PDF(Pubmed)
Abstract：
BACKGROUND: After decades of praziquantel mass drug administration (MDA), several countries approach schistosomiasis elimination. Continuing MDA in largely uninfected populations no longer seems justified. Alternative interventions to maintain the gains or accelerate interruption of transmission are needed. We report results, strengths, and shortcomings of novel test-treat-track-test-treat (5T) interventions in low Schistosoma haematobium prevalence areas on Pemba, Tanzania.
METHODS: School- and household-based surveys were conducted in 2021 and 2022 to monitor the S. haematobium and microhematuria prevalence and assess the impact of interventions. In 2021, 5T interventions were implemented in 15 low-prevalence areas and included: (i) testing schoolchildren in primary and Islamic schools for microhematuria as a proxy for S. haematobium, (ii) treating positive children, (iii) tracking them to their households and to water bodies they frequented, (iv) testing individuals at households and water bodies, and (v) treating positive individuals. Additionally, test-and-treat interventions were implemented in the 22 health facilities of the study area.
RESULTS: The S. haematobium prevalence in the school-based survey in 15 low-prevalence implementation units was 0.5% (7/1560) in 2021 and 0.4% (6/1645) in 2022. In the household-based survey, 0.5% (14/2975) and 0.7% (19/2920) of participants were infected with S. haematobium in 2021 and 2022, respectively. The microhematuria prevalence, excluding trace results, in the school-based survey was 1.4% (21/1560) in 2021 and 1.5% (24/1645) in 2022. In the household-based survey, it was 3.3% (98/2975) in 2021 and 5.4% (159/2920) in 2022. During the 5T interventions, the microhaematuria prevalence was 3.8% (140/3700) and 5.8% (34/594) in children in primary and Islamic schools, respectively, 17.1% (44/258) in household members, and 16.7% (10/60) in people at water bodies. In health facilities, 19.8% (70/354) of patients tested microhematuria-positive.
CONCLUSIONS: The targeted 5T interventions maintained the very low S. haematobium prevalence and proved straightforward and feasible to identify and treat many of the few S. haematobium-infected individuals. Future research will show whether 5T interventions can maintain gains in the longer-term and expedite elimination.
BACKGROUND: ISRCTN, ISCRCTN91431493. Registered 11 February 2020, https://www.isrctn.com/ISRCTN91431493 .
METHODS: School- and household-based surveys were conducted in 2021 and 2022 to monitor the S. haematobium and microhematuria prevalence and assess the impact of interventions. In 2021, 5T interventions were implemented in 15 low-prevalence areas and included: (i) testing schoolchildren in primary and Islamic schools for microhematuria as a proxy for S. haematobium, (ii) treating positive children, (iii) tracking them to their households and to water bodies they frequented, (iv) testing individuals at households and water bodies, and (v) treating positive individuals. Additionally, test-and-treat interventions were implemented in the 22 health facilities of the study area.
RESULTS: The S. haematobium prevalence in the school-based survey in 15 low-prevalence implementation units was 0.5% (7/1560) in 2021 and 0.4% (6/1645) in 2022. In the household-based survey, 0.5% (14/2975) and 0.7% (19/2920) of participants were infected with S. haematobium in 2021 and 2022, respectively. The microhematuria prevalence, excluding trace results, in the school-based survey was 1.4% (21/1560) in 2021 and 1.5% (24/1645) in 2022. In the household-based survey, it was 3.3% (98/2975) in 2021 and 5.4% (159/2920) in 2022. During the 5T interventions, the microhaematuria prevalence was 3.8% (140/3700) and 5.8% (34/594) in children in primary and Islamic schools, respectively, 17.1% (44/258) in household members, and 16.7% (10/60) in people at water bodies. In health facilities, 19.8% (70/354) of patients tested microhematuria-positive.
CONCLUSIONS: The targeted 5T interventions maintained the very low S. haematobium prevalence and proved straightforward and feasible to identify and treat many of the few S. haematobium-infected individuals. Future research will show whether 5T interventions can maintain gains in the longer-term and expedite elimination.
BACKGROUND: ISRCTN, ISCRCTN91431493. Registered 11 February 2020, https://www.isrctn.com/ISRCTN91431493 .
摘要：
背景：经过数十年的吡喹酮大规模给药（MDA），几个国家接近消除血吸虫病。在大部分未感染的人群中继续使用MDA似乎不再合理。需要采取替代干预措施来维持增益或加速传输中断。我们报告结果，优势,以及奔巴血吸虫低流行地区新型测试-治疗-追踪-测试-治疗（5T）干预措施的缺点，坦桑尼亚。
方法：在2021年和2022年进行了基于学校和家庭的调查，以监测血链球菌和微血尿的患病率，并评估干预措施的影响。2021年，在15个低流行地区实施了5T干预措施，包括：（i）对小学和伊斯兰学校的学童进行微血尿测试，以代替血吸虫，(ii)治疗积极的儿童，(iii)将他们追踪到他们经常光顾的家庭和水体，（iv）在家庭和水体中测试个人，和(V)治疗阳性个体。此外,试验和治疗干预措施在研究区域的22个医疗机构实施.
结果：在以学校为基础的15个低患病率实施单位的调查中，2021年和2022年分别为0.5％（7/1560）和0.4％（6/1645）。在以家庭为基础的调查中，在2021年和2022年，分别有0.5％（14/2975）和0.7％（19/2920）的参与者感染了S。微血尿患病率，不包括跟踪结果，在以学校为基础的调查中，2021年为1.4%(21/1560)，2022年为1.5%(24/1645)。在以家庭为基础的调查中，2021年为3.3%（98/2975），2022年为5.4%（159/2920）。在5T干预期间，在小学和伊斯兰学校的儿童中，微血尿患病率分别为3.8％（140/3700）和5.8％（34/594），分别,家庭成员占17.1%(44/258)，水体中的人占16.7%(10/60)。在卫生设施中，19.8%(70/354)的患者检测微血尿阳性。
结论：有针对性的5T干预措施维持了极低的血吸虫流行率，并且被证明可以直接和可行地识别和治疗少数血吸虫感染的个体。未来的研究将显示5T干预措施是否可以长期维持收益并加快消除。
背景：ISRCTN，ISCRCTN91431493。2020年2月11日注册，https://www。isrctn.com/ISRCTN91431493.
方法：在2021年和2022年进行了基于学校和家庭的调查，以监测血链球菌和微血尿的患病率，并评估干预措施的影响。2021年，在15个低流行地区实施了5T干预措施，包括：（i）对小学和伊斯兰学校的学童进行微血尿测试，以代替血吸虫，(ii)治疗积极的儿童，(iii)将他们追踪到他们经常光顾的家庭和水体，（iv）在家庭和水体中测试个人，和(V)治疗阳性个体。此外,试验和治疗干预措施在研究区域的22个医疗机构实施.
结果：在以学校为基础的15个低患病率实施单位的调查中，2021年和2022年分别为0.5％（7/1560）和0.4％（6/1645）。在以家庭为基础的调查中，在2021年和2022年，分别有0.5％（14/2975）和0.7％（19/2920）的参与者感染了S。微血尿患病率，不包括跟踪结果，在以学校为基础的调查中，2021年为1.4%(21/1560)，2022年为1.5%(24/1645)。在以家庭为基础的调查中，2021年为3.3%（98/2975），2022年为5.4%（159/2920）。在5T干预期间，在小学和伊斯兰学校的儿童中，微血尿患病率分别为3.8％（140/3700）和5.8％（34/594），分别,家庭成员占17.1%(44/258)，水体中的人占16.7%(10/60)。在卫生设施中，19.8%(70/354)的患者检测微血尿阳性。
结论：有针对性的5T干预措施维持了极低的血吸虫流行率，并且被证明可以直接和可行地识别和治疗少数血吸虫感染的个体。未来的研究将显示5T干预措施是否可以长期维持收益并加快消除。
背景：ISRCTN，ISCRCTN91431493。2020年2月11日注册，https://www。isrctn.com/ISRCTN91431493.
