Hillyer G V, Soler de Galanes M
Department of Pathology and Laboratory Medicine, University of Puerto Rico School of Medicine, San Juan 00936-5067, USA.
Am J Trop Med Hyg. 1999 May;60(5):827-30. doi: 10.4269/ajtmh.1999.60.827.
The current study summarizes our findings of anti-schistosome egg antibody by the circumoval precipitin test for two different populations in Puerto Rico. One group, exclusively males more than 40 years of age and from all municipalities on the island, was from the Veterans Administration Hospital for the period 1988-1997. The second group resided southeast of San Juan, around the municipality of Caguas and adjacent municipalities east of Caguas, was of both sexes and mostly until 1997 of undetermined ages for the period 1993-1997. Results reveal a yearly decrease in testing requests from the Veterans Administration Hospital from 148 in 1988 and 1989 with 16% positive to three in 1996 through 1998 with none positive. This decrease in testing requests was because of a decrease of suspicion of schistosomiasis in this group. The other patient population from the Caguas region showed a gradual but continuous decrease in seropositive individuals from 21% in 1993 to 12% in 1996, with precipitous decrease to 5% in 1997 and only 1% in 1998. Moreover, there were four patients from which at least two serum samples were obtained one or two years apart and tested. In each instance the more recently obtained sample had lower antibody reactions than the first as reflected in lower percentages of positive egg reactors. The fact that they were treated with praziquantel after the first testing also suggests that the infected population was being eliminated through chemotherapy. These combined results suggest the elimination of infections with Schistosoma mansoni in the traditionally high prevalence regions east of San Juan in the absence of any proactive control efforts in Puerto Rico. Because of the rapid urbanizing of Puerto Rico, the one identifiable control effort is economic development and well being.
本研究总结了我们通过环卵沉淀试验对波多黎各两个不同人群进行抗血吸虫卵抗体检测的结果。一组为1988 - 1997年期间来自退伍军人管理局医院的人群，全是40岁以上的男性，来自该岛的所有市镇。第二组居住在圣胡安东南部，围绕卡瓜斯市及卡瓜斯以东的相邻市镇，包括男女两性，在1993 - 1997年期间大多数人的年龄不确定，至1997年为止。结果显示，退伍军人管理局医院的检测申请量逐年下降，从1988年和1989年的148例（阳性率16%）降至1996年至1998年的3例（无阳性）。检测申请量下降是因为该组对血吸虫病的怀疑减少。来自卡瓜斯地区的另一组患者中，血清阳性个体逐渐但持续减少，从1993年的21%降至1996年的12%，1997年急剧降至5%，1998年仅为1%。此外，有4名患者相隔一两年采集了至少两份血清样本并进行检测。在每个病例中，最近采集的样本抗体反应低于第一次，表现为阳性虫卵反应者的百分比更低。他们在首次检测后接受了吡喹酮治疗这一事实也表明，感染人群正在通过化疗被清除。这些综合结果表明，在波多黎各没有任何积极防控措施的情况下，圣胡安以东传统上血吸虫病高流行地区的曼氏血吸虫感染已被消除。由于波多黎各的快速城市化，一项可确定的防控措施是经济发展和改善民生。
