中非共和国的黄热病风险评估。
Yellow fever risk assessment in the Central African Republic.
作者信息
Staples J Erin, Diallo Mawlouth, Janusz Kristen B, Manengu Casimir, Lewis Rosamund F, Perea William, Yactayo Sergio, Sall Amadou A
机构信息
Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, CO, 80521, USA
Institut Pasteur de Dakar, BP 220, Dakar, Senegal.
出版信息
Trans R Soc Trop Med Hyg. 2014 Oct;108(10):608-15. doi: 10.1093/trstmh/tru086. Epub 2014 Jun 19.
BACKGROUND
Starting in 2008, the Central African Republic (CAR) experienced an unprecedented number of reported yellow fever (YF) cases. A risk assessment of YF virus (YFV) activity was conducted to estimate potential disease risk and vaccine needs.
METHODS
A multistage cluster sampling design was used to sample humans, non-human primates, and mosquitoes in distinct ecologic zones. Humans and non-human primates were tested for YFV-specific antibodies; mosquitoes were tested for YFV RNA.
RESULTS
Overall, 13.3% (125/938) of humans were found to have naturally-acquired YFV antibodies. Antibody levels were higher in zones in the southern and south central regions of CAR. All sampled non-human primates (n=56) were known YFV reservoirs; one tested positive for YFV antibodies. Several known YF vectors were identified including Aedes africanus, Ae. aegypti, Ae. luteocephalus, and Ae. simpsoni. Several more urban locations were found to have elevated Breateau and Container indices for Ae. aegypti.
CONCLUSIONS
A country-wide assessment of YF risk found YFV to be endemic in CAR. The potential for future YF cases and outbreaks, however, varied by ecologic zone. Improved vaccination coverage through mass campaign and childhood immunization was recommended to mitigate the YF risk.
背景
自2008年起，中非共和国（CAR）报告的黄热病（YF）病例数量空前。开展了黄热病毒（YFV）活动风险评估，以估计潜在疾病风险和疫苗需求。
方法
采用多阶段整群抽样设计，在不同生态区域对人类、非人灵长类动物和蚊子进行抽样。对人类和非人灵长类动物进行YFV特异性抗体检测；对蚊子进行YFV RNA检测。
结果
总体而言，发现13.3%（125/938）的人具有自然获得的YFV抗体。中非共和国南部和中南部地区的抗体水平较高。所有抽样的非人灵长类动物（n = 56）均为已知的YFV储存宿主；一只检测出YFV抗体呈阳性。鉴定出几种已知的黄热传播媒介，包括非洲伊蚊、埃及伊蚊、黄头伊蚊和辛氏伊蚊。发现更多城市地区埃及伊蚊的布雷图指数和容器指数升高。
结论
一项全国范围的黄热风险评估发现YFV在中非共和国呈地方流行。然而，未来黄热病例和疫情的可能性因生态区域而异。建议通过大规模疫苗接种运动和儿童免疫接种提高疫苗接种覆盖率，以降低黄热风险。
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