OneHealth Research Group, Facultad de Ciencias de la Salud, Universidad De Las Américas (UDLA), Quito, Ecuador.
Department of Cell Biology, Physiology and Immunology, Universitat de Barcelona, Barcelona, Spain.
PLoS Negl Trop Dis. 2020 Feb 21;14(2):e0007858. doi: 10.1371/journal.pntd.0007858. eCollection 2020 Feb.
We review epidemiological and clinical data on human myiasis from Ecuador, based on data from the Ministry of Public Health (MPH) and a review of the available literature for clinical cases. The larvae of four flies, Dermatobia hominis, Cochliomyia hominivorax, Sarcophaga haemorrhoidalis, and Lucilia eximia, were identified as the causative agents in 39 reported clinical cases. The obligate D. hominis, causing furuncular lesions, caused 17 (43.5%) cases distributed along the tropical Pacific coast and the Amazon regions. The facultative C. hominivorax was identified in 15 (38%) clinical cases, infesting wound and cavitary lesions including orbital, nasal, aural and vaginal, and occurred in both subtropical and Andean regions. C. hominivorax was also identified in a nosocomial hospital-acquired wound. Single infestations were reported for S. haemorrhoidalis and L. eximia. Of the 39 clinical cases, 8 (21%) occurred in tourists. Ivermectin, when it became available, was used to treat furuncular, wound, and cavitary lesions successfully. MPH data for 2013-2015 registered 2,187 cases of which 54% were reported in men; 46% occurred in the tropical Pacific coast, 30% in the temperate Andes, 24% in the tropical Amazon, and 0.2% in the Galapagos Islands. The highest annual incidence was reported in the Amazon (23 cases/100,000 population), followed by Coast (5.1/100,000) and Andes (4.7/100,000). Human myiasis is a neglected and understudied ectoparasitic infestation, being endemic in both temperate and tropical regions of Ecuador. Improved education and awareness among populations living in, visitors to, and health personnel working in high-risk regions, is required for improved epidemiological surveillance, prevention, and correct diagnosis and treatment.
我们基于厄瓜多尔公共卫生部的数据以及对现有临床病例文献的回顾，综述了有关人体蝇蛆病的流行病学和临床数据。在 39 例报告的临床病例中，共鉴定出 4 种蝇幼虫为病原体，分别是狄氏曼氏蚴、人肤蝇、嗜尸性麻蝇和亮斑丽蝇。引起毛囊性损伤的专性狄氏曼氏蚴导致了 17 例（43.5%）病例，分布在热带太平洋沿岸和亚马逊地区。兼性人肤蝇导致 15 例（38%）临床病例，寄生于包括眼眶、鼻腔、耳腔和阴道在内的伤口和腔洞性病变，发生在亚热带和安第斯地区。在一家医院发生的院内获得性感染病例中也鉴定出人肤蝇。嗜尸性麻蝇和亮斑丽蝇仅造成了单一的感染。在 39 例临床病例中，有 8 例（21%）发生在游客身上。伊维菌素问世后，成功地用于治疗毛囊性、伤口和腔洞性病变。2013-2015 年公共卫生部的数据显示，有 2187 例病例，其中 54%的病例报告发生在男性；46%发生在热带太平洋沿岸，30%发生在温带安第斯地区，24%发生在热带亚马逊地区，0.2%发生在加拉帕戈斯群岛。亚马逊地区的年发病率最高（每 10 万人中有 23 例），其次是沿海地区（5.1/10 万）和安第斯地区（4.7/10 万）。人体蝇蛆病是一种被忽视和研究不足的外寄生虫感染，在厄瓜多尔的温带和热带地区均为地方性疾病。需要对生活在高风险地区、来访人员和卫生工作者进行更好的教育和提高认识，以加强流行病学监测、预防以及正确诊断和治疗。
