Wanji S, Tendongfor N, Esum M, Che J N, Mand S, Tanga Mbi C, Enyong P, Hoerauf A
Research Foundation for Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon; Department of Biochemistry and Microbiology, University of Buea, P.O. Box 63, Buea, Cameroon.
Ann Trop Med Parasitol. 2008 Sep;102(6):529-40. doi: 10.1179/136485908X311849.
Lymphoedema, a condition of localized fluid retention, results from a compromised lymphatic system. Although one common cause in the tropics is infection with filarial worms, non-filarial lymphoedema, also known as podoconiosis, has been reported among barefoot farmers in volcanic highland zones of Africa, Central and South America and north-western India. There are conflicting reports on the causes of lymphoedema in the highland regions of Cameroon, where the condition is of great public-health importance. To characterise the focus of lymphoedema in the highlands of the North West province of Cameroon and investigate its real causes, a cross-sectional study was carried out on the adults (aged > or =15 years) living in the communities that fall within the Ndop and Tubah health districts. The subjects, who had to have lived in the study area for at least 10 years, were interviewed, examined clinically, and, when possible, checked for microfilaraemia. The cases of lymphoedema confirmed by ultrasonography and a random sample of the other subjects were also tested for filarial antigenaemia. The interviews, which explored knowledge, attitudes and perceptions (KAP) relating to lymphoedema, revealed that the condition was well known, with each study community having a local name for it. Of the 834 individuals examined clinically, 66 (8.1%) had lymphoedema of the lower limb, with all the clinical stages of this condition represented. None of the 792 individuals examined parasitologically, however, had microfilariae of W. bancrofti (or any other filarial parasite) in their peripheral blood, and only one (0.25%) of the 399 individuals tested for the circulating antigens of W. bancrofti gave a positive result. In addition, none of the 504 mosquitoes caught landing on human bait in the study area and dissected was found to harbour any stage of W. bancrofti. These findings indicate that the elephantiasis seen in the North West province of Cameroon is of non-filarial origin.
淋巴水肿是一种局部液体潴留病症，由淋巴系统受损所致。虽然热带地区的一个常见病因是感染丝虫，但在非洲、中美洲和南美洲以及印度西北部的火山高地地区，赤脚农民中也出现了非丝虫性淋巴水肿，即俗称的足分支菌病。关于喀麦隆高地地区淋巴水肿的病因，存在相互矛盾的报道，而这种病症在公共卫生方面具有重要意义。为了明确喀麦隆西北省高地地区淋巴水肿的发病情况并探究其真正病因，对居住在恩多普和图巴卫生区所属社区的成年人（年龄≥15岁）开展了一项横断面研究。研究对象必须在研究区域居住至少10年，对其进行了访谈、临床检查，并在可能的情况下检查是否有微丝蚴血症。通过超声检查确诊的淋巴水肿病例以及其他对象的随机样本也进行了丝虫抗原血症检测。有关淋巴水肿的知识、态度和认知（KAP）的访谈显示，这种病症广为人知，每个研究社区都有其当地名称。在接受临床检查的834人中，66人（8.1%）下肢出现淋巴水肿，涵盖了该病的所有临床阶段。然而，在接受寄生虫学检查的792人中，外周血中均未发现班氏吴策线虫（或任何其他丝虫寄生虫）的微丝蚴，在接受班氏吴策线虫循环抗原检测的399人中，只有1人（0.25%）呈阳性结果。此外，在研究区域捕获并解剖的504只叮咬人体的蚊子中，均未发现任何阶段的班氏吴策线虫。这些发现表明，喀麦隆西北省出现的象皮肿源自非丝虫性病因。
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