Impact of Mass Drug Administration with or Without Insecticide Impregnated Nets

有或没有杀虫剂浸渍网的大规模药物管理的影响

• 批准号: 7895029
• 负责人: James Walter Kazura
• 金额: $ 48.91万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7895029
• 关键词: Adult; Africa; Africa South of the Sahara; Albendazole; Anemia; Anopheles Genus; Anthelmintics; Area; Back; Benzimidazoles; Child; Childhood; Classification; Clinical; Communities; Complement; Country; Culicidae; Data; Dose; Ecology; Extinction (Psychology); Filaria bancrofti; Filarial Elephantiases; Filariasis; Frequencies; Funding; Genetic Polymorphism; Goals; Growth; Health; Health Benefit; Health Policy; Helminths; Hookworms; Incidence; Individual; Infection; Insecticide Resistance; Insecticides; Institutes; Institution; Intention; Interruption; Intervention; Intestines; Ivermectin; Malaria; Measures; Morbidity - disease rate; Papua New Guinea; Parasite resistance; Pharmaceutical Preparations; Population; Population Intervention; Prevalence; Province; Public Health; Research Infrastructure; Resistance; Resources; Schools; Soil; Time; Work; base; benzimidazole; cohort; expectation; human disease; killings; mathematical model; programs; rural area; success; transmission process; vector; vector control; vector mosquito; weapons

The global program to eliminate lymphatic filariasis (GPELF) is based on the expectation that 4 to 6 annual mass drug administrations (MDA) will reduce LF morbidity to an acceptable level and interrupt transmission, thereby leading to extinction of LF. This strategy is based on as yet limited data from field settings where the burden of LF infection and morbidity are high. Our long terms goals are to assess the proscribed GPELF strategy has been sustained in an area of Papua New Guinea where we have previously nearly completed eliminated LF infection and transmission with four annual cycles of MDA, evaluate in new populations whether integration of MDA with vector control enhances morbidity control and transmission elimination, and under what levels of LF endemicity these complementary interventions are most effective. The specific aims are: 1.To determine the long-term impact of the currently recommended GPELF MDA strategy on reduction of LF morbidity and infection. We will determine whether reduction/elimination of LF-related disease and human infection indicators resulting from 4 consecutive rounds of MDA are sustained 7 to 8 years after cessation of any systematic intervention. 2.To quantify the added benefit of vector control (insecticide impregnated mosquito nets, ITN) to MDA (annual single dose DEC plus albendazole) on Anopheles mosquito-transmitted Wuchereria bancrofti. This aim compares changes in LF morbidity and infection following institution of ITN plus MDA or MDA alone in previously untreated residents of high transmission and moderate transmission areas. 3. To estimate the impact of MDA and ITN on infection levels and transmission of soil transmitted helminths and associated co-morbidities. This aim determines whether MDA that includes albendazole increases the well being of school children, and the possible emergence of parasite resistance against benzimidazole in MDA-treated populations. This work complements parallel studies of the mosquito vector and provides empirical data for mathematical modeling of LF ecology and eradication. Results of these inter-related projects will inform public health policy not only in Papua New Guinea but also other areas of the world where both LF and malaria are transmitted by Anopheles mosquitoes, such as sub-Saharan Africa.

全球消除淋巴丝虫病计划 (GPELF) 的预期是，每年 4 至 6 次大规模药物管理 (MDA) 将把 LF 发病率降低到可接受的水平并中断传播，从而导致 LF 灭绝。该策略基于来自现场环境的有限数据，这些环境中 LF 感染负担和发病率很高。我们的长期目标是评估巴布亚新几内亚地区是否持续实施了被禁止的 GPELF 策略，我们之前已通过每年四个周期的 MDA 几乎完成了消除 LF 感染和传播的工作，在新人群中评估 MDA 是否与病媒控制相结合加强发病控制和传播消除，以及在 LF 流行的何种水平下，这些补充干预措施最有效。具体目标是： 1. 确定目前推荐的 GPELF MDA 策略对降低 LF 发病率和感染的长期影响。我们将确定连续 4 轮 MDA 带来的 LF 相关疾病和人类感染指标的减少/消除是否在停止任何系统干预后持续 7 至 8 年。 2. 量化媒介控制（浸有杀虫剂的蚊帐，ITN）与 MDA（每年单剂 DEC 加阿苯达唑）对按蚊传播的班克罗夫按蚊的额外益处。该目的比较了高传播和中度传播地区先前未经治疗的居民在接受 ITN 加 MDA 或单独使用 MDA 后 LF 发病率和感染的变化。 3. 评估 MDA 和 ITN 对土源性蠕虫感染水平和传播及相关并发症的影响。这一目标决定了含有阿苯达唑的 MDA 是否会增加学童的健康状况，以及在接受 MDA 治疗的人群中是否可能出现寄生虫对苯并咪唑的耐药性。 这项工作补充了蚊子媒介的平行研究，并为 LF 生态和根除的数学模型提供了经验数据。这些相互关联的项目的结果不仅将为巴布亚新几内亚的公共卫生政策提供信息，而且还将为世界上按蚊传播疟疾和疟疾的其他地区（例如撒哈拉以南非洲）提供信息。