Mwakitalu Mbutolwe E, Malecela Mwele N, Mosha Franklin W, Simonsen Paul E
National Institute for Medical Research, P.O. Box 9653, Dar es Salaam, Tanzania.
KCM-College, Tumaini University, P.O. Box 2240, Moshi, Tanzania.
Acta Trop. 2014 May;133:35-41. doi: 10.1016/j.actatropica.2014.01.012. Epub 2014 Feb 2.
Rapid urbanization in resource poor countries often results in expansion of unplanned settlements with overcrowding and inadequate sanitation. These conditions potentially support transmission of schistosomiasis and soil transmitted helminths (STH), but knowledge on the occurrence, transmission and control of these infections in urban settings is limited. The present study assessed the status of urinary schistosomiasis and STH across two different-sized cities in Tanzania - Dar es Salaam and Tanga - after a decade of anthelminthic intervention. Primary school children were examined for parasite eggs in urine and stool. Questionnaires were administered to the children, and observations were made on the urban environments. The burden of urinary schistosomiasis and STH was found to be low in both cities (overall 1.2% in Dar es Salaam and 0.3% in Tanga for urinary schistosomiasis; overall <1% in Dar es Salaam and 1-2% in Tanga for each STH infection), and the identified cases showed no clear pattern of spatial distribution. The findings indicated that a marked decrease in prevalence of these infections had occurred in the two cities during recent years. The observed promising developments appeared to have been accomplished by implementation of drug based intervention programs, in combination with environmental change (fewer snail habitats) and generally improved levels of hygiene. Continued efforts, including anthelminthic treatment and health education, are important to maintain these positive achievements.
资源匮乏国家的快速城市化往往导致无规划定居点的扩张,出现过度拥挤和卫生设施不足的情况。这些条件可能助长血吸虫病和土壤传播蠕虫(STH)的传播,但关于这些感染在城市环境中的发生、传播和控制的知识有限。本研究评估了在进行了十年驱虫干预后,坦桑尼亚两个不同规模城市——达累斯萨拉姆和坦噶——的泌尿血吸虫病和STH的状况。对小学生的尿液和粪便进行寄生虫卵检测。对儿童进行问卷调查,并对城市环境进行观察。结果发现,两个城市的泌尿血吸虫病和STH负担都很低(达累斯萨拉姆泌尿血吸虫病总体患病率为1.2%,坦噶为0.3%;达累斯萨拉姆每种STH感染总体患病率<1%,坦噶为1 - 2%),且确诊病例没有明显的空间分布模式。研究结果表明,近年来这两个城市这些感染的患病率显著下降。观察到的良好进展似乎是通过实施基于药物的干预计划、结合环境变化(蜗牛栖息地减少)以及总体卫生水平的提高而实现的。持续努力,包括驱虫治疗和健康教育,对于维持这些积极成果很重要。