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首页> 外文期刊>Filaria journal >Mapping the distribution of Loa loa in Cameroon in support of the African Programme for Onchocerciasis Control
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Mapping the distribution of Loa loa in Cameroon in support of the African Programme for Onchocerciasis Control

机译：绘制喀麦隆Loa loa分布图，以支持非洲盘尾丝虫病控制计划

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Background Loa loa has recently emerged as a filarial worm of significant public health importance as a consequence of its impact on the African Programme for Onchocerciasis Control (APOC). Severe, sometimes fatal, encephalopathic reactions to ivermectin (the drug of choice for onchocerciasis control) have occurred in some individuals with high Loa loa microfilarial counts. Since high density of Loa loa microfilariae is known to be associated with high prevalence rates, a distribution map of the latter may determine areas where severe reactions might occur. The aim of the study was to identify variables which were significantly associated with the presence of a Loa microfilaraemia in the subjects examined, and to develop a spatial model predicting the prevalence of the Loa microfilaraemia. Methods Epidemiological data were collected from 14,225 individuals living in 94 villages in Cameroon, and analysed in conjunction with environmental data. A series of logistic regression models (multivariate analysis) was developed to describe variation in the prevalence of Loa loa microfilaraemia using individual level co-variates (age, sex, μl of blood taken for examination) and village level environmental co-variates (including altitude and satellite-derived vegetation indices). Results A spatial model of Loa loa prevalence was created within a geographical information system. The model was then validated using an independent data set on Loa loa distribution. When considering both data sets as a whole, and a prevalence threshold of 20%, the sensitivity and the specificity of the model were 81.7 and 69.4%, respectively. Conclusions The model developed has proven very useful in defining the areas at risk of post-ivermectin Loa-related severe adverse events. It is now routinely used by APOC when projects of community-directed treatment with ivermectin are examined.
机译：背景技术Loa loa最近因其对非洲盘尾丝虫病控制计划（APOC）的影响而成为具有重要公共卫生重要性的丝虫。在一些Loa loa微丝计数较高的个体中，发生了对伊维菌素（控制盘尾丝虫病选择的药物）的严重，有时是致命的脑病反应。由于已知高密度的Loa loa microfilariae与高流行率相关，后者的分布图可以确定可能发生严重反应的区域。这项研究的目的是确定与所检查的受试者中Loa微丝蛋白血症的存在显着相关的变量，并开发一种空间模型来预测Loa微丝蛋白血症的患病率。方法收集喀麦隆94个村庄的14225个人的流行病学数据，并结合环境数据进行分析。开发了一系列逻辑回归模型（多变量分析），使用个体水平协变量（年龄，性别，所采集血液的微升）和乡村水平环境协变量（包括海拔高度）来描述Loa loa微丝虫病患病率的变化。和卫星衍生的植被指数）。结果在地理信息系统中创建了Loa loa流行的空间模型。然后使用关于Loa loa分布的独立数据集验证模型。当同时考虑这两个数据集时，患病率阈值为20％，该模型的敏感性和特异性分别为81.7和69.4％。结论开发的模型已被证明对确定伊维菌素后Loa相关严重不良事件的危险区域非常有用。现在，APOC通常在检查伊维菌素的社区指导治疗项目时使用它。

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