Dziedzom K de Souza, Jeffrey G Sumboh, Nii A Laryea, Odame Asiedu, Bright Alomatu, Sedzro K Mensah, Joseph Otchere, Joseph Larbi Opare, Collins S Ahorlu
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引用次数: 0
摘要
背景：本研究旨在验证“参与与治疗”（Engage & Treat, E&T）和“测试与治疗”（Test & Treat, T&T）策略对很少或从未参与淋巴丝虫病大规模给药（LF MDA）的个体的治疗效果。方法：研究在加纳的一个热点地区进行，MDA为20年。使用记录参与情况的治疗登记册来识别未参与的个体。自愿接受治疗的个体被给予药物（E&T）。拒绝治疗的患者使用丝虫病试纸（FTS）进行检测，如果呈阳性则进一步接受治疗。一部分E&T参与者也接受了测试。结果：总的来说，25 068人错过了最后一个MDA；接受药品的占93.13%；9958人接受了检测，显示总体患病率为7.26% （95% CI 6.76至7.79%）。T&T阳性率较高(12.10%；95% CI 10.43 - 13.92%)高于E&T组(6.47%；95% CI 5.96 ~ 7.01%)。检测阳性的几率较高(OR=1.99；95% CI 1.66 ~ 2.39；结论：该研究证实了这些策略在解决LF MDA期间未治疗的挑战方面的有效性。在持续传播地区实施这些措施可支持在这些环境中消除疾病。
Beyond business as usual for lymphatic filariasis mass drug administration in hotspot districts.
Background: This study aimed to validate the 'Engage & Treat' (E&T) and 'Test & Treat' (T&T) strategies to treat individuals who seldom or never participate in lymphatic filariasis mass drug administration (LF MDA).
Methods: The study was conducted in a hotspot district of Ghana, with 20 years of MDA. Treatment registers documenting participation were used to identify non-participating individuals. Individuals willingly accepting treatment were given the drugs (E&T). Those who refused treatment were offered testing using the filaria test strip (FTS) and further engaged to receive treatment if positive (T&T). A portion of the E&T participants were also tested.
Results: Overall, 25 068 individuals who missed the last MDA were identified; 93.13% accepted the drugs; 9958 people were tested, revealing an overall prevalence of 7.26% (95% CI 6.76 to 7.79%). Positivity was higher in T&T (12.10%; 95% CI 10.43 to 13.92%) than in the E&T group (6.47%; 95% CI 5.96 to 7.01%). The odds of testing positive were higher (OR=1.99; 95% CI 1.66 to 2.39; p<0.0001) among the T&T population and missing three consecutive MDAs (OR=2.22; 95% CI 1.86 to 2.64; p<0.0001).
Conclusions: The study confirms the validity of the strategies in addressing the challenges with non-treatment during LF MDA. Their implementation in areas of persistent transmission can support elimination in these settings.
期刊介绍：
International Health is an official journal of the Royal Society of Tropical Medicine and Hygiene. It publishes original, peer-reviewed articles and reviews on all aspects of global health including the social and economic aspects of communicable and non-communicable diseases, health systems research, policy and implementation, and the evaluation of disease control programmes and healthcare delivery solutions.
It aims to stimulate scientific and policy debate and provide a forum for analysis and opinion sharing for individuals and organisations engaged in all areas of global health.
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