Background:Despite the progress made in the control of Neglected Tropical Diseases(NTD),schistosome and soil-transmitted helminth infections are far from being effectively managed in many parts of the world.Chemothera...Background:Despite the progress made in the control of Neglected Tropical Diseases(NTD),schistosome and soil-transmitted helminth infections are far from being effectively managed in many parts of the world.Chemotherapy,the key element of all control strategies,is faced with some difficulties in terms of access to treatment.Our study aims to describe the factors involved in the success or failure of the community-directed intervention(CDI)approach through control programmes,which aims to achieve consistent high coverage at affordable and sustainable costs in endemic areas.Methods:The CDI approach was carried out from December 2007 to October 2008 in ten villages of the district of Diéma,Mali.At inclusion,each child part of the study’s sample was interviewed and submitted for a physical examination.The study focused on:data collection,treatment of the eligible population,evaluation of the treatment coverage,performance of community drug distributors(CDDs),and the involvement and perception of populations.Results:A total of 8,022 eligible people were studied with a mean coverage rate of 76.7%.Using multiple regression,it was determined that receiving praziquantel as treatment was associated with five factors:belonging to the Fulani or Moorish ethnic minority versus the Bambara/Soninke,use of the central versus the house-to-house drug distribution mode,the ratio of the population to the number of CDDs,the lack of supervision and belonging to the age group of 15 years or above(p<0.05).As well as that,it was found that the presence of parallel community-based programmes(HIV,tuberculosis)that provide financial incentives for community members discouraged many CDDs(who in most cases are volunteers)to participate in the CDI approach due to a lack of incentives.Conclusions:The findings indicate that the success of the CDI approach depends on,amongst other things,the personal characteristics of the respondents,as well as on community factors.展开更多
Background:Schistosomiasis is classically described as a rural disease that occurs in areas with poor sanitary conditions.However,over recent decades,there has been an expansion of schistosomiasis foci towards urban a...Background:Schistosomiasis is classically described as a rural disease that occurs in areas with poor sanitary conditions.However,over recent decades,there has been an expansion of schistosomiasis foci towards urban areas faced with a rapid and disordered urbanization.In Bamako,Mali,the impact of environmental change on vector-borne diseases such as schistosomiasis is not well known.This study sought to identify the presence of schistosomiasis transmission hotspots in Bamako.Using this perspective,we aimed to describe the risk factors of the endemization and maintenance of schistosomiasis.Materials and methods:A cross-sectional study was carried out in the six municipalities(communes)in Bamako.Environmental information was obtained from earth observation satellites in order to maximize ecological contrasts.Twenty-nine blocks of 200 m x 200 m were identified.We selected a school inside or nearest to each block for urine and stool samples examination.The study cohort was school children aged between eight and 15 years.The Kato-Katz technique and filtration were used for Schistosoma mansoni and S.haematobium ova research in stools and urine,respectively.The schools and snail breeding sites were georeferenced.Four malacological surveys were conducted between October 2011 and February 2012.Bivariate analysis was used to identify independent predictors of being infected with schistosomiasis.Results:The prevalence rate of S.haematobium was 14.7%(n=1,761)and that of S.mansoni 1.5%(n=1,491).Overall,the urinary form was endemic in 76.6%of schools.The infection significantly varied between the municipalities(p<0.001).It was also more prevalent on the left side of the Niger River than the right side(17.4%vs.9.5%respectively;p<0.001).The vicinity to snail breeding sites(OR=3.677;95%IC[2.765–4.889];p<10-3)and parents’occupations(OR=7.647;95%IC[2.406–24.305];p<0.001)were the most important risk factors associated with S.haematobium infection exposure.Biomphalaria pfeifferi,Bulinus truncatus,and B.globosus were the intermediate hosts captured.The schistosome natural infection rates(SNIRs),which were low or nil in October and November,rose to 2.8%in January and 8.3%in February for B.pfeifferi and B.truncatus,respectively.Conclusion:Our findings show that there is a high transmission risk for schistosomiasis in Bamako.Appropriate integrated control measures need to be introduced to control the transmission of this disease in the study area.展开更多
文摘Background:Despite the progress made in the control of Neglected Tropical Diseases(NTD),schistosome and soil-transmitted helminth infections are far from being effectively managed in many parts of the world.Chemotherapy,the key element of all control strategies,is faced with some difficulties in terms of access to treatment.Our study aims to describe the factors involved in the success or failure of the community-directed intervention(CDI)approach through control programmes,which aims to achieve consistent high coverage at affordable and sustainable costs in endemic areas.Methods:The CDI approach was carried out from December 2007 to October 2008 in ten villages of the district of Diéma,Mali.At inclusion,each child part of the study’s sample was interviewed and submitted for a physical examination.The study focused on:data collection,treatment of the eligible population,evaluation of the treatment coverage,performance of community drug distributors(CDDs),and the involvement and perception of populations.Results:A total of 8,022 eligible people were studied with a mean coverage rate of 76.7%.Using multiple regression,it was determined that receiving praziquantel as treatment was associated with five factors:belonging to the Fulani or Moorish ethnic minority versus the Bambara/Soninke,use of the central versus the house-to-house drug distribution mode,the ratio of the population to the number of CDDs,the lack of supervision and belonging to the age group of 15 years or above(p<0.05).As well as that,it was found that the presence of parallel community-based programmes(HIV,tuberculosis)that provide financial incentives for community members discouraged many CDDs(who in most cases are volunteers)to participate in the CDI approach due to a lack of incentives.Conclusions:The findings indicate that the success of the CDI approach depends on,amongst other things,the personal characteristics of the respondents,as well as on community factors.
基金We acknowledge the generous support provided by the International Mix Unity(UMI)of the National Scientific Research Centre(CNRS)of France,the Academic Centres of the right and left sides of the Niger River,the directors the selected schools,the schoolchildren,the research assistants for their input and dedication to the study,the staff of the Faculty of Pharmacy,and all other persons without whose support this study would not have been possible.
文摘Background:Schistosomiasis is classically described as a rural disease that occurs in areas with poor sanitary conditions.However,over recent decades,there has been an expansion of schistosomiasis foci towards urban areas faced with a rapid and disordered urbanization.In Bamako,Mali,the impact of environmental change on vector-borne diseases such as schistosomiasis is not well known.This study sought to identify the presence of schistosomiasis transmission hotspots in Bamako.Using this perspective,we aimed to describe the risk factors of the endemization and maintenance of schistosomiasis.Materials and methods:A cross-sectional study was carried out in the six municipalities(communes)in Bamako.Environmental information was obtained from earth observation satellites in order to maximize ecological contrasts.Twenty-nine blocks of 200 m x 200 m were identified.We selected a school inside or nearest to each block for urine and stool samples examination.The study cohort was school children aged between eight and 15 years.The Kato-Katz technique and filtration were used for Schistosoma mansoni and S.haematobium ova research in stools and urine,respectively.The schools and snail breeding sites were georeferenced.Four malacological surveys were conducted between October 2011 and February 2012.Bivariate analysis was used to identify independent predictors of being infected with schistosomiasis.Results:The prevalence rate of S.haematobium was 14.7%(n=1,761)and that of S.mansoni 1.5%(n=1,491).Overall,the urinary form was endemic in 76.6%of schools.The infection significantly varied between the municipalities(p<0.001).It was also more prevalent on the left side of the Niger River than the right side(17.4%vs.9.5%respectively;p<0.001).The vicinity to snail breeding sites(OR=3.677;95%IC[2.765–4.889];p<10-3)and parents’occupations(OR=7.647;95%IC[2.406–24.305];p<0.001)were the most important risk factors associated with S.haematobium infection exposure.Biomphalaria pfeifferi,Bulinus truncatus,and B.globosus were the intermediate hosts captured.The schistosome natural infection rates(SNIRs),which were low or nil in October and November,rose to 2.8%in January and 8.3%in February for B.pfeifferi and B.truncatus,respectively.Conclusion:Our findings show that there is a high transmission risk for schistosomiasis in Bamako.Appropriate integrated control measures need to be introduced to control the transmission of this disease in the study area.
