Zusammenfassung
Vor 30 Jahren hat das Institut für Tropenmedizin der Universität Tübingen ein Forschungszentrum und Onchozerkose-Referenzlabor (ORL) in Togo in Westafrika gegründet. Das ORL war maßgeblich an der Erprobung und Einführung von Ivermectin als Standardtherapie gegen die Filarie Onchocerca volvulus, Erreger der Onchozerkose, beteiligt. Die Bekämpfung von Filariosen und vernachlässigten parasitären Infektionen bilden bis heute Schwerpunkte der Aktivitäten des ORL, die zusammen mit dem nationalen Hygieneinstitut und der Universität Lomé in Togo verwirklicht werden. Nach 24 Jahren regelmäßiger Behandlung mit Ivermectin haben die Untersuchungen des ORL gezeigt – der Onchozerkose kommt keine tragende Gesundheitsgefährdende Bedeutung mehr zu; Augenschäden und infektionsbedingte Erblindung sind kaum noch zu erwarten. Dennoch verbleibt die ländliche Bevölkerung mit intestinalen Würmern, Schistosomen und Protozoen stark belastet; im Besonderen sind Schulkinder häufig mit mehreren Parasiten gleichzeitig infiziert. Jährlich wiederholte Behandlungen von Schulkindern mit Albendazol und Praziquantel können die Parasitenlast um mehr als 80 % verringern; hingegen sind gelegentliche Interventionen nicht ausreichend, um parasitäre Koinfektionen zu eliminieren, und pro-inflammatorische zelluläre Immunreaktionen zu mindern.
Summary
The Institute for Tropical Medicine at University of Tübingen has established 30 years ago in Togo a Research Centre and Onchocerciasis Reference Laboratory (ORL). Onchocerca volvulus infection control and of other neglected tropical diseases has been the focus of activities, and those were performed together with the National Institute of Hygiene in Togo, the Medical Faculty at University of Lomé, national disease control programs and district and regional hospitals. The ORL contributed significantly to the assessment of ivermectin as the prime choice for onchocerciasis treatment, and 24 years of repeated annual treatment with ivermectin has progressively reduced disease prevalence and notably the level of ocular and dermal manifestations of onchocerciasis in the endemic population. The ORL has shown that large parts of the rural population in Togo is concurrently infected with intestinal and intravascular protozoan and helminth parasites, notably school children. The application of repeated treatments with albendazole and praziquantel against Schistosoma spp. and instestinal helminthes for several years has reduced infection intensities by more than 80%. Longitudinal investigations of the cellular immune responses in adults and children have found that parasite co-infections will generate prominent pro-inflammatory responses, and a single or few interventions will not suffice to eliminate co-infections and not establish an appropriately balanced immunity.
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Soboslay, P., Gantin, R., Banla, M. et al. Applied field research for comprehensive helminth infection control. Wien Klin Wochenschr 122 (Suppl 1), 27–30 (2010). https://doi.org/10.1007/s00508-010-1332-2
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DOI: https://doi.org/10.1007/s00508-010-1332-2