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首页> 外文期刊>Filaria journal >Impact of ivermectin on onchocerciasis transmission: assessing the empirical evidence that repeated ivermectin mass treatments may lead to elimination/eradication in West-Africa
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Impact of ivermectin on onchocerciasis transmission: assessing the empirical evidence that repeated ivermectin mass treatments may lead to elimination/eradication in West-Africa

机译：伊维菌素对盘尾丝虫病传播的影响：评估经验证据，反复进行伊维菌素的大规模治疗可能导致西非的消灭/根除

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Background The Onchocerciasis Control Program (OCP) in West Africa has been closed down at the end of 2002. All subsequent control will be transferred to the participating countries and will almost entirely be based on periodic mass treatment with ivermectin. This makes the question whether elimination of infection or eradication of onchocerciasis can be achieved using this strategy of critical importance. This study was undertaken to explore this issue. Methods An empirical approach was adopted in which a comprehensive analysis was undertaken of available data on the impact of more than a decade of ivermectin treatment on onchocerciasis infection and transmission. Relevant entomological and epidemiological data from 14 river basins in the OCP and one basin in Cameroon were reviewed. Areas were distinguished by frequency of treatment (6-monthly or annually), endemicity level and additional control measures such as vector control. Assessment of results were in terms of epidemiological and entomological parameters, and as a measure of inputs, therapeutic and geographical coverage rates were used. Results In all of the river basins studied, ivermectin treatment sharply reduced prevalence and intensity of infection. Significant transmission, however, is still ongoing in some basins after 10–12 years of ivermectin treatment. In other basins, transmission may have been interrupted, but this needs to be confirmed by in-depth evaluations. In one mesoendemic basin, where 20 rounds of four-monthly treatment reduced prevalence of infection to levels as low as 2–3%, there was significant recrudescence of infection within a few years after interruption of treatment. Conclusions Ivermectin treatment has been very successful in eliminating onchocerciasis as a public health problem. However, the results presented in this paper make it almost certain that repeated ivermectin mass treatment will not lead to the elimination of transmission of onchocerciasis from West Africa. Data on 6-monthly treatments are not sufficient to draw definitive conclusions.
机译：背景技术西非的盘尾丝虫病控制计划（OCP）已于2002年底关闭。所有后续控制措施将转移至参与国，并且几乎完全基于依维菌素的定期大规模治疗。这就提出了使用这种至关重要的策略能否实现消除感染或消除盘尾丝虫病的问题。进行这项研究是为了探索这个问题。方法采用经验方法，对十多年来伊维菌素治疗对盘尾丝虫病的感染和传播的影响进行了综合分析。回顾了OCP的14个流域和喀麦隆的一个流域的有关昆虫学和流行病学数据。通过治疗频率（每6个月或每年一次），流行程度和其他控制措施（如病媒控制）来区分区域。根据流行病学和昆虫学参数评估结果，并使用治疗和地理覆盖率作为衡量投入的指标。结果在所有研究的流域中，伊维菌素治疗均能显着降低感染率和感染强度。然而，在伊维菌素治疗10-12年后，某些盆地仍在继续发生重大传播。在其他盆地，传播可能已经中断，但这需要通过深入评估来确认。在一个中流行流域，每四个月进行20轮治疗将感染率降低到2％至3％，在中断治疗后的几年内，感染会明显复发。结论伊维菌素治疗在消除盘尾丝虫病这一公共卫生问题方面非常成功。但是，本文提出的结果几乎可以肯定，反复进行伊维菌素的大规模治疗不会消除西非盘尾丝虫病的传播。六个月治疗的数据不足以得出明确的结论。

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