Chimbari M J, Chirebvu E, Ndlela B
University of Zimbabwe, Lake Kariba Research Station, P.O. Box 48, Kariba, Zimbabwe.
Acta Trop. 2004 Jan;89(2):205-13. doi: 10.1016/j.actatropica.2003.09.015.
A comparative assessment of the malaria and schistosomiasis risks associated with surface and sprinkler irrigation systems in Zimbabwe was carried out. The risk assessment of the two diseases was done in accordance with the three standard components of health impact assessment, namely (i) community vulnerability, (ii) environmental receptivity, and (iii) capability of health services to respond to malaria and schistosomiasis. Records of the two diseases were obtained from four health centres serving two surface irrigation schemes and two sprinkler irrigation schemes. For comparison records were also obtained from health centres serving nearby dryland areas. Incidence of schistosomiasis as estimated from recorded new cases of the disease was much higher in surface irrigation schemes than in sprinkler irrigation schemes. For malaria it was the other way around. These findings were confirmed by rapid risk assessments. Malaria risk factors were more prominent in sprinkler irrigation schemes, whereas more schistosomiasis risk factors were identified in surface irrigation schemes. These observations were attributed to poorly maintained infrastructure and inadequate landscape-levelling, which created mosquito breeding sites within the fields in the case of sprinkler schemes, and to poor drainage structures, which created snail-breeding sites in the case of surface-irrigation schemes. Importantly, poor maintenance of sprinkler scheme infrastructure accounted for more disease promoting features than the engineering designs per se. This study demonstrated the value of complementing routinely collected health data with rapid assessment procedures for appraisal of commonly reported diseases.
对津巴布韦地表水灌溉系统和喷灌系统相关的疟疾和血吸虫病风险进行了比较评估。这两种疾病的风险评估是根据健康影响评估的三个标准组成部分进行的，即：（i）社区脆弱性，（ii）环境易感性，以及（iii）卫生服务应对疟疾和血吸虫病的能力。这两种疾病的记录来自为两个地表水灌溉方案和两个喷灌方案服务的四个卫生中心。为作比较，还从为附近旱地地区服务的卫生中心获取了记录。根据记录的新发病例估计，血吸虫病的发病率在地表水灌溉方案中比在喷灌方案中高得多。疟疾的情况则相反。这些发现通过快速风险评估得到了证实。疟疾风险因素在喷灌方案中更为突出，而在地表水灌溉方案中发现了更多的血吸虫病风险因素。这些观察结果归因于基础设施维护不善和地形平整不足，在喷灌方案中导致田间形成蚊虫滋生地，而在地表水灌溉方案中则归因于排水结构不良，导致形成钉螺滋生地。重要的是，喷灌方案基础设施维护不善所造成的促进疾病的因素比工程设计本身更多。这项研究证明了用快速评估程序补充常规收集的健康数据以评估常见疾病的价值。
