Abstract:
Sri Lanka has successfully met the challenge of controlling both lymphatic filariasis (LF) and soil-transmitted helminthiases (STH) as public health problems. The primary public health strategy for combatting both conditions has been preventive chemotherapy. The national programme for the elimination of LF implemented five annual rounds of mass chemotherapy in the endemic districts from 2002 to 2006 using a combination of diethylcarbamazine and albendazole. The overall microfilaria rate declined from 0.21% in 2001 before the mass chemotherapy, to 0.06% in 2016, at declaration of elimination of LF as a public health problem by the World Health Organization. Currently Sri Lanka is in the phase of post-validation surveillance. Achieving control of STH has been more difficult. Mass deworming programmes have been implemented for nearly a century, and national-level surveys reported prevalence rates declining from 6.9% in 2003 to 1% in 2017. However, neither of these infections has been completely eliminated. A situation analysis indicates continued transmission of both among high-risk communities. This paper explores the reasons for persistence of transmission of both LF and STH in residual pockets and the measures that are required to achieve long-term control, or perhaps even interrupt transmission in Sri Lanka. This article is part of the theme issue \'Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs\'.
摘要:
斯里兰卡已成功应对了控制淋巴丝虫病(LF)和土壤传播的蠕虫病(STH)作为公共卫生问题的挑战。对抗这两种情况的主要公共卫生策略是预防性化疗。从2002年至2006年,消除LF的国家方案在流行地区使用二乙基卡巴嗪和阿苯达唑的组合实施了五轮年度大规模化疗。整体微丝虫病率从2001年的0.21%下降到大规模化疗前,到2016年的0.06%,世界卫生组织宣布消除LF作为公共卫生问题。目前,斯里兰卡正处于验证后监测阶段。实现STH的控制更加困难。大规模驱虫计划已经实施了近一个世纪,国家层面的调查显示,患病率从2003年的6.9%下降到2017年的1%.然而,这些感染都没有完全消除。情况分析表明,两者在高风险社区之间继续传播。本文探讨了LF和STH在剩余口袋中持续传播的原因,以及实现长期控制所需的措施,或者甚至在斯里兰卡中断传输。本文是主题为“抗击被忽视的热带病的挑战和机遇:《伦敦NTDs宣言》十年”的一部分。