背景:土壤传播的蠕虫(STH)感染是流行地区的公共卫生问题。为了有效控制,该疾病的流行病学需要监测。这份报告评估了患病率,发病率,治疗后感染(PTI)率,以及加蓬两个农村地区STH感染的危险因素。
方法:在这项纵向和前瞻性研究中,纳入了来自Lambaréné附近的6~30岁参与者,以及使用简单随机分组方法选择的家庭,并对参与者进行了为期6个月和9个月的连续两个随访.在每个后续阶段(FUP)的开始和结束时获得粪便样品。Kato-Katz技术用于检测STH卵,而Harada-Mori技术和共同培养用于在最多四个小时的收集时间内检测粪便中的幼虫。在研究的三个主要时间点确定患病率,在两个研究阶段评估发病率,PTI定义为治疗后9个月检测到的感染。
结果:共纳入262名参与者。在6个月和9个月FUP的基线时,STH感染的总体患病率为42%(95CI:34-50)和44%(95CI:37-51)。分别。在每个评估时间点,Trichiura都是最普遍的物种。在6个月和9个月的随访中,STH的累积发生率为18%(95CI:12-27)和35%(95CI:27-43),分别,而发病率为41(95CI:28-55)和56(95CI:46-67)每100人年,分别。TrichiuraT.的9个月随访时的PTI率,钩虫,和蛔虫为58%(95CI:41-74),31%(95CI:11-59)和18%(95CI:5-40),分别。STH感染强度一般较轻。
结论:在Lambaréné附近,STH感染的患病率中等,T.trichiura是最普遍的物种。我们的结果揭示了该疾病在人群中的快速传播,主要是在干预之后,特别是对于毛虫病,因此,呼吁在该领域全面实施世界卫生组织的建议。试验注册clinicaltrials.gov标识符NCT02769013。2016年4月21日注册,https://clinicaltrials.gov/study/NCT02769013。
BACKGROUND: Soil-transmitted helminth (STH) infections are a public health concern in endemic areas. For efficient control, the epidemiology of the disease needs to be monitored. This report assesses the prevalence, incidence, post-treatment infection (PTI) rate, and risk factors for STH infections in two rural areas of Gabon.
METHODS: In this longitudinal and prospective study, participants aged six to 30 years from the vicinity of Lambaréné and selected households using a simple randomization process were included and followed in two consecutive periods of six and nine months. Stool samples were obtained at the beginning and the end of each follow-up phase (FUP). The Kato-Katz technique was used for the detection of STH eggs, while the Harada-Mori technique and coproculture were used for the detection of larvae in stool processed within a maximum of four hours of collection. Prevalence was determined at the three main time points of the study, incidence was assessed during the two study phases, and PTI was defined as an infection detected nine months post-treatment.
RESULTS: A total of 262 participants were included. The overall prevalence of STH infections was 42% (95%CI: 34-50) and 44% (95%CI: 37-51) at baseline for the six and nine month FUPs, respectively. Trichuris trichiura was the most prevalent species at each time point of assessment. The cumulative incidence of STH at the 6- and 9-month follow-ups was 18% (95%CI: 12-27) and 35% (95%CI: 27-43), respectively, while the incidence rates were 41 (95%CI: 28-55) and 56 (95%CI: 46-67) per 100 person-years, respectively. The PTI rates at the 9-month follow-up for T. trichiura, hookworm, and Ascaris lumbricoides were 58% (95%CI: 41-74), 31% (95%CI: 11-59) and 18% (95%CI: 5-40), respectively. The STH infection intensity was generally light.
CONCLUSIONS: The prevalence level of STH infection is moderate in the vicinity of Lambaréné, with T. trichiura being the most prevalent species. Our results reveal a rapid spread of the disease in the population mainly following intervention, particularly for trichuriasis, and therefore call for the full implementation of the World Health Organization\'s recommendations in the area. Trial registration clinicaltrials.gov Identifier NCT02769013. Registered 21 April 2016, https://clinicaltrials.gov/study/NCT02769013.