安徽省基本消除淋巴丝虫病后的流行病学监测研究

目的通过监测,发现、清除残存传染源,为消除丝虫病提供科学依据。方法各流行县(市、区)按照《安徽省丝虫病监测技术方案》的要求开展基本消除丝虫病后的横向、纵向的人群与蚊媒的病原监测。结果至2006年,安徽省丝虫病微丝蚴率已由基本消除丝虫病考核验收时的平均0.13%下降至零;82个县(市、区)开展消除丝虫病监测的持续时间都达到了基本消除丝虫病后10年以上;无微丝蚴血症后病原学监测范围,以县为单位都达到了覆盖流行乡镇30%以上和流行区人口3%以上。结论安徽省丝虫病传播已被阻断,达到消除丝虫病国家标准。     

An Evaluation of Coverage and Compliance of Mass Drug Administration 2006 for Elimination of Lymphatic Filariasis in Endemic Areas of Gujarat

Background:

Mass drug administration (MDA) means once-in-a-year administration of diethyl carbamazine (DEC) tablet to all people (excluding children under 2 years, pregnant women and severely ill persons) in identified endemic areas. It aims at cessation of transmission of lymphatic filariasis.

Objective:

What has been the coverage and compliance of MDA in Gujarat during the campaign in December 2006?

Study Design:

Cross-sectional population based house-to-house visit.

Setting:

Urban and rural areas in Gujarat identified as endemic for filariasis where MDA 2006 was undertaken.

Study Variables:

Exploratory - Rural and urban districts; Outcome - coverage, compliance, actual coverage, side effects.

Analysis:

Percentage and proportions.

Results:

Twenty-six clusters, each comprising 32 households from six endemic districts, yielded an eligible population of 4164. The coverage rate was 85.2% with variation across different areas. The compliance with drug ingestion was 89% with a gap of 11% to be targeted by intensive IEC. The effective coverage (75.8%) was much below the target (85%). Side effects of DEC were minimum, transient and drug-specific. Overall coverage was marginally better in rural areas. The causes of poor coverage and compliance have been discussed and relevant suggestions have been made.     

Adverse reactions following mass drug administration during the Programme to Eliminate Lymphatic Filariasis in Orissa State, India

The frequency and severity of adverse reactions are the main reasons for low compliance of mass drug administration (MDA) under the Programme to Eliminate Lymphatic Filariasis (PELF). This paper reports the frequency and types of adverse reactions during two MDAs during January 2002 and September 2004 in the State of Orissa, India. Of the people who consumed the drugs, 15.5% in the 2002 MDA and 16.5% in the 2004 MDA reported one or more adverse reactions. This rate is higher (49.7%) in a group of individuals who were monitored for 6 days from the day of consumption of drugs during the 2002 MDA. However, many of these reactions were mild. No significant difference was found in the frequency of adverse reactions between MDA with diethylcarbamazine (DEC) alone and with DEC and albendazole. Significant gender differences were found in the 2004 MDA but no such differences were found in the 2002 MDA; however, the frequency of adverse reactions increased with age. Of all the adverse reactions, systemic adverse reactions typically associated with microfilarial death were more frequent. The frequency of adverse reactions was higher in microfilaraemics compared with amicrofilaraemic controls. The present study warrants developing an active adverse reaction surveillance system to minimise the impact of adverse reactions on MDA compliance.     

四川省消除丝虫病后慢性丝虫病调查

目的 了解消除丝虫病后慢性丝虫病发病情况和原患者转归及变化,为对患者开展关怀与照料提供依据.方法 以10周岁以上人群为调查对象,逐户逐人访问与体检；对原慢性丝虫病患者逐个询问、复查,完善个案资料.结果 四川省消除丝虫病后,无新发慢性丝虫病病例；2010年尚存原慢性丝虫病患者341例.原患者因年老自然减员等原因,分别比基本消除丝虫病和消除丝虫病时自然减少89.83％、62.32％,分布区域已明显缩小.遗留的患者年龄以60岁以上老年人居多(92.08％)；患者病程多在40年以上(78.59％).淋巴液肿部位和分期以双下肢和I～Ⅱ期为主,分别占整个病例的46.92％、75.07％.结论四川省消除丝虫病后,慢性丝虫病患者明显减少,体征程度减轻,表现为高龄、病程长的特点,后期监测应加强患者自身保健治疗,给予关怀和照料,减轻症状与体征,控制发病.     

Mass Drug Administration Coverage Evaluation Survey for Lymphatic Filariasis in Bagalkot and Gulbarga Districts

Background:

Lymphatic filariasis (LF) is endemic in 83 countries and territories, with more than a billion people at risk of infection. In view with the global elimination, mass drug administration (MDA) with single dose of diethylcarbamazine and albendazole tablets was carried out for the eligible population in Bagalkot and Gulbarga districts.

Objective:

Assess coverage of MDA against LF in Bagalkot and Gulbarga districts.

Materials and Methods:

In this cross-sectional coverage evaluation survey, one urban and three rural clusters were selected randomly in each district. The data were collected in a pretested performa, computed and analyzed using SPSS-10 to calculate frequencies and proportions.

Results:

A total of eight clusters in two districts resulted in a total study population of 1,228 individuals. The overall compliance rate in Bagalkot district was 78.6% and in Gulbarga district it was only 38.8%. The prime reason for noncompliance was fear of side effects and not received tablets.

Conclusion:

There is an urgent need for more effective drug delivery strategies to improve the compliance in both the districts.     

Elimination of Lymphatic Filariasis: Mass Drug Administration in Endemic Areas of (Bidar District) Karnataka-2008

Background:

Lymphatic Filariasis is a mosquito transmitted disease, caused by parasitic worm Wuchereria bancrofti. Global Programme for Elimination of Lymphatic Filariasis was established in early 2000. The strategy recommended by the World Health Organization is annual Mass Drug Administration (MDA) of single-dose of Diethylcarbamazine 6 mg/kg (DEC), distributed to inhabitants of Filariasis endemic areas, excluding children below 2 years of age, pregnant women, and seriously ill persons, and Morbidity Management. The health system distributes the drugs by a door-to-door strategy.

Objective:

To assess the coverage and compliance of MDA in Bidar district during the campaign in November 2008.

Materials and Methods:

Cross-sectional population-based house-to-house visit. Outcome is assessed as actual coverage and compliance, in Percentage and proportions.

Results:

Eight clusters, total eligible population of 1 131 individuals were interviewed. The coverage rate was 78% with variation across different areas. The compliance with drug ingestion was 68%.

Conclusion:

The effective coverage was below the target (85%). Side effects of DEC were minimum, the overall coverage was better in rural areas compared with urban areas.     

Lymphatic filariasis: possible pathophysiological nexus with oxidative stress

Wuchereria bancrofti-mediated lymphatic filariasis is widely prevalent. Diversity in immune response presumably may lead to myriad clinical presentations, such as overt chronic filariasis, occult filariasis with atypical systemic manifestation and asymptomatic microfilariae carrier state. Anticipated oxidative stress during inflammatory response to infective conditions might complicate the immune response and thus might alter the disease outcome. The present study was carried out to assess the status of oxidative stress in different clinical presentations of bancroftian filariasis. Twenty-five microfilariae carriers and 30 cases each of chronic filariasis and occult filariasis were compared to 30 endemic normal individuals. Serum malondialdehyde level and superoxide dismutase enzyme activity were measured by spectrophotometric methods and levels of filarial antigen were measured by ELISA. In the filarial cases, the levels of these parameters were assayed again after treatment with diethylcarbamazine citrate (DEC). Results showed significant (P<0.05) association of oxidative stress with chronic and occult filariasis but not with microfilarial carriers. DEC therapy in both clinical cases and carriers resulted in a significant reduction of oxidative stress associated with decreased antigen level (P<0.01). These findings suggest the possible involvement of oxidative stress in filarial disease pathology.     

福建省基本消灭丝虫病后的监测结果与动态分析

福建省各县基本消灭丝虫病后，陆续开展了监测工作至１９８８年，全省达到基本消灭丝虫病的标准时，已监测９０１１９１人，查出微丝血症者２３９１人，１９８８年以后全省累计监测１８７０８２６人，查出微丝蚴血症得１２０３人，明显少于１９８８年以前监测中查出的人数；剖验蚊媒５３０１９８只，仅发现阳性蚊１９只，并已连续３年未发现阳性蚊；纵向监测点的２９例微线血症阳性者，１９９５年也全部自然转阴；人群血清抗丝虫抗体     

Surveillance and Vector Control of Lymphatic Filariasis in the Republic of Korea

ObjectivesUntil the early 2000s, lymphatic filariasis would commonly break out in the coastal areas in Korea. Through steady efforts combining investigation and treatment, filariasis was officially declared eradicated in 2008. This study surveyed the density of vector species of filariasis in past endemic areas, and inspected filariasis DNA from collected mosquitoes for protection against the reemergence of filariasis.MethodsBetween May and October 2009, mosquitoes were caught using the black night trap in past endemic coastal areas: Gyeongsangnam-do, Jeollanam-do, and Jeju-do. The collected mosquitoes were identified, and the extracted DNA from the collected vector mosquitoes was tested by polymerase chain reaction for Brugia malayi filariasis.ResultsOchletotatus togoi, Anophel es (Hyrcanus) group and Culex pipiens were most frequently caught in Jeollanam-do (Geomun Island, Bogil Island, Heuksan Island), Jeju-do (Namone-ri, Wimi-ri). and Gyeongsangnam-do (Maemul Island). DNA of B malayi was not found in Och Togoi and An (Hyrcanus) group as main vectors of filariasis.ConclusionLymphatic filariasis was not found in the vector mosquitoes collected in past endemic areas. However, considering that the proportion of vector species is quite high, there is a potential risk that filariasis could be reemerging through overseas travel or trade. Thus, there is a need to continuously monitor vector mosquitoes of lymphatic filariasis.     

Chronic clinical manifestations related to Wuchereria bancrofti infection in a highly endemic area in Kenya

Clinical examinations were conducted in an effort to provide baseline data for a pilot filariasis elimination programme implemented in a Wuchereria bancrofti-endemic focus in Malindi district, Kenya. Of 186 males aged 15 years and above examined, 64 individuals (34.4%) had hydrocele, and the prevalence of the manifestation in those above 40 years old was 55.3%. The prevalence of leg lymphoedema in persons aged 15 years and above was 8.5%, with a higher rate in males (12.6%) than in females (5.7%). The overall prevalence of inguinal adenopathy was 8.6%, and males had a significantly higher (12.9%) prevalence of adenopathy than females (5.1%) (P<0.001). The data in the present study provided support for consideration of filarial infection as a possible cause of inguinal lymphadenopathy in bancroftian filariasis-endemic areas. The results of this study also indicate that lymphatic filariasis is a serious public health problem in the northern coastal areas and morbidity control programmes should be implemented to alleviate the suffering of those affected.     

An Epidemiological Study of Filariasis in a Village of District Datia, MP

Background:

District Datia has been known to be endemic for filariasis. A number of cases have been reported in recent past. The present study was an epidemiological investigation carried out in village Barganya, Datia in the month of Sept 2004.

Aims and Objectives:

The objectives of this study were to confirm the epidemic in village Barganya and to study the causes of the present epidemic.

Materials and Methods:

The study was a cross sectional study carried out through house to house survey, covering a population of 1512.

Result:

A total of 78 clinically confirmed cases were reported. The study calculated a microfilarial rate of 6.9% and 1.65% in males and females respectively. The microfilarial density among confirmed cases ranged from 3.1 to 10.6 per 20 cmm.

Conclusion:

The study concluded that majority of the cases were males who worked in open field and there was a lack of proper management of these cases at village level.     

肥西县丝虫病流行特征及防治措施评析

目的　了解肥西县丝虫病的流行特征和防治工作采取措施的效果 ,为开展类似的工作提供借鉴作用。方法　对本县 1970～ 2 0 0 0年丝虫病的防治研究及相关调查资料进行整理、统计分析并进行评价。结果　 1970年调查人群微丝蚴率高达 18.2 5 % ,1973年平均微丝蚴率为 6 .31% ,80年代为 1.15 % ,全县各乡镇均有丝虫病的流行。 1991年调查人群平均微丝蚴率为 0 .6 1% ,主要流行区分布于县西北区域的 15个乡镇 ,以马来丝虫为主的马来、班氏两种丝虫病混合流行区。主要传播媒介为中华按蚊和嗜吸人血按蚊。经过 30年的积极防治 ,特别是 1991年 ,在现况调查的基础上 ,以行政村为单位 ,按不同的流行程度采用不同剂量的海群生药盐的防治 ,加快了基本消灭丝虫病的步伐 ,1993年经省厅考核 ,人群微丝蚴率为 0 .0 7% ,达到了基本消灭丝虫病的标准。 2 0 0 0年全县开展消灭丝虫病的监测 ,人群微丝蚴率和按蚊幼丝虫的自然感染率均为0 %。达到部颁消灭丝虫病的标准。结论　肥西县是以马来丝虫为主的马来和班氏两种丝虫病混合流行的地区 ,经过 30年的查治 ,传播已被阻断 ,达到部颁消灭丝虫病的标准     

防治后期马来丝虫病传播动态观察

目的：探讨基本消灭马来丝虫病地区残存微丝蚴血症者的流行病学意义。方法：不采取任何防治措施，对居民微丝蚴率降至0．97％的水洼村连续进行了10年纵向监测。结果：（1）1982年查出的18例微丝蚴阳性者在1～8年内先后转阴，在观察期间未发现新的微丝蚴血症者；（2）从1984年开始丝虫病的传播强度降至为0。结论：当居民微丝蚴率降至1％以下时，少量低密度微丝拗血症者在流行病学上已不起传播作用。     

阳山县消灭丝虫病防治策略和技术措施的研究

为了消灭阳山县丝虫病 ,从 1 959年起对该县进行丝虫病流行病学摸底调查 ,发现共有 1 9个乡镇的 2 1 7个管理区有班氏丝虫病流行 ,平均人群微丝蚴率为 4 3 5%。据此提出以防治病原为主导的策略 ,制订出三项防治技术措施 :①在一个中度流行镇以海群生间歇双疗程法进行连续四年反复查治 ,微丝蚴率从查治前的 1 5 0 8%降至 0 4 5% ;②对连成一片且有固定食盐供应渠道的三个中度流行镇采用全民服食海群生掺拌食盐 ( 3g/kg)防治 6个月 ,微丝蚴率从 5 0 7%降至 0 4 3 % ;③查治结合重点村全民服药 ( 7岁以上人群全民用海群生 3g ,5天分服 ) ,共血检 1 3 2 58人 ,查出并治疗微丝蚴血症 1 5例 ,全民服药 1 8757人 ,巩固丝虫病防治效果。 1 980年经卫生部考核 ,微丝蚴率降至 0 0 0 %～ 0 2 5% ,达到基本消灭丝虫病标准。 1 988～ 1 992年进行纵向监测和 1 9个乡镇横向监测分别血检 60 85、2 80 1 2人次 ,均未发现微丝蚴血症者 ;分别解剖致倦库蚊 1 0 545、4 61 6只 ,均未发现有丝虫感染。 1 996年经省及卫生部考核达到消灭丝虫病部颁标准     

Evidence for the interruption of transmission of lymphatic filariasis among schoolchildren in Trinidad and Tobago

This study was carried out to provide some evidence for the interruption of transmission of lymphatic filariasis (LF) among schoolchildren in Trinidad and Tobago. A cross-sectional survey for LF antigenaemia was performed among 63 (13.2%) of the 479 primary schools located in eight administrative (and geographical) regions of Trinidad and Tobago. From these communities, 2597 schoolchildren aged 6-12 years were sequentially selected for a survey of bancroftian antigenaemia. From each child, 100 microl (finger-prick) whole blood sample was applied to a Binax immunochromatographic card test (ICT), and read for the presence of antigenaemia. The ICT results showed a negative finding for LF antigenaemia and suggest that LF transmission has been interrupted in the survey areas.     

以中华按蚊为单一媒介的马来丝虫病防治后期流行动态观察

目的:了解丝虫病防治后期中华按蚊传播马来丝虫病的作用及丝虫病流行病学特征.方法:在不进行任何防治的基础上,对马来丝虫病流行区4个试点村进行人群参数、蚊媒参数和免疫学参数的纵向观察.结果:3个试点村微丝蚴率逐年下降,已不足以构成传播,即水洼1982～1985年微丝蚴率分别为0.97%、0.63%、0.55%、0.37%,1998年为0.05%,1990和1992年均为0.古柏门1986～1989年微丝蚴率依次为1.55%、0.84%、0.42%和0.31%;黄垸1990～1994年为0.72%、0.30%、0.08%、0.08%、0.08%;而莫市微丝蚴率无明显变化,维持在2.3%左右,1986～1989年依次为2.31%、2.23%、2.30%和2.43%.水洼于1982年蚊媒感染期幼丝虫率0.46%,1983年为0.10%;莫市媒介感染期幼丝虫率1987年为0.09%,1988年为0.19%.黄垸血清阳性反应率逐年下降,与血检结果相一致.结论:以中华按蚊为单一传播媒介的马来丝虫病流行区,其丝虫病传播的微丝蚴率临界水平为1.5%～2.3%;在达到基本消灭丝虫病地区,马来丝虫病传播流行呈下降态势,防治措施可以终止,仅对原微丝蚴血症者连续数年查治,直至转阴,丝虫病即可被消灭.     

Knowledge and beliefs about elephantiasis and hydrocele of lymphatic filariasis and some socio-demographic determinants in an endemic community of Eastern India

This study reports the knowledge and beliefs about filarial elephantiasis and hydrocele of people from an endemic area of Orissa, India. Both qualitative and quantitative data were collected from 12 villages, sampled from four blocks in the Khurda district of Orissa. This study found that people were aware of different manifestations of filariasis, and perceived them as problems in their community. A high proportion of people knew that mosquitoes are the reason for the spread of elephantiasis, but less people were aware of the cause of hydrocele and the association between elephantiasis and hydrocele. Only half of the respondents believed that elephantiasis is curable by modern medicines, and about 84% of respondents thought that surgery is the only method to cure hydrocele. About two-thirds of people know that avoiding mosquitoes can prevent elephantiasis. Age, gender, educational level and caste affiliation were identified as factors influencing awareness and knowledge. These findings may be used in the development of group-specific health education programmes to change health behaviour and to achieve higher involvement of the community in annual mass drug administration to eliminate lymphatic filariasis.     

龙岩地区消灭丝虫病的防治策略及流行病学监测研究

目的；本文是龙岩地区消灭丝虫病的防治策略及流行病学监测工作的总结。方法；对全区各年度丝虫病防治监测资料及防治效果进行了统计分析。１９７６年后继续开展残存和输入性传染监测，并系统开展病原学，蚊媒和血清学横向和纵向监测。结果：病原横向监测流行乡镇覆盖率达７２．６５％，人群覆盖率达５．４６％。１９８９年监测点发现２例本地籍微丝蚴血症者已自然有，连续年未发现新病例，蚊媒监测无阳性蚊。     

Immigrant parent involvement in government funded early childhood education programming: an examination of FACES

ABSTRACT

Head Start is a federally funded early childhood education programme that takes a unique 2-generation approach to working with families. Family engagement in early education like Head Start has been shown to improve academic and behavioural outcomes in children, with particular beneficial effects in the children of immigrant parents. This study seeks to explore predictors of involvement in Head Start services among immigrant families. Through an examination of Family and Child Experiences Survey (FACES) 2009 data, this study uses bivariate and multivariate regression, and Karlson/Holm/Breen (KHB) analyses to determine variables associated with involvement in Head Start services. Results indicate that immigrant and U.S.-born parents do not differ in their levels of involvement in Head Start services. Rather, for both groups of parents, parental education attainment and satisfaction in services predicted levels of involvement. Furthermore, for mothers, the relationship between levels of educational attainment and involvement was fully mediated by mothers’ levels of employment.