6-51.7),higher than the general population’s 27.3%(95%CI:26.4-28.2).Common AEs included nausea(11.3%),diarrhea(11.3%),abdominal pain(7.6%),and headache(5.7%).Risk factors for AEs included age,overweight status,concomitant medication use,chronic illness,and fasting before MDA.Conclusions Triple therapy with IDA is safe and well-tolerated,with some mild-to-moderate and transient adverse events among LF-infected individuals.The high incidence of AEs highlights the need for safety monitoring during MDA.The significant reductions in LF antigenemia prevalence and high CFA clearance rates underscore IDA’s effectiveness in reducing LF transmission,positioning it as a key strategy for eliminating LF as a public health problem by 2030.展开更多
Background:A high prevalence of epilepsy has been observed in many onchocerciasis endemic regions.This study is to estimate the prevalence of active epilepsy and exposure to Onchocerca volvulus infection in a rural po...Background:A high prevalence of epilepsy has been observed in many onchocerciasis endemic regions.This study is to estimate the prevalence of active epilepsy and exposure to Onchocerca volvulus infection in a rural population in Ituri province,Democratic Republic of Congo.Methods:In August 2016,a community-based cross-sectional study was conducted in an onchocerciasis endemic area in the rural health zone of Logo,Ituri Province.Households within two neighbouring health areas were randomly sampled.To identify persons with epilepsy,a three-stage approach was used.In the first stage,all individuals of the selected households were screened for epilepsy by non-medical field workers using a validated 5-item questionnaire.In the second and third stage,suspected cases of epilepsy were examined by non-specialist medical doctors,and by a neurologist,respectively.A case of epilepsy was defined according to the 2014 International League Against Epilepsy(ILAE)guidelines.Exposure to O.volvulus was assessed by testing for IgG4 antibodies to an O.volvulus antigen(OV16 Rapid Test,)in individuals aged 3 years and older.Results:Out of 1389 participants included in the survey,64 were considered to have active epilepsy(prevalence 4.6%)(95%confidence interval[CI]:3.6-5.8).The highest age-specific epilepsy prevalence estimate was observed in those aged 20 to 29 years(8.2%).Median age of epilepsy onset was 10 years,with a peak incidence of epilepsy in the 10 to 15 year-old age group.OV16 test results were available for 912 participants,of whom 30.5%(95%CI,27.6-33.6)tested positive.The prevalence of OV16 positivity in a village ranged from 8.6 to 68.0%.After adjusting for age,gender and ivermectin use,a significant association between exposure to onchocerciasis and epilepsy was observed(adjusted odds ratio=3.19,95%CI:1.63-5.64)(P<0.001).Conclusions:A high prevalence of epilepsy and a significant association between epilepsy and exposure to O.volvulus were observed in the population in Ituri province,Democratic Republic of Congo.There is an urgent need to implement a CDTI programme and to scale up an epilepsy treatment and care programme.展开更多
Background:Baseline mapping of soil-transmitted helminth(STH)infections among school age children(SAC)in 2008-2009 found high or moderate prevalence in 13 of the 14 districts in Sierra Leone.Following these surveys,ma...Background:Baseline mapping of soil-transmitted helminth(STH)infections among school age children(SAC)in 2008-2009 found high or moderate prevalence in 13 of the 14 districts in Sierra Leone.Following these surveys,mass drug administration(MDA)of mebendazole/albendazole was conducted biannually at national level targeting pre-school children(PSC)aged 12-59 months and intermittently at sub-national level targeting SAC.In addition,MDA with ivermectin and albendazole for eliminating lymphatic filariasis(LF)has been conducted nationwide since 2010 targeting individuals over 5 years of age.Each MDA achieved high coverage,except in 2014 when all but one round of MDA for PSC was cancelled due to the Ebola emergency.The objective of the current study was to determine the prevalence and intensity of STH infections among SAC after a decade of these deworming campaigns.Methods:Seventy-three schools in 14 districts were purposefully selected,including 39 schools from the baseline surveys,with approximately two sites from each of low,moderate and high prevalence categories at baseline per district.Fresh stool samples were collected from 3632 children aged 9-14 years(male 51%,female 49%)and examined using the Kato Katz technique.Results:The prevalence of STH infections in Sierra Leone decreased in 2016 compared to 2008:Ascaris lumbricoides 4.4%(95%confidence interval[CI]:3.7-5.1%)versus 6.6%(95%CI:0-25%),Trichuris trichiura 0.7%(95%CI:0.5-1.1%)versus 1.8%(95%CI:0-30.2%),hookworm 14.9%(95%CI:13.8-16.1)versus 38.5%(95%CI:5.4-95.1%),and any STH 18.3%(95%CI:17.0-19.5%)versus 48.3%(CI:5.4-96.3%),respectively.In 2016,no district had high hookworm prevalence and four districts had moderate prevalence,compared with eight and four districts respectively in 2008.In 2016,the arithmetic mean hookworm egg count in all children examined was light:45.5 eggs per gram(EPG)of faeces,(95%CI:\35.96-55.07 EPG);three(0.08%)children had heavy infections and nine(0.25%)children had moderate infections.Conclusions:Sierra Leone has made considerable progress toward controlling STH as a public health problem among SAC.As LF MDA phases out(between 2017 and 2021),transition of deworming to other platforms and water and sanitation strategies need to be strengthened to maintain STH control and ultimately interrupt transmission.展开更多
文摘Schistosomiasis is a parasitic disease of the tropics which is estimated to affect up to 300 million people worldwide. While it is being successfully controlled in many countries, it remains a major public health problem, especially in developing countries including Ghana. Extensive work on schistosomiasis has been undertaken along theVoltaRiverbasin, leaving very little data and information on this infection in the urban and peri-urban areas inGhana. This study was aimed at determining the urinary schistosomiasis burden among children of school going age within Zenu, a suburb of the capital city. Urine samples were taken from 274 school children within the Zenu community and examined with urine chemistry dipsticks for detection and confirmation of haematuria, followed by microscopy for detection of Schistosoma haematobium ova. Prevalence of urinary schistosomiasis was 30.7% (95% CI: 25.2-36.2). 44 (52%) of the positive samples were collected from males whiles 40 (48%) were collected from females, but prevalence of the infection was not significantly associated with gender (χ2 = 0.041, DF = 1, P-Value = 0.839). Among the S. haematobium positive children, haematuria was detected by the dipstick in 88.1% (74/84, 95% CI: 81.2- 95.0), but it was not detected in 11.9% (10/84, 95% CI: 5.0-18.8). Meanwhile, the dipstick detected haematuria in 7.3% (20/274, 95% CI: 4.3-7.3) of the total population but microscopy could not detect the presence of Schistosoma ova in those children. An association was found between Schistosoma infection and haematuria detected by dipstick (χ2 = 84.715, DF = 1,
文摘Introduction: Lymphatic filariasis (LF) is one of the neglected tropical diseases targeted for elimination as a public health issue in the world by 2020. To achieve this goal, one of the strategies is interruption of transmission using chemotherapy (mass drug administration). Burkina Faso in west Africa, an endemic country, has endorsed this resolution. In 2000, all Sanitary Districts (SD) in the country were endemic, and then a national elimination program has made it possible to stop mass treatment in 45 out of 70 SD over 12 years. Sixteen years later, 13 other SD were reeligible for Transmission Assessment Surveys (TAS). This study aimed to determine the current level of the Mass drugs Administration (MDA) impact indicators in these 13 targeted SD in order to decide whether we need to continue MDA. Method: It was a descriptive study that took place from June to September 2017 in 13 SD regrouped into 7 Evaluation Units (EU). The population of the study was 6 to 7 years old children. The community-based cluster survey method was used. The diagnostic test used to detect Wuchereria bancrofti’s circulating antigen (W. bancrofti) is the Filariasis Test Strip (FTS). The critical threshold of positivity was set at 18 positive subjects per EU. Results: We sampled a total of 12,060 children, 48.9% were female and 51.1% male. In the 7 EU, 13 children were positive to W. bancrofti test. The average antigenic prevalence was 0.11% (13/12,060). In all EU, the number of positive subjects was below the critical threshold. Conclusion: At the end of this evaluation of the transmission of lymphatic filariasis in 13 SD of Burkina Faso, we can tell the MDA could be stopped in these areas without risk of resurgence of the disease, according to the current recommendations of WHO. This can be possible by setting up post-TMM surveillance, considering migratory flows, and including villages where positive cases were found to search possible residual transmission zones.
基金the European Union’s Horizon 2020 Framework for Research and Innovation through the European and Developing Countries Clinical Trials Partnership Association(EDCTP2)(Grant agreement number CSA2016S-1618)the Swedish International Development Cooperation Agency(SIDA)(Grant number CSA2016S-1618).
文摘Background In 2018,Kenya introduced triple-drug therapy with ivermectin,diethylcarbamazine,albendazole(IDA)through mass drug administration(MDA)to accelerate the elimination of lymphatic filariasis(LF).This communitybased surveillance study assessed the safety and effectiveness of IDA-MDA in reducing LF-antigenemia prevalence and circulating filarial antigens(CFA)clearance among LF infected individuals.Methods A total of 8928 residents in Mombasa,Kenya,were screened for CFA using the Filarial Test Strip:3464 were screened in 2018 and 5464 in 2021 after two annual IDA-MDA rounds.CFA-positive individuals in 2021 were re-tested at two and four months of post-MDA for CFA-clearance rates.Adverse events(AEs)associated with IDA-MDA were monitored via door-to-door visits on days 1,2,and 7 post-MDA to document the incidence,type and risk factors.Efficacy outcomes included post-MDA LF-antigenemia prevalence reduction after two rounds of annual MDA and CFA clearance rate.Chi-square test compared proportions,and logistic regression analysis identified AE predictors.Results LF antigenemia prevalence significantly decreased from 1.39%(n=48)in 2018 to 0.66%(n=36)in 2021[P<0.001;95%confidence interval(CI)for difference in proportions:0.003-0.012].CFA clearance rates were 63.2%(12/19,95%CI:41.0-80.1%)at 2 months and 68.4%(13/19,95%CI:46.0-86.6%)at 4 months post-MDA.Among 53 CFA-positive individuals monitored,the cumulative 7-day AE incidence was 37.7%(95%CI:25.6-51.7),higher than the general population’s 27.3%(95%CI:26.4-28.2).Common AEs included nausea(11.3%),diarrhea(11.3%),abdominal pain(7.6%),and headache(5.7%).Risk factors for AEs included age,overweight status,concomitant medication use,chronic illness,and fasting before MDA.Conclusions Triple therapy with IDA is safe and well-tolerated,with some mild-to-moderate and transient adverse events among LF-infected individuals.The high incidence of AEs highlights the need for safety monitoring during MDA.The significant reductions in LF antigenemia prevalence and high CFA clearance rates underscore IDA’s effectiveness in reducing LF transmission,positioning it as a key strategy for eliminating LF as a public health problem by 2030.
基金CR received funding from the European Research Council(grant No.ERC 671055).
文摘Background:A high prevalence of epilepsy has been observed in many onchocerciasis endemic regions.This study is to estimate the prevalence of active epilepsy and exposure to Onchocerca volvulus infection in a rural population in Ituri province,Democratic Republic of Congo.Methods:In August 2016,a community-based cross-sectional study was conducted in an onchocerciasis endemic area in the rural health zone of Logo,Ituri Province.Households within two neighbouring health areas were randomly sampled.To identify persons with epilepsy,a three-stage approach was used.In the first stage,all individuals of the selected households were screened for epilepsy by non-medical field workers using a validated 5-item questionnaire.In the second and third stage,suspected cases of epilepsy were examined by non-specialist medical doctors,and by a neurologist,respectively.A case of epilepsy was defined according to the 2014 International League Against Epilepsy(ILAE)guidelines.Exposure to O.volvulus was assessed by testing for IgG4 antibodies to an O.volvulus antigen(OV16 Rapid Test,)in individuals aged 3 years and older.Results:Out of 1389 participants included in the survey,64 were considered to have active epilepsy(prevalence 4.6%)(95%confidence interval[CI]:3.6-5.8).The highest age-specific epilepsy prevalence estimate was observed in those aged 20 to 29 years(8.2%).Median age of epilepsy onset was 10 years,with a peak incidence of epilepsy in the 10 to 15 year-old age group.OV16 test results were available for 912 participants,of whom 30.5%(95%CI,27.6-33.6)tested positive.The prevalence of OV16 positivity in a village ranged from 8.6 to 68.0%.After adjusting for age,gender and ivermectin use,a significant association between exposure to onchocerciasis and epilepsy was observed(adjusted odds ratio=3.19,95%CI:1.63-5.64)(P<0.001).Conclusions:A high prevalence of epilepsy and a significant association between epilepsy and exposure to O.volvulus were observed in the population in Ituri province,Democratic Republic of Congo.There is an urgent need to implement a CDTI programme and to scale up an epilepsy treatment and care programme.
基金the United States Agency for International Developm ent(USAID)through a grant to Helen Keller International,Cooperative Agreement No.GHS-A-00-06-00006-00 with the End NTDs in Africa project managed by Family Health International 360.
文摘Background:Baseline mapping of soil-transmitted helminth(STH)infections among school age children(SAC)in 2008-2009 found high or moderate prevalence in 13 of the 14 districts in Sierra Leone.Following these surveys,mass drug administration(MDA)of mebendazole/albendazole was conducted biannually at national level targeting pre-school children(PSC)aged 12-59 months and intermittently at sub-national level targeting SAC.In addition,MDA with ivermectin and albendazole for eliminating lymphatic filariasis(LF)has been conducted nationwide since 2010 targeting individuals over 5 years of age.Each MDA achieved high coverage,except in 2014 when all but one round of MDA for PSC was cancelled due to the Ebola emergency.The objective of the current study was to determine the prevalence and intensity of STH infections among SAC after a decade of these deworming campaigns.Methods:Seventy-three schools in 14 districts were purposefully selected,including 39 schools from the baseline surveys,with approximately two sites from each of low,moderate and high prevalence categories at baseline per district.Fresh stool samples were collected from 3632 children aged 9-14 years(male 51%,female 49%)and examined using the Kato Katz technique.Results:The prevalence of STH infections in Sierra Leone decreased in 2016 compared to 2008:Ascaris lumbricoides 4.4%(95%confidence interval[CI]:3.7-5.1%)versus 6.6%(95%CI:0-25%),Trichuris trichiura 0.7%(95%CI:0.5-1.1%)versus 1.8%(95%CI:0-30.2%),hookworm 14.9%(95%CI:13.8-16.1)versus 38.5%(95%CI:5.4-95.1%),and any STH 18.3%(95%CI:17.0-19.5%)versus 48.3%(CI:5.4-96.3%),respectively.In 2016,no district had high hookworm prevalence and four districts had moderate prevalence,compared with eight and four districts respectively in 2008.In 2016,the arithmetic mean hookworm egg count in all children examined was light:45.5 eggs per gram(EPG)of faeces,(95%CI:\35.96-55.07 EPG);three(0.08%)children had heavy infections and nine(0.25%)children had moderate infections.Conclusions:Sierra Leone has made considerable progress toward controlling STH as a public health problem among SAC.As LF MDA phases out(between 2017 and 2021),transition of deworming to other platforms and water and sanitation strategies need to be strengthened to maintain STH control and ultimately interrupt transmission.
