Chemotherapy-based Control of Ascariasis and Hookworm in Highly Endemic Areas of China:Field Observations and a Modeling Analysis  

作　　者：WANG Jun LI Hua Zhong CHEN Ying Dan LIU Chang Hua TANG Lin Hua 

机构地区：[1]National Institute of Parasitic Disease, Chinese Center for Disease Control and Prevention, Shanghai 200025, China [2]Center for Drug Evaluation, SFDA, Beijing 100038, China [3]Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention, Beijing 102206, China [4]Sichuan Center for Disease Control and Prevention, Chengdu 610041, Sichuan, China

出　　处：《Biomedical and Environmental Sciences》2012年第3期272-281,共10页生物医学与环境科学（英文版）

基　　金：supported by the Special Fund for National Health Scientific Research in the Public Interest by the Ministry of Health of China (No.200802023)

摘　　要：Objective Our objective was to systematically evaluate chemotherapy-based control of ascariasis and hookworm infection and make predictions of the effectiveness of repeated mass treatment at different levels of coverage in highly endemic areas of China. Methods Field surveys were carried out to acquire the ascariasis and hookworm prevalence and intensity （mean worm burden） at baseline, one month and one year later. We calculated model parameters based on the survey data, then incorporated them into a quantitative framework to predict the prevalence and intensity one year later. Sensitivity analyses were performed to assess the influence of the chemotherapy measures on prevalence and intensity, and model simulations were performed to evaluate the feasibility of achieving the proposed transmission control criteria under different chemotherapy measures. Results The predicted prevalence and intensity one year from baseline were within the 95% confidence interval of actual values. As treatment frequency or coverage increased, the prevalence and intensity decreased. Model simulations show that many rounds of treatment are needed to maintain the prevalence at a low level in highly endemic areas of China. Conclusion We should select different combinations of treatment frequency, coverage and drug efficacy according to available resources and practical attainable conditions. Mathematical modeling could be used to help optimize the chemotherapeutic scheme aiming at specific parasitic species and areas, and to direct the establishment of soil-transmitted helminthiasis control criteria in China.Objective Our objective was to systematically evaluate chemotherapy-based control of ascariasis and hookworm infection and make predictions of the effectiveness of repeated mass treatment at different levels of coverage in highly endemic areas of China. Methods Field surveys were carried out to acquire the ascariasis and hookworm prevalence and intensity （mean worm burden） at baseline, one month and one year later. We calculated model parameters based on the survey data, then incorporated them into a quantitative framework to predict the prevalence and intensity one year later. Sensitivity analyses were performed to assess the influence of the chemotherapy measures on prevalence and intensity, and model simulations were performed to evaluate the feasibility of achieving the proposed transmission control criteria under different chemotherapy measures. Results The predicted prevalence and intensity one year from baseline were within the 95% confidence interval of actual values. As treatment frequency or coverage increased, the prevalence and intensity decreased. Model simulations show that many rounds of treatment are needed to maintain the prevalence at a low level in highly endemic areas of China. Conclusion We should select different combinations of treatment frequency, coverage and drug efficacy according to available resources and practical attainable conditions. Mathematical modeling could be used to help optimize the chemotherapeutic scheme aiming at specific parasitic species and areas, and to direct the establishment of soil-transmitted helminthiasis control criteria in China.

关 键 词：ASCARIASIS HOOKWORM CHEMOTHERAPY Field survey Mathematical modeling 

分 类 号：S858.285.9[农业科学—临床兽医学] TP393[农业科学—兽医学]