Barnett Paul G, Singh S P, Bern Caryn, Hightower Allen W, Sundar Shyam
Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Am J Trop Med Hyg. 2005 Oct;73(4):720-5.
We conducted a cross-sectional study to determine the incidence of visceral leishmaniasis (VL) and risk factors in two villages in Uttar Pradesh, India reported to have had a recent outbreak. In 245 households with 2,203 people, we detected 3 current VL cases, 32 past cases, and 8 VL deaths since 2001 (annual incidence = 6 per 1,000). Risk factors included living in the same household as a VL case (odds ratio [OR] = 76, P < 0.0005 in one village and OR = 22, P < 0.0005 in the other village), sleeping downstairs and outside in the summer (OR = 4.7, P = 0.004), and an age > or = 15 years old (OR = 2.9, P = 0.024). Increasing cattle density was a risk factor in one village but not the other. We were not able to determine the route by which VL entered the villages. Our data demonstrate a new spread of VL in previously unaffected areas. We recommend carefully supervised spraying with DDT, surveillance to pinpoint other affected villages, and efforts to increase availability of diagnostic and treatment facilities.
我们开展了一项横断面研究，以确定印度北方邦两个报告近期有疫情暴发的村庄内脏利什曼病（VL）的发病率及风险因素。在有2203人的245户家庭中，自2001年以来我们检测到3例现患VL病例、32例既往病例和8例VL死亡病例（年发病率为千分之6）。风险因素包括与VL病例同住一户（一个村庄的比值比[OR]=76，P<0.0005，另一个村庄的OR=22，P<0.0005）、夏季睡在楼下和户外（OR=4.7，P=0.004）以及年龄≥15岁（OR=2.9，P=0.024）。牛密度增加在一个村庄是风险因素，在另一个村庄则不是。我们无法确定VL进入村庄的途径。我们的数据表明VL在以前未受影响的地区出现了新的传播。我们建议进行严格监督下的滴滴涕喷洒、开展监测以确定其他受影响村庄，并努力增加诊断和治疗设施的可及性。
