Chandiwana S K, Christensen N O
Blair Research Laboratory, Harare, Zimbabwe.
Trop Med Parasitol. 1988 Sep;39(3):187-93.
With the starting point in a comprehensive and integrated longitudinal study conducted by the Blair Research Laboratory from March 1982 to May 1984 in Bushu and Chiweshe communal areas, a review is presented of the dynamics of transmission of urinary (Schistosoma haematobium) and intestinal (S. mansoni) human schistosomiasis in the highveld region of Zimbabwe. The study comprised observations on snail-related aspects of transmission, on human water contact patterns, and on prevalence, intensity and incidence of infection in the human definitive host population. S. haematobium was found to be of high endemicity whereas the endemicity of S. mansoni was moderate. This reflects that Bulinus globosus, the snail host for S. haematobium, is better adapted to the biologically unstable freshwater environments than Biomphalaria pfeifferi, the snail host for S. mansoni. The most essential findings comprise a marked seasonality and focality of transmission, an overdispersed distribution of infection, individual predisposition to infection, peak of prevalence and intensity of infection among children and young adults, a positive correlation between infection status in population subgroup and the relative transmission potential of water contact sites used, a pronounced specificity and marked conservatism in the human water contact pattern. The epidemiological background for schistosomiasis control strategies is outlined, and a community-based strategy within the primary health care system for schistosomiasis morbidity control is described. The community-based primary health care approach to schistosomiasis morbidity control is the strategy adopted in Zimbabwe.
以布莱尔研究实验室于1982年3月至1984年5月在布舒和奇韦舍社区开展的一项全面综合的纵向研究为起点，本文对津巴布韦高草原地区人体泌尿生殖道血吸虫病（埃及血吸虫）和肠道血吸虫病（曼氏血吸虫）传播动态进行了综述。该研究包括对传播过程中与钉螺相关方面、人类与水接触模式以及人类终宿主群体中感染率、感染强度和发病率的观察。研究发现埃及血吸虫的流行程度很高，而曼氏血吸虫的流行程度为中等。这反映出埃及血吸虫的钉螺宿主球拟沼螺比曼氏血吸虫的钉螺宿主菲氏双脐螺更能适应生物稳定性较差的淡水环境。最重要的研究结果包括：传播具有明显的季节性和聚集性、感染分布过度分散、个体易感性、儿童和年轻人中感染率和感染强度达到峰值、人群亚组的感染状况与所使用的水接触地点的相对传播潜力之间呈正相关、人类水接触模式具有显著的特异性和保守性。本文概述了血吸虫病控制策略的流行病学背景，并描述了初级卫生保健系统内以社区为基础的血吸虫病发病控制策略。以社区为基础的初级卫生保健方法来控制血吸虫病发病是津巴布韦所采用的策略。
