Stothard J R, Mgeni A F, Khamis S, Seto E, Ramsan M, Rollinson D
Wolfson Wellcome Biomedical Laboratories, Biomedical Parasitology Division, Department of Zoology, Natural History Museum, Cromwell Road, London SW7 5BD, UK.
Trans R Soc Trop Med Hyg. 2002 Sep-Oct;96(5):507-14. doi: 10.1016/s0035-9203(02)90421-9.
The distribution of urinary schistosomiasis in schoolchildren on Zanzibar Island (Unguja) was surveyed in May 2001 to test a potential correlation with the distribution of snail species of the Bulinus africanus group and to record contemporary baseline epidemiological data. Quasi-random samples of 40 schoolchildren of mixed sexes were selected from each of 10 schools. Schistosoma haematobium infections were detected upon the basis of micro-haematuria with subsequent confirmation by microscopy examination for schistosome eggs. At the time of urine collection, each child was interviewed with a suite of 12 questions prepared as a standardized questionnaire. Total prevalence of urinary schistosomiasis (known locally as kichocho) was 12% although schistosome infections were absent in 5 schools. Schools located west of 39 degrees 19'E and north of 6 degrees 10'S harboured nearly all of the infections; the highest prevalence (55%) was found at Kinyasini where many B. globosus habitats occur nearby. The general level of understanding of kichocho was low (24%) and individual self-diagnosis was poor (sensitivity, 8.5%; specificity, 85%). Grouped freshwater-contact patterns of schoolchildren differed significantly between schools and correlated well with prevalence of infections within schools. Across the island the area of active transmission of S. haematobium to humans appears confined within the distribution of B. globosus. There was no epidemiological evidence to suggest any involvement of B. nasutus in local transmission, confirming previous laboratory findings. In areas where B. globosus occurs, targeted snail control should be considered, to reduce schistosome transmission.
2001年5月，对桑给巴尔岛（温古贾岛）学童的泌尿血吸虫病分布情况进行了调查，以检验其与非洲小泡螺属蜗牛种类分布之间的潜在相关性，并记录当代基线流行病学数据。从10所学校中，每所学校选取40名男女混合的学童作为准随机样本。根据镜下血尿检测埃及血吸虫感染情况，随后通过显微镜检查血吸虫卵进行确认。在收集尿液时，用一套作为标准化问卷准备的12个问题对每个孩子进行访谈。泌尿血吸虫病（当地称为基乔乔）的总患病率为12%，尽管有5所学校未发现血吸虫感染。位于东经39度19分以西和南纬6度10分以北的学校几乎存在所有感染病例；在金亚西尼发现了最高患病率（55%），该地区附近有许多球泡螺栖息地。对基乔乔的总体了解程度较低（24%），个人自我诊断能力较差（敏感性为8.5%；特异性为85%）。不同学校学童的分组淡水接触模式差异显著，且与学校内的感染患病率密切相关。在全岛范围内，埃及血吸虫向人类的活跃传播区域似乎局限于球泡螺的分布范围内。没有流行病学证据表明鼻形小泡螺参与了当地传播，这证实了之前的实验室研究结果。在球泡螺出现的地区，应考虑有针对性地控制蜗牛，以减少血吸虫传播。
