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厄瓜多尔亚马逊地区吸血蝙蝠咬伤情况:特征及对野生动物狂犬病预防的影响

Haematophagous bat bites in Ecuadorian Amazon: characterisation and implications for sylvatic rabies prevention.

作者信息

Romero-Sandoval N, Parra C, Gallegos G, Guanopatín A, Campaña M F, Haro M, Calapaqui S, Moreta C, Viteri F, Feijoo-Cid M, Martin M

机构信息

Ministerio de Salud Pública, Quito, Ecuador ; Red de Investigación GRAAL, Unidad de Bioestadística, Facultad de Medicina, Universidad Autónoma de Barcelona, Cerdanyola del Vallés, Spain.

Ministerio de Salud Pública, Quito, Ecuador.

出版信息

Public Health Action. 2013 Mar 21;3(1):85-9. doi: 10.5588/pha.12.0070.

Abstract

OBJECTIVE

To characterise the risk factors of haematophagous bat bites and to provide information to contribute to the prevention of rabies in Ecuador.

DESIGN

Cross-sectional study based on interviews with 3518 individuals, from which two sets of variables were generated: characteristics of haematophagous bat attacks in the previous year among humans and risk factors for being bitten.

METHODS

Data were analysed using multivariate logistic regression models, taking history of bat bites in the previous year as the response variable.

RESULTS

In the previous year 723 (20.6%, 95%CI 19.3-21.9) of the participants declared having received haematophagous bat bites and 50.4% in the previous month, giving an incidence rate of 10.4% (95%CI 9.6-11.6) per month. Sleeping on the floor or in a hammock (adjusted odds ratio [aOR] 1.58, 95%CI 1.21-2.06), not using a protective bed net (aOR 1.25, 95%CI 1.03-1.50) and living in a dwelling with permanent openings in the structure (aOR 1.49, 95%CI 1.12-1.95) were associated with a higher probability of bat bites. Those most affected were the group aged ≤12 years (age 13-19 years, aOR 0.39, 95%CI 0.32-0.48; age ≥20 years, aOR 0.67, 95%CI 0.50-0.90).

CONCLUSION

Primary prevention based on pre-exposure vaccination would be justifiable given the high dispersion of the population and the high incidence of bat bites. As a secondary protective measure, communities should work towards increasing the use of protective measures and putting barriers in permanent openings in their dwellings.

摘要

目的

确定吸血蝙蝠叮咬的风险因素,并提供有助于在厄瓜多尔预防狂犬病的信息。

设计

基于对3518人的访谈进行的横断面研究,从中生成了两组变量:前一年人类中吸血蝙蝠攻击的特征以及被咬伤的风险因素。

方法

以去年蝙蝠叮咬史作为反应变量,使用多变量逻辑回归模型分析数据。

结果

在前一年,723名(20.6%,95%置信区间19.3 - 21.9)参与者宣称曾被吸血蝙蝠叮咬,前一个月为50.4%,每月发病率为10.4%(95%置信区间9.6 - 11.6)。睡在地板上或吊床上(调整优势比[aOR] 1.58,95%置信区间1.21 - 2.06)、未使用防护蚊帐(aOR 1.25,95%置信区间1.03 - 1.50)以及居住在结构上有永久性开口的住所(aOR 1.49,95%置信区间1.12 - 1.95)与被蝙蝠叮咬的较高概率相关。受影响最大的是年龄≤12岁的群体(13 - 19岁,aOR 0.39,95%置信区间0.32 - 0.48;≥20岁,aOR 0.67,95%置信区间0.50 - 0.90)。

结论

鉴于人群分布广泛且蝙蝠叮咬发生率高,基于暴露前疫苗接种的一级预防是合理的。作为二级保护措施,社区应努力增加防护措施的使用,并在住所的永久性开口处设置屏障。

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