Proof-of-Principle of Onchocerciasis Elimination with Ivermectin Treatment in Endemic Foci in Africa Final Results of a Study in Mali and Senegal 英文参考文献.docVIP

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Proof-of-Principle of Onchocerciasis Elimination with Ivermectin Treatment in Endemic Foci in Africa Final Results of a Study in Mali and Senegal 英文参考文献.doc

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Proof-of-Principle of Onchocerciasis Elimination with Ivermectin Treatment in Endemic Foci in Africa Final Results of a Study in Mali and Senegal 英文参考文献

Proof-of-PrincipleofOnchocerciasisEliminationwith IvermectinTreatmentinEndemicFociinAfrica:Final ResultsofaStudyinMaliandSenegal MamadouO.Traore1,MoussaD.Sarr2,AliouneBadji2,YiribaBissan3,LamineDiawara2, KonimbaDoumbia1,SoulaF.Goita1,LassanaKonate4,KalifaMounkoro1,AmadouF.Seck2,LaurentToe3, SeyniToure2,JanH.F.Remme5* 1DirectionNationaledelaSante′, Bamako,Mali,2MinisteredelaSante′ etdelaPre′vention,Dakar,Senegal,3Multi-diseaseSurveillanceCentre,Ouagadougou,Burkina Faso,4UniversityCheikhAntaDiop,Dakar,Senegal,5Ornex,France Abstract Background:Masstreatmentwithivermectincontrolsonchocerciasisasapublichealthproblem,butitwasnotknownifit couldalsointerrupttransmissionandeliminatetheparasiteinendemicfociinAfricawherevectorsarehighlyefficient.A longitudinalstudywasundertakeninthreehyperendemicfociinMaliandSenegalwith15to17yearsofannualorsix- monthlyivermectintreatmentinordertoassessresiduallevelsofinfectionandtransmission,andtestwhethertreatment couldbesafelystopped.Thisarticlereportstheresultsofthefinalevaluationsupto5yearsafterthelasttreatment. Methodology/PrincipalFindings:Skinsnipsurveyswereundertakenin131villageswhere29,753peoplewereexamined and492,600blackflieswereanalyzedforthepresenceofOnchocercavolvuluslarvausingaspecificDNAprobe.Therewasa decliningtrendininfectionandtransmissionlevelsafterthelasttreatment.Intwositestheprevalenceofmicrofilariaand vector infectivity rate were zero 3 to 4 years after the last treatment. In the third site, where infection levels were comparativelyhighbeforestoppingtreatment,therewasalsoaconsistentdeclineininfectionandtransmissiontoverylow levels3to5yearsafterstoppingtreatment.Allinfectionandtransmissionindicatorswerebelowpostulatedthresholdsfor elimination. Conclusion/Significance:Thestudyhasestablishedtheproofofprinciplethatonchocerciasiseliminationwithivermectin treatment is feasible in at least some endemic foci in Africa. The study results have been instrumental for the current evolutionfromonchocerciasiscontroltoeliminatio