人类内脏利什曼病及其与病媒和犬类控制措施的关系。
Human visceral leishmaniasis and relationship with vector and canine control measures.
作者信息
Costa Danielle Nunes Carneiro Castro, Bermudi Patricia Marques Moralejo, Rodas Lilian Aparecida Colebrusco, Nunes Caris Maroni, Hiramoto Roberto Mitsuyoshi, Tolezano José Eduardo, Cipriano Rafael Silva, Cardoso Graziela Cândido Diniz, Codeço Cláudia Torres, Chiaravalloti Neto Francisco
机构信息
Universidade de São Paulo. Faculdade de Saúde Pública. Programa de Pós-Graduação em Saúde Pública. São Paulo, SP, Brasil.
Superintendência de Controle de Endemias. Serviço Regional 9. Araçatuba, SP, Brasil.
出版信息
Rev Saude Publica. 2018 Nov 23;52:92. doi: 10.11606/S1518-8787.2018052000381.
OBJECTIVE
Estimate the coverage of control measures of visceral leishmaniasis and relate them with the occurrence of human visceral leishmaniasis in endemic urban area.
METHODS
Cases of human and canine visceral leishmaniasis were considered as study population and evaluated by a serological survey conducted in Araçatuba, state São Paulo, from 2007 to 2015. The cases of human visceral leishmaniasis were geocoded by the address of the patients and the canine disease by the address of the dogs' owners. The coverage of serological survey, euthanasia, and insecticide spraying was calculated, as well as the canine seroprevalence and the incidence rates of human visceral leishmaniasis. The relationship between human visceral leishmaniasis and control measures was evaluated, as well as the seroprevalence by comparing maps and by linear regression. The relationship between the canine and the human disease was also evaluated by the Ripley's K function.
RESULTS
The incidence rates of human visceral leishmaniasis showed a period of decline (2007 to 2009) and a period of stability (2010 to 2015), a behavior similar to that of canine seroprevalence. In general, the coverage of control measures was low, and the non-association with the incidence of human visceral leishmaniasis can be a result of the period analyzed and of the small number of analyzed units (sectors of the Superintendence for the Control of Endemic Diseases). The distribution of human cases showed spatial dependence with the distribution of seropositive dogs from 2007 to 2009.
CONCLUSIONS
This study reaffirmed the relationship between the occurrence of the disease in humans and dogs, it verified a decrease in the rates of visceral leishmaniasis in Araçatuba over time, even at low coverage of control activities. However, further studies are needed to determine if factors beyond monitoring and control measures are involved in the reduction of incidences.
目的
评估内脏利什曼病控制措施的覆盖情况,并将其与城市流行地区人类内脏利什曼病的发生情况相关联。
方法
将人类和犬类内脏利什曼病病例视为研究人群,并通过2007年至2015年在圣保罗州阿拉萨图巴进行的血清学调查进行评估。人类内脏利什曼病病例根据患者地址进行地理编码,犬类疾病根据犬主地址进行地理编码。计算血清学调查、安乐死和杀虫剂喷洒的覆盖率,以及犬类血清阳性率和人类内脏利什曼病的发病率。通过比较地图和线性回归评估人类内脏利什曼病与控制措施之间的关系,以及血清阳性率。还通过Ripley's K函数评估犬类和人类疾病之间的关系。
结果
人类内脏利什曼病的发病率呈现出下降期(2007年至2009年)和稳定期(2010年至2015年),这与犬类血清阳性率的变化趋势相似。总体而言,控制措施的覆盖率较低,与人类内脏利什曼病发病率无关联可能是由于所分析的时间段以及所分析单元(地方病控制监督部门的分区)数量较少所致。2007年至2009年,人类病例的分布与血清阳性犬的分布呈现出空间依赖性。
结论
本研究再次证实了人类和犬类疾病发生之间的关系,验证了阿拉萨图巴内脏利什曼病发病率随时间下降,即使控制活动覆盖率较低。然而,需要进一步研究以确定除监测和控制措施之外的因素是否参与了发病率的降低。
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