Feasibility of Onchocerciasis Elimination with Ivermectin Treatment in Endemic Foci in Africa First Evidence from Studies in Mali and Senegal 英文参考文献.docVIP

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Feasibility of Onchocerciasis Elimination with Ivermectin Treatment in Endemic Foci in Africa First Evidence from Studies in Mali and Senegal 英文参考文献.doc

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Feasibility of Onchocerciasis Elimination with Ivermectin Treatment in Endemic Foci in Africa First Evidence from Studies in Mali and Senegal 英文参考文献

FeasibilityofOnchocerciasisEliminationwithIvermectin TreatmentinEndemicFociinAfrica:FirstEvidencefrom StudiesinMaliandSenegal LamineDiawara1,MamadouO.Traore′2,AliouneBadji1,YiribaBissan3,KonimbaDoumbia2,SoulaF. Goita2,LassanaKonate′4,KalifaMounkoro2,MoussaD.Sarr1,AmadouF.Seck1,LaurentToe′3 ,Seyni Toure′e1,JanH.F.Remme5* 1Ministe`redelaSante′ etdelaPre′ventionMe′dicale,Dakar,Senegal,2DirectionNationaledelaSante′, Bamako,Mali,3Multi-diseaseSurveillanceCentre,Ouagadougou, BurkinaFaso,4Universite′ CheikhAntaDiop,Dakar,Senegal,5Consultant,Ornex,France Abstract Background:Masstreatmentwithivermectinisaprovenstrategyforcontrollingonchocerciasisasapublichealthproblem, butitisnotknownifitcanalsointerrupttransmissionandeliminatetheparasiteinendemicfociinAfricawherevectorsare highlyefficient.AlongitudinalstudywasundertakeninthreehyperendemicfociinMaliandSenegalwith15to17yearsof annualorsix-monthlyivermectintreatmentinordertoassessresiduallevelsofinfectionandtransmissionandtestwhether ivermectintreatmentcouldbesafelystoppedinthestudyareas. Methodology/Principal Findings: Skinsnip surveyswereundertaken in126villages, and17,801 peoplewereexamined. Theprevalenceofmicrofilaridermiawas,1%inallthreefoci.Atotalof157,500blackflieswerecollectedandanalyzedfor the presence of Onchocerca volvulus larvae using a specific DNA probe, and vector infectivity rates were all below 0.5 infective flies per 1,000 flies. Except for a subsection of one focus, all infection and transmission indicators were below postulated thresholds for elimination. Treatment was therefore stopped in test areas of 5 to 8 villages in each focus. Evaluations16to22monthsafterthelasttreatmentinthetestareasinvolvedexaminationof2,283peopleusingtheskin snipmethodandaDECpatchtest,andanalysisof123,000blackflies.Noinfectedpersonsandnoinfectedblackflieswere detectedinthetestareas,andvectorinfectivityratesinothercatchingpointswere,0.2infectivefliesper1,000. Conclusion/Significance: This study has provided the first emp