| 1 | Reaching the last mile:main challenges relating to and recommendations to accelerate onchocerciasis elimination in Africa显示文摘Background:Onchocerciasis(river blindness),caused by the filarial worm speciesOnchocerca volvulus,is a serious vector-borne neglected tropical disease(NTD)of public health and socioeconomic concern.It is transmitted through the bite of black flies of the genusSimulium,and manifested in dermal and ocular lesions.Ninety-nine percent of the total global risk and burden of onchocerciasis is in Africa.This scoping review examines the key challenges related to the elimination of onchocerciasis by 2020-2025 in Africa,and proposes recommendations to overcome the challenges and accelerate disease elimination.To find relevant articles published in peer-reviewed journals,a search of PubMed and Google Scholar databases was carried out.Main text:Rigorous regional interventions carried out to control and eliminate onchocerciasis in the past four decades in Africa have been effective in bringing the disease burden under control;it is currently not a public health problem in most endemic areas.Notably,transmission of the parasite is interrupted in some hyperendemic localities.Recently,there has been a policy shift from control to complete disease elimination by 2020 in selected countries and by 2025 in the majority of endemic African countries.The WHO has published guidelines for stopping mass drug administration(MDA)and verifying the interruption of transmission and elimination of human onchocerciasis.Therefore,countries have revised their plans,established a goal of disease elimination in line with an evidence based decision to stop MDA and verify elimination,and incorporated it into their NTDs national master plans.Nevertheless,challenges remain pertaining to the elimination of onchocerciasis in Africa.The challenge we review in this paper are:incomplete elimination mapping of all transmission zones,co-endemicity of onchocerciasis and loiasis,possible emergence of ivermectin resistance,uncoordinated cross-border elimination efforts,conflict and civil unrest,suboptimal program implementation,and technical and financial challenges.This paper also proposes recommendations to overcome the challenges and accelerate disease elimination.These are:a need for complete disease elimination mapping,a need for collaborative elimination activities between national programs,a need for a different drug distribution approach in conflict-affected areas,a need for routine monitoring and evaluation of MDA programs,a need for implementing alternative treatment strategies(ATSs)in areas with elimination anticipated beyond 2025,and a need for strong partnerships and continued funding.Conclusions:National programs need to regularly monitor and evaluate the performance and progress of their interventions,while envisaging the complete elimination of onchocerciasis from their territory.Factors hindering the targeted goal of interruption of parasite transmission need to be identified and remedial actions should be taken.If possible and appropriate,ATSs need to be implemented to accelerate disease elimination by 2025. | Gebremedhin Gebrezgabiher Zeleke Mekonnen Delenasaw Yewhalaw Asrat Hailu | 2019 | Infectious Diseases of Poverty2019，8，4： | 1 |
| 2 | Soil-transmitted helminth infection in school age children in Sierra Leone after a decade of preventive chemotherapy interventions显示文摘Background:Baseline mapping of soil-transmitted helminth(STH)infections among school age children(SAC)in 2008-2009 found high or moderate prevalence in 13 of the 14 districts in Sierra Leone.Following these surveys,mass drug administration(MDA)of mebendazole/albendazole was conducted biannually at national level targeting pre-school children(PSC)aged 12-59 months and intermittently at sub-national level targeting SAC.In addition,MDA with ivermectin and albendazole for eliminating lymphatic filariasis(LF)has been conducted nationwide since 2010 targeting individuals over 5 years of age.Each MDA achieved high coverage,except in 2014 when all but one round of MDA for PSC was cancelled due to the Ebola emergency.The objective of the current study was to determine the prevalence and intensity of STH infections among SAC after a decade of these deworming campaigns.Methods:Seventy-three schools in 14 districts were purposefully selected,including 39 schools from the baseline surveys,with approximately two sites from each of low,moderate and high prevalence categories at baseline per district.Fresh stool samples were collected from 3632 children aged 9-14 years(male 51%,female 49%)and examined using the Kato Katz technique.Results:The prevalence of STH infections in Sierra Leone decreased in 2016 compared to 2008:Ascaris lumbricoides 4.4%(95%confidence interval[CI]:3.7-5.1%)versus 6.6%(95%CI:0-25%),Trichuris trichiura 0.7%(95%CI:0.5-1.1%)versus 1.8%(95%CI:0-30.2%),hookworm 14.9%(95%CI:13.8-16.1)versus 38.5%(95%CI:5.4-95.1%),and any STH 18.3%(95%CI:17.0-19.5%)versus 48.3%(CI:5.4-96.3%),respectively.In 2016,no district had high hookworm prevalence and four districts had moderate prevalence,compared with eight and four districts respectively in 2008.In 2016,the arithmetic mean hookworm egg count in all children examined was light:45.5 eggs per gram(EPG)of faeces,(95%CI:\35.96-55.07 EPG);three(0.08%)children had heavy infections and nine(0.25%)children had moderate infections.Conclusions:Sierra Leone has made considerable progress toward controlling STH as a public health problem among SAC.As LF MDA phases out(between 2017 and 2021),transition of deworming to other platforms and water and sanitation strategies need to be strengthened to maintain STH control and ultimately interrupt transmission. | Yakuba Mohamed Bah Mohamed Salieu Bah Jusufu Paye Abdulai Conteh Sam Saffa Alie Tia Mustapha Sonnie Amy Veinoglou Joseph J.Amon Mary Hamer Hodges Yaobi Zhang | 2019 | Infectious Diseases of Poverty2019，8，4： | 0 |
您所在的机构暂未开通此部分的功能，请联系管理员