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Lymphedema in three previously Wuchereria bancrofti-endemic health districts in Mali after cessation of mass drug administration.
BMC Infectious Diseases ( IF 3.7 ) Pub Date : 2020-01-15 , DOI: 10.1186/s12879-020-4777-6
Housseini Dolo 1, 2 , Yaya Ibrahim Coulibaly 1, 3 , Fatoumata Nene Konipo 1 , Siaka Yamoussa Coulibaly 1 , Salif Seriba Doumbia 1 , Moussa Brema Sangare 1 , Lamine Soumaoro 1 , Michel Emmanuel Coulibaly 1 , Abdallah Amadou Diallo 1 , Yaye Diarra 1 , Modibo Sangare 1 , Seydou Doumbia 1 , Robert Colebunders 2 , Thomas B Nutman 4
Affiliation  

BACKGROUND Lymphedema is a public health problem in countries with lymphatic filariasis (LF) including Mali. We studied the epidemiology and clinical presentation of lymphedema in three previously LF-endemic health districts of Mali after at least five consecutive rounds of mass drug administration (MDA) with albendazole and ivermectin. METHODS From 2016 to 2018, we used passive and active case finding methods to identify lymphedema cases in three health districts with high pre-MDA LF prevalence: Kolondieba (66%), Bougouni (44%) and Kolokani (34%). RESULTS Three hundred and thirty nine cases of lymphedema were identified, 235 (69.32%) through active case finding. Their median age was 56 years (range 2-90) and 286 (84.36%) were women. Lymphedema was reported in 226 (78.5%) people aged 41 years and older compared to 73 (21.5%) people below the age of 41 years (Chi2 = 17.28, df = 5, p = 0.004). One hundred and seventy five cases of lymphedema were found in Kolondieba (66 per 100,000 people), 116 in Bougouni (19 per 100,000) and 48 in Kolokani (16 per 100,000). Stage III lymphedema was observed in 131 (38.64%), stage II in 108 (31.86%), stage IV in 46 (13.57%), stage I in 23 (6.78%), stage V in 21 (6.19%) and stage VI in ten (2.95%). In the three study districts, lymphedema affected the legs in 281 (82.89%), the arms in 42 (12.39%) and both in 16 (4.72%) (Chi2 = 13.63, p = 0.008). CONCLUSION Health districts in Mali with the highest pre-MDA LF prevalences had the highest prevalence of lymphedema. Efforts to actively identify lymphedema cases should be scaled up in previous LF-endemic areas, and should be supplemented by a morbidity management and disability prevention plan at the peripheral health system level.

中文翻译:

停止大规模药物管理后,马里三个先前的Wuchereria bancrofti地方性卫生区出现了淋巴水肿。

背景技术在包括马里在内的淋巴丝虫病(LF)的国家中,淋巴水肿是一个公共卫生问题。在至少连续五轮使用阿苯达唑和伊维菌素进行大规模药物管理(MDA)后,我们研究了马里的三个先前LF流行性健康区的淋巴水肿的流行病学和临床表现。方法从2016年到2018年,我们使用被动和主动病例发现方法来确定三个MDA发生前LF患病率较高的卫生区的淋巴水肿病例:Kolondieba(66%),Bougouni(44%)和Kolokani(34%)。结果共发现339例淋巴水肿,其中235例(69.32%)通过积极病例发现。他们的中位年龄为56岁(2-90岁),女性为286名(84.36%)。41岁及以上的人中有226名(78.5%)淋巴水肿,而73名(21。5%)41岁以下的人(Chi2 = 17.28,df = 5,p = 0.004)。在Kolondieba发现了175例淋巴水肿(每10万人中有66例),在Bougouni中发现了116例(每10万人中有19例),在Kolokani中发现了48例(每10万人中有16例)。观察到III期淋巴水肿131(38.64%),II期108(31.86%),IV期46(13.57%),I期23(6.78%),V期21(6.19%)和VI期十分之二(2.95%)。在这三个研究区中,淋巴水肿影响了281腿(82.89%),42臂(12.39%)和16臂(4.72%)(Chi2 = 13.63,p = 0.008)。结论马里卫生区MDA前LF患病率最高,淋巴水肿患病率最高。在以前的LF流行地区,应扩大积极识别淋巴水肿病例的努力,
更新日期:2020-01-15
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