Mak J W
Ciba Found Symp. 1987;127:5-14. doi: 10.1002/9780470513446.ch2.
Human lymphatic filariasis is caused mainly by Wuchereria bancrofti, Brugia malayi and Brugia timori. Of the estimated 90.2 million people infected, more than 90% have bancroftian and less than 10% brugian filariasis. The distribution and transmission of the disease are closely associated with socioeconomic and behavioural factors in endemic populations. Urban W. bancrofti infection, as seen in South-East Asia, is related to poor urban sanitation, which leads to intense breeding of Culex quiquefasciatus, the principal vector. Rural strains of W. bancrofti are transmitted primarily by Anopheles spp. and Aedes spp. mosquitoes. Brugian filariasis is mainly a rural disease transmitted by Mansonia, Anopheles and Aedes spp. mosquitoes. The periodic form of B. malayi is principally a human parasite, whereas the subperiodic form is zoonotically transmitted in some countries. The control of filariasis has relied on chemotherapy, vector control and reduction of human-vector contact. Although eradication of W. bancrofti and periodic B. malayi can be achieved, it is possible only to reduce transmission of zoonotic subperiodic B. malayi in some areas. A rational approach to control should consider ecological, socioeconomic and behavioural factors and, where feasible, integrate control programmes into the delivery system for primary health care.
人类淋巴丝虫病主要由班氏吴策线虫、马来布鲁线虫和帝汶布鲁线虫引起。在估计的9020万感染者中，超过90%患班氏丝虫病，不到10%患马来丝虫病。该病的分布和传播与流行地区人群的社会经济和行为因素密切相关。如在东南亚所见，城市班氏吴策线虫感染与城市卫生条件差有关，这导致主要传播媒介致倦库蚊大量繁殖。班氏吴策线虫的农村毒株主要由按蚊属和伊蚊属蚊子传播。马来丝虫病主要是一种由曼蚊属、按蚊属和伊蚊属蚊子传播的农村疾病。马来布鲁线虫的周期型主要是人类寄生虫，而亚周期型在一些国家是通过动物传播的。丝虫病的控制依赖于化疗、病媒控制和减少人与病媒的接触。虽然可以实现根除班氏吴策线虫和周期型马来布鲁线虫，但在某些地区只能减少动物传播的亚周期型马来布鲁线虫的传播。合理的控制方法应考虑生态、社会经济和行为因素，并在可行的情况下将控制方案纳入初级卫生保健服务体系。
