Dhiman R C, Sen A B
Rajendra Memorial Research Institute of Medical Sciences, Patna.
Indian J Med Res. 1991 May;93:155-60.
It is assumed that some features like intra-macrophage habitat of the Leishmania parasites, rare availability of infected macrophages in peripheral blood for vector sandflies to suck in, short flight range of sandflies, non-availability of an animal reservoir encountered in visceral leishmaniasis indicate slow and limited transmission potential and even so epidemics occur every 15 to 20 yr. To verify if these assumptions are true, the natural history of kala-azar was studied, using an endemic village in Bihar (India) as an unit of study, over a period of 5 yr (1984-1988). Village Jethuli is bound by the river Ganga on the north and separated from neighbouring endemic villages on other three sides by agricultural land, is isolated entomologically (as regards sandflies). The village has a population of 3236 persons of different social status and depending on economic conditions have three types of dwellings, brick made with cement plaster, brick made with mud plaster and mud houses. The first case of kala-azar was reported in a migrant from district Vaishali on the other side of Ganga where kala-azar appeared in an epidemic form. Studies showed that the infection is built up slowly, first in the same house and then in the immediate neighbourhood. In this village, maximum number of cases occurred in 1984 and 1985, and they were treated by our Institute and cured. In subsequent years, only a few cases occurred (i.e., 6 in 1986 and 4 in 1987) while no case occurred in 1988.(ABSTRACT TRUNCATED AT 250 WORDS)
据推测，利什曼原虫寄生于巨噬细胞内、外周血中感染巨噬细胞数量稀少致使媒介白蛉难以吸食、白蛉飞行距离短、内脏利什曼病缺乏动物宿主等特征表明其传播潜力低且有限，即便如此，该病仍每隔15至20年就会暴发一次。为验证这些推测是否属实，以印度比哈尔邦一个地方性流行村庄为研究单位，在5年时间（1984 - 1988年）内对黑热病的自然史进行了研究。杰图利村北面是恒河，其他三面与相邻的地方性流行村庄被农田隔开，在昆虫学意义上（就白蛉而言）是隔离的。该村有3236人，社会地位各异，根据经济状况有三种类型的住所，即水泥灰泥砌砖房、泥灰泥砌砖房和泥屋。首例黑热病报告病例是一名来自恒河对岸瓦伊沙利区的移民，那里黑热病呈流行形式出现。研究表明，感染是缓慢形成的，首先在同一房屋内，然后在紧邻区域。在这个村庄，1984年和1985年病例数最多，由我们研究所进行治疗并治愈。在随后几年，仅出现少数病例（即1986年6例，1987年4例），而1988年未出现病例。（摘要截取自250词）
