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墨西哥尤卡坦半岛一个有大量锥蝽媒介的地区,克氏锥虫感染和慢性恰加斯心肌病的血清阳性率较低。

Low seroprevalence of Trypanosoma cruzi infection and chronic chagasic cardiomyopathy in a region with abundance of triatomine vectors in Yucatan Peninsula of Mexico.

作者信息

Monteón Victor, Solis-Oviedo Rosa, Lopez Ruth, Hernández Oscar, Tellez Cesar Alducin

机构信息

Centro de Investigaciones Biomédicas, Universidad Autónoma de Campeche, Av Patrico Trueba s/n, 24090 Campeche, Mexico.

Hospital General de Especialidades "Dr Javier Buenfil Osorio", Secretaria de Salud, Av. Jose Lopez Portillo (Por Patricio Trueba de Regil), 24050 Campeche, Mexico.

出版信息

Ann Parasitol. 2015;61(4):263-7. doi: 10.17420/ap6104.17.

DOI:10.17420/ap6104.17
PMID:26878624
Abstract

The Yucatan Peninsula of Mexico is endemic with Chagas disease. The main vector responsible for Trypanosoma cruzi transmission is Triatoma dimidiata which is abundant in domestic, peridomestic and sylvan cycles. The abundance of vectors favours T. cruzi transmission and is a high risk for developing chronic chagasic cardiomyopathy (CCC). In the past 10 years, little information was available on parasite seroprevalence and the prevalence of CCC in the Yucatan Peninsula. In the present work, we studied two Mayan communities with a high abundance of T. dimidiata and a random serial sample of 233 patients with an altered electrocardiogram or cardiac failure admitted to the Regional Hospital. A homemade enzyme-linked immunosorbent assay and indirect immunofluorescence standardized techniques were used to detect anti-T. cruzi IgG. In addition, Mayan volunteers were monitored by electrocardiography. In the Mayan communities, 4.8% (3/63) subjects were positive for T. cruzi antibodies none of them presented electrocardiographic alterations, however in seronegative subjects were detected right or left ventricle hypertrophy in 25% (16/63). A remarkable finding was that 90% of the Mayan population recognized the vector and 65% of them had experienced contact with triatomines bites. At the Regional Hospital 0.42% (1/233) were positive for T. cruzi antibodies showing compatible diagnosis with CCC; the most frequent pathology in this population was hypertension in 65% (151/233) and the less frequent was dilated myocardiopathy 6% (14/233). In conclusion, the prevalence of T. cruzi infection and CCC can be considered low in Yucatan, Mexico.

摘要

墨西哥的尤卡坦半岛是恰加斯病的地方病流行区。传播克氏锥虫的主要病媒是二斑锥蝽,其在家庭、住宅周边和森林生态循环中大量存在。病媒的大量存在有利于克氏锥虫的传播,并且是发展为慢性恰加斯病性心肌病(CCC)的高风险因素。在过去10年里,尤卡坦半岛关于寄生虫血清阳性率和CCC患病率的信息很少。在本研究中,我们调查了两个二斑锥蝽大量存在的玛雅社区,并对区域医院收治的233例心电图异常或心力衰竭患者进行了随机系列抽样。采用自制的酶联免疫吸附试验和间接免疫荧光标准化技术检测抗克氏锥虫IgG。此外,对玛雅志愿者进行了心电图监测。在玛雅社区,4.8%(3/63)的受试者克氏锥虫抗体呈阳性,他们均未出现心电图改变,然而在血清阴性的受试者中,25%(16/63)检测到右心室或左心室肥厚。一个显著的发现是,90%的玛雅人认识这种病媒,其中65%的人有过被锥蝽叮咬的经历。在区域医院,0.42%(1/233)的患者克氏锥虫抗体呈阳性,显示与CCC诊断相符;该人群中最常见的病理情况是高血压,占65%(151/233),最不常见的是扩张型心肌病,占6%(14/233)。总之,在墨西哥的尤卡坦半岛,克氏锥虫感染和CCC的患病率可被认为较低。

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