Kabatereine Narcis B, Brooker Simon, Tukahebwa Edridah M, Kazibwe Francis, Onapa Ambrose W
Vector Control Division, Ministry of Health, Kampala, Uganda.
Trop Med Int Health. 2004 Mar;9(3):372-80. doi: 10.1046/j.1365-3156.2003.01176.x.
Intestinal schistosomiasis caused by infection with Schistosoma mansoni is a widespread public health problem in Uganda. Although long known to be endemic, its current distribution within the country requires updating of parasitological data to help guide planned control. We report such data collected between 1998 and 2002 from 201 schools and 68 communities across Uganda. In accordance with epidemiological expectation, prevalence and intensity increased with age, peaking at 10-20 years and thereafter declined moderately with age, whereas intensity declined more rapidly with age, and the prevalence of infection in a school was non-linearly related to the mean intensity of infection. We used geographical information systems to map the distribution of infection and to overlay parasitological data with interpolated environmental surfaces. The derived maps indicate both a widespread occurrence of infection and a marked variability in infection prevalence, with prevalence typically highest near the lakeshore and along large rivers. No transmission occurred at altitudes >1400 m or where total annual rainfall was <900 mm; limits which can help estimate the population at risk of schistosomiasis. The results are discussed in reference to the ecology of infection and provide an epidemiological framework for the design and implementation of control efforts underway in Uganda.
由曼氏血吸虫感染引起的肠道血吸虫病是乌干达一个广泛存在的公共卫生问题。尽管长期以来已知其为地方病，但其在该国目前的分布情况需要更新寄生虫学数据，以帮助指导计划中的防治工作。我们报告了1998年至2002年期间从乌干达201所学校和68个社区收集的此类数据。根据流行病学预期，患病率和感染强度随年龄增长而增加，在10至20岁达到峰值，此后随年龄适度下降，而感染强度随年龄下降更快，且学校中的感染患病率与平均感染强度呈非线性关系。我们使用地理信息系统绘制感染分布图，并将寄生虫学数据与插值环境表面叠加。得出的地图显示感染广泛存在且感染患病率存在显著差异，患病率通常在湖岸附近和大河流沿岸最高。在海拔>1400米或年总降雨量<900毫米的地方没有传播发生；这些界限有助于估计血吸虫病的高危人群。结合感染生态学对结果进行了讨论，并为乌干达正在开展的防治工作的设计和实施提供了一个流行病学框架。
