Sehgal S C, Vijayachari P, Murhekar M V, Sugunan A P, Sharma S, Singh S S
Regional Medical Research Centre (Indian Council of Medical Research), Andaman and Nicobar Islands, India.
Epidemiol Infect. 1999 Jun;122(3):423-8. doi: 10.1017/s0950268899002435.
The Andaman islands were known to be endemic for leptospirosis during the early part of the century. Later, for about six decades no information about the status of the disease in these islands was available. In the late 1980s leptospirosis reappeared among the settler population and several outbreaks have been reported with high case fatality rates. Besides settlers, these islands are the home of six primitive tribes of which two are still hostile. These tribes have ample exposure to environment conducive for transmission of leptospirosis. Since no information about the level of endemicity of the disease among the tribes is available, a seroprevalence study was carried out among all the accessible tribes of the islands. A total of 1557 serum samples from four of the tribes were collected and examined for presence of antileptospiral antibodies using Microscopic Agglutination Test (MAT) employing 10 serogroups as antigens. An overall seropositivity rate of 191% was observed with the highest rate of 53.5% among the Shompens. The seropositivity rates in the other tribes were 16.4% among Nicobarese, 222% among the Onges and 14.8% among the Great Andamanese. All of the tribes except the Onges showed a similar pattern of change in the seroprevalence rates with age. The prevalence rates were rising from low values among children to reach a peak in those aged 2140 years and then declined. Among Onges the seroprevalence rates continued to rise beyond 40 years. In all the tribes, seroprevalence rates were found to be significantly higher among the males. The commonest serogroups encountered were Australis followed by Grippotyphosa, Icterohaemorrhagiae, Pomona and Canicola.
安达曼群岛在本世纪初就被认为是钩端螺旋体病的地方病流行区。后来,大约有六十年的时间,这些岛屿上没有关于该疾病状况的信息。20世纪80年代末,钩端螺旋体病在定居者中再次出现,并报告了几起高病死率的疫情。除了定居者,这些岛屿还是六个原始部落的家园,其中两个部落仍然怀有敌意。这些部落大量接触有利于钩端螺旋体病传播的环境。由于没有关于该疾病在部落中的地方病流行程度的信息,因此对该岛所有可接触到的部落进行了血清阳性率研究。从四个部落共采集了1557份血清样本,并使用以10个血清群为抗原的显微镜凝集试验(MAT)检测抗钩端螺旋体抗体的存在。总体血清阳性率为19.1%,其中绍姆彭人血清阳性率最高,为53.5%。其他部落的血清阳性率分别为:尼科巴人16.4%,昂格人22.2%,大安达曼人14.8%。除昂格人外,所有部落的血清阳性率随年龄变化的模式相似。患病率从儿童时期的低值上升,在21至40岁人群中达到峰值,然后下降。在昂格人中,血清阳性率在40岁以后继续上升。在所有部落中,男性的血清阳性率明显更高。最常见的血清群是澳洲群,其次是波摩那群、出血性黄疸群、波蒙那群和犬群。