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长须罗蛉与美洲内脏利什曼病的生态流行病学,特别提及巴西:综述

Lutzomyia longipalpis and the eco-epidemiology of American visceral leishmaniasis, with particular reference to Brazil: a review.

作者信息

Lainson Ralph, Rangel Elizabeth F

机构信息

Departamento de Parasitologia, Instituto Evandro Chagas, Belém, PA, Brazil.

出版信息

Mem Inst Oswaldo Cruz. 2005 Dec;100(8):811-27. doi: 10.1590/s0074-02762005000800001. Epub 2006 Jan 20.

Abstract

An historical review is given of American visceral leishmaniasis (AVL), with particular reference to the eco-epidemiology of the disease in Brazil. Following the first records of AVL in this country, in 1934, the sandfly Lutzomyia longipalpis (Lutz and Neiva, 1912) was incriminated as the principal vector. It is now generally accepted, however, that there exist a number of cryptic species under the name of Lu. longipalpis s.l. and that variations in the quantity of the vasodilatory peptide maxadilan in the saliva of flies from different populations of Lu. longipalpis s.l., may account for the variable clinical manifestations of AVL seen in different geographic regions. Distribution of AVL has been shown to extend throughout most of South and Central America, with the domestic dog serving as the principal reservoir of infection for man. However, while one hypothesis suggests that the causative parasite is Leishmania infantum, imported from Europe with the Portuguese and Spanish colonists, the demonstration of a high rate of benign, inapparent infection in foxes in Amazonian Brazil raised an opposing suggestion that the parasite is indigenous to the Americas. Recent reports of similar infections in native marsupials, and possibly rodents, tend to support this view, particularly as Lu. longipalpis is primordially a silvatic sandfly. Although effective control measures in foci of the disease will diminish the number of canine and human infections, the presence of such an enzootic in a variety of native animals will render the total eradication of AVL unlikely.

摘要

本文对美洲内脏利什曼病(AVL)进行了历史回顾,特别提及了该疾病在巴西的生态流行病学情况。自1934年该国首次记录到AVL以来,长须罗蛉(Lutzomyia longipalpis,Lutz和Neiva,1912年)被认定为主要传播媒介。然而,现在人们普遍认为,在长须罗蛉复合种(Lu. longipalpis s.l.)名下存在多个隐种,并且来自不同长须罗蛉复合种种群的苍蝇唾液中血管舒张肽马沙迪兰(maxadilan)含量的差异,可能是导致不同地理区域出现AVL临床表现差异的原因。已证明AVL的分布范围遍及南美洲和中美洲的大部分地区,家犬是人类感染的主要传染源。然而,一种假说认为致病寄生虫是婴儿利什曼原虫(Leishmania infantum),它是随葡萄牙和西班牙殖民者从欧洲传入的;而在巴西亚马逊地区狐狸中发现的高比例良性隐性感染情况则提出了相反的观点,即该寄生虫原产于美洲。最近关于本地有袋动物以及可能还有啮齿动物感染类似疾病的报道倾向于支持这一观点,特别是因为长须罗蛉原本是一种森林沙蝇。尽管在疾病疫源地采取有效的控制措施将减少犬类和人类感染的数量,但这种动物流行病在多种本地动物中的存在使得彻底根除AVL不太可能。

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