Background:The current mainstay for control/elimination of onchocerciasis and soil-transmitted helminthiasis(STH)relies on ivermectin-and mebendazole/albendazole-based preventive chemotherapies.However,children under ...Background:The current mainstay for control/elimination of onchocerciasis and soil-transmitted helminthiasis(STH)relies on ivermectin-and mebendazole/albendazole-based preventive chemotherapies.However,children under fve years of age have been excluded in both research activities and control programs,because they were believed to have insignifcant infection rates.There is therefore a need for up-to-date knowledge on the prevalence and inten‑sity of STH and onchocerciasis infections in this age group.This study aimed at assessing the rates and intensities of onchocerciasis and STH infections in children under fve years of age who are excluded from ivermectin-or mebenda‑zole/albendazole-based preventive chemotherapies.Methods:A series of cross-sectional surveys was conducted in four Health Districts in the Centre and Littoral Regions of Cameroon between 2018 and 2019.All subjects aged 2 to 4 years,were screened for prevalence(or infection rate)and intensity[number of eggs per gram of stool(epg)or number of microflariae per skin snip(mf/ss)]of STH and onchocerciasis infections respectively using the Kato-Katz and skin snip methodologies.Chi-square and the nonparametric tests(Mann Whitney and Kruskal Wallis)were used to compare infection rates and intensities of infections between Health Districts and genders,respectively.Results:A total of 421 children were enrolled in this study.The overall prevalence of onchocerciasis was 6.6%[95% confdence interval(CI):4.3‒9.9],ranging from 3.6%(in the Ntui Health District)to 12.2%(in the Bafa Health District).The intensity of infection ranged from 0.5 to 46 microflariae per skin snip[median:5;interquartile range(IQR):2.25‒8.5].The overall prevalence of STH was 9.6%(95%CI:6.5‒13.9),with a high infection rate(29.6%)in the Akonolinga Health District.Two STH species(Ascaris lumbricoides and Trichuris trichiura)were found among infected individuals.The median intensities of STH infections were 1,992 epg(IQR:210‒28,704)and 96 epg(IQR:48‒168)for A.lumbricoides and T.trichiura,respectively.Conclusions:This study reveals that children<5 years of age are highly infected with STH and onchocerciasis,and could contribute to the spread of these diseases,perpetuating a vicious circle of transmission and hampering elimi‑nation eforts.These fndings reveal the urgent need to provide(or scale)treatments(likely pediatric formulations)to these preschool-aged children,especially in areas of high transmission,to accelerate eforts to reach WHO 2030 target.展开更多
文摘Background:The current mainstay for control/elimination of onchocerciasis and soil-transmitted helminthiasis(STH)relies on ivermectin-and mebendazole/albendazole-based preventive chemotherapies.However,children under fve years of age have been excluded in both research activities and control programs,because they were believed to have insignifcant infection rates.There is therefore a need for up-to-date knowledge on the prevalence and inten‑sity of STH and onchocerciasis infections in this age group.This study aimed at assessing the rates and intensities of onchocerciasis and STH infections in children under fve years of age who are excluded from ivermectin-or mebenda‑zole/albendazole-based preventive chemotherapies.Methods:A series of cross-sectional surveys was conducted in four Health Districts in the Centre and Littoral Regions of Cameroon between 2018 and 2019.All subjects aged 2 to 4 years,were screened for prevalence(or infection rate)and intensity[number of eggs per gram of stool(epg)or number of microflariae per skin snip(mf/ss)]of STH and onchocerciasis infections respectively using the Kato-Katz and skin snip methodologies.Chi-square and the nonparametric tests(Mann Whitney and Kruskal Wallis)were used to compare infection rates and intensities of infections between Health Districts and genders,respectively.Results:A total of 421 children were enrolled in this study.The overall prevalence of onchocerciasis was 6.6%[95% confdence interval(CI):4.3‒9.9],ranging from 3.6%(in the Ntui Health District)to 12.2%(in the Bafa Health District).The intensity of infection ranged from 0.5 to 46 microflariae per skin snip[median:5;interquartile range(IQR):2.25‒8.5].The overall prevalence of STH was 9.6%(95%CI:6.5‒13.9),with a high infection rate(29.6%)in the Akonolinga Health District.Two STH species(Ascaris lumbricoides and Trichuris trichiura)were found among infected individuals.The median intensities of STH infections were 1,992 epg(IQR:210‒28,704)and 96 epg(IQR:48‒168)for A.lumbricoides and T.trichiura,respectively.Conclusions:This study reveals that children<5 years of age are highly infected with STH and onchocerciasis,and could contribute to the spread of these diseases,perpetuating a vicious circle of transmission and hampering elimi‑nation eforts.These fndings reveal the urgent need to provide(or scale)treatments(likely pediatric formulations)to these preschool-aged children,especially in areas of high transmission,to accelerate eforts to reach WHO 2030 target.
