Rapid Identification of Paragonimiasis Foci by Lay Informants in Lao Peoples Democratic Republic 英文参考文献.docVIP

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Rapid Identification of Paragonimiasis Foci by Lay Informants in Lao Peoples Democratic Republic 英文参考文献.doc

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Rapid Identification of Paragonimiasis Foci by Lay Informants in Lao Peoples Democratic Republic 英文参考文献

RapidIdentificationofParagonimiasisFocibyLay InformantsinLaoPeople’sDemocraticRepublic PeterOdermatt1,2*,DuongVeasna2,3,WeiZhang2,NanthasaneVannavong2,SouraxayPhrommala4, ShigehisaHabe5,HubertBarennes2,MichelStrobel2 1DepartmentofPublicHealthandEpidemiology,SwissTropicalInstitute,Basel,Switzerland,2InstitutdelaFrancophoniepourlame′dicinetropicale,Vientiane,Laos, 3Institut Pasteur du Cambodge, Phnom Penh, Cambodia, 4National Institute of Public Health, Vientiane, Lao PDR, 5Department of Microbiology and Immunology, SchoolofMedicine,FukuokaUniversity,Fukuoka,Japan Abstract Background: Paragonimiasis is a food-borne trematodiasis leading to lung disease. Worldwide, an estimated 21 million peopleareinfected.Fociofongoingtransmissionremainoftenunnoticed.Weevaluatedasimplequestionnaireapproach usinglay-informantsatthevillageleveltoidentifyparagonimiasisfociandsuspectedparagonimiasiscases. Methodology/Principal Findings: The study was carried out in an endemic area of Lao People’s Democratic Republic. Leadersof49remotevillagesinnorthernVientianeProvincewereaskedtonotifysuspectedparagonimiasispatientsusinga four-item questionnaire sent through administrative channels: persons responding positively for having chronic cough (more than 3 weeks) and/or blood in sputum with or without fever. We validated the village leaders’ reports in ten representative villages with a door-to-door survey. We examined three sputa of suspected patients for the presence of Paragonimuseggsandacidfastbacilli.91.8%ofvillageleadersparticipatedandnotifiedatotalof220suspectedpatients; 76.2%wereeventuallyconfirmed;anadditional138suspectedcaseswerefoundinthesurvey.Sensitivityofvillageleaders’ noticefor‘‘chroniccough’’and‘‘bloodinsputum’’was100%;‘‘bloodinsputum’’alonereachedasensitivityof85.7%. Significance:Ourapproachledtotheidentificationofthreepreviouslyunknownfocioftransmission.Arapidandsimple lay-informant questionnaire approach is a promising low-cost community diagnostic tool of paragonimiasis co