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在印度维护内脏莱什曼病控制计划的消除后阶段的挑战:基于现场的实地研究

Subhasish Kamal Guha¹, Ashif Ali Sardar², Pabitra Saha^2,3

¹School of Tropical Medicine, Kolkata, West Bengal, India.

PLoS neglected tropical diseases

|March 7, 2024

概括

治疗无症状莱什曼感染 (ALI) 对于保持内脏莱什曼病 (VL) 消除在印度至关重要. 未经治疗的ALI负担会增加新的感染,并威胁到VL消除目标.

科学领域:

医学昆虫学医学昆虫学
寄生虫学的寄生虫学
公共卫生公共卫生

背景情况:

印度的内脏莱什曼病 (VL) 消除计划面临来自无症状莱什曼病感染 (ALI) 和后卡拉阿扎尔皮肤莱什曼病 (PKDL) 持续寄生虫储备的威胁.
了解VL,PKDL和ALI的负担对于维持消除后阶段至关重要.

研究的目的:

确定印度特有地区的VL,PKDL和ALI的流行病负担.
评估治疗ALI对维护VL消除后阶段的影响.

主要方法:

印度西孟加拉州马尔达区 (2016-2021) 的"研究" (ALI治疗) 和"控制" (ALI未治疗) 臂的比较研究.
积极群体调查用于VL和PKDL诊断和治疗,ALI管理,以及对寄生虫DNA的沙飞池分析.

主要成果:

在手臂之间VL和PKDL发病率没有显著差异.
在"研究"组中,ALI发生率下降,但在"控制"组中增加.
"对照"组中较高的血清转化率与未经治疗的ALI相关;Leishmania DNA在22.8%的ALI病例和2.2%的沙中被发现.

结论:

持续的PKDL和ALI病例,以及沙寄生DNA显示的持续传播,危及VL消除维护.
需要积极的病原体消除策略来防止VL复发.

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